Fluoride content of still bottled water in Australia

BACKGROUND: Recently there has been a considerable increase in the consumption of bottled water in Australia. Overseas studies have found the fluoride levels in many bottled waters are well below levels considered optimal for preventing dental caries. This raises the concern that if bottled water is regularly consumed an effective means of preventing dental caries is unavailable. The aim of this study was to determine the fluoride concentration in 10 popular brands of still bottled water currently sold in Australia. METHODS: The fluoride content of water samples were determined using an ion analyser and compared to a fluoride standard. RESULTS: The fluoride concentration of all bottled waters was less than 0.08 ppm. Only three of the 10 brands indicated the fluoride content on their labels. Melbourne reticulated water was found to be fluoridated at 1.02 ppm. CONCLUSIONS: All bottled waters tested contained negligible fluoride which justifies the concern that regular consumption of bottled water may reduce the benefits gained from water fluoridation. It is recommended that all bottled water companies should consider stating their fluoride content on their labels. This will inform consumers and dental care providers of the levels of fluoride in bottled water and allow an informed decision regarding consumption of fluoridated versus non-fluoridated drinking water.     

Fluoride content of bottled waters available in Northern Greece

OBJECTIVE: The aim of this study was to evaluate the fluoride content of bottled drinking waters commercially available in northern Greece and to report on the accuracy of the labelling of fluoride concentration. MATERIALS AND METHODS: Twenty-two randomly selected commercial brands of bottled water were obtained from three supermarkets in Thessaloniki, Greece. Three bottles of each brand were purchased. Following calibration, six tests were conducted on each bottle using a combination fluoride-ion selective electrode (Orion, 96-09-00, MA, USA). The average reading for each brand was estimated and also compared with the fluoride content printed on the label. RESULTS: The mean (+/- SD) fluoride content of the bottled water samples was 0.35 (+/- 1.00) mg F/L with a range from 0.05 to 4.8 mg F/L. Only 18% (N = 4) of brands tested mention the fluoride concentration on the label, and 90% (N = 22) had a tested fluoride between 0.05 and 0.21 mg F/L. Of the remaining two brands, one was found to contain 0.3 mg F/L without having the fluoride concentration indicated on the label, and the other was labelled at 6 mg F/L, whereas the concentration was estimated as 4.8 mg F/L. CONCLUSIONS: The use of bottled water may be a significant source of systemic fluoride and therefore be considered as a risk factor for dental fluorosis in young children. This article shows that bottled drinking waters contain differing concentrations of fluoride. The manufacturers' labelling of fluoride concentrations may be inaccurate. When prescribing fluoride supplements, dentists should be aware of the fluoride content of bottled waters used by paediatric patients, especially brands with a concentration higher than 0.3 mg F/L. In view of the wide variation of fluoride concentration in the tested bottled waters, regulatory guidelines for controlling concentration in order to prevent dental fluorosis are recommended.     

Prevalence of dental trauma in 5–6- and 12–14-year-old boys in Riyadh, Saudi Arabia

Abstract – This study involved 354 boys aged 5–6 years and 862 boys aged 12–14 years, attending 40 schools in Riyadh. All children were examined at school by a single dental examiner, using criteria similar to those employed in the survey of children's dental health in the United Kingdom. The prevalence of dental trauma in 354 Saudi boys aged 5–6 years was 33%. The most common type of dental trauma was fracture of enamel (71%) followed by loss of tooth due to trauma (13%), fracture into enamel and dentine (7%), discolouration (5%), pulp involvement (4%). No relationship between the degree of overjet and the occurrence of dental trauma in the primary dentition was observed. The prevalence of dental trauma in 862 12–14-year-old boys was 34%. The commonest dental trauma was fracture of enamel (74%) followed by fracture into enamel and dentine (15%), fracture into enamel-dentine and pulp (5%), loss of tooth due to trauma (3%), and discolouration (0.4%). A significant relationship ( P =0.02) between the increased overjet (≥ 6 mm) and the occurrence of dental trauma in the permanent dentition was reported. The present study found no evidence of dental care provided for traumatised primary incisors in 5–6-year-old boys. The treatment of dental trauma in 12–14-year-old boys was negligible (2.4%). The present Saudi Arabian study showed higher prevalence of dental trauma in 5–6- and 12–14-year-old boys than the reported results of the United Kingdom Children's Dental Health Survey of the same age groups.     

A cross-sectional study of the prevalence and severity of maxillofacial fractures resulting from motor vehicle accidents in Riyadh,Saudi Arabia

ObjectivesTo investigate the prevalence and severity of maxillofacial fractures resulting from motor vehicle accidents (MVAs) at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia.Materials and methodsA cross-sectional study of 325 males (89%) and 47 females (9%) was conducted that retrospectively reviewed records of patients referred to oral and maxillofacial surgery department from emergency department from 1st January 2016 to 31st December 2017 at KAMC, Riyadh.ResultsA total of 372 subjects were included in the study. MVAs (80%) were the most prevalent cause of trauma. The age range most susceptible to MVAs was between 20 and 24 years old (28%). The most common site of fracture was the midface (64%), specifically orbit (32%). For mandibular fractures, the subcondylar was the most common site of fractures (19%). The most common treatment approach was conservative (65%). In terms of severity, approximately half of patients needed admission to the intensive care unit (ICU) (50%); the mean score on the Glasgow Coma Scale (GCS) was 11.34, but most scores fell in the mild range; and (68%) of subjects presented with other associated systemic injuries, especially orthopedic injuries (36%).ConclusionsMVAs were the main cause of trauma and affected mainly young males. The most common site of fracture was midface, specifically orbit. Subcondylar was the most prevalent fracture site for mandibular fractures. The severity of MVAs injuries was significantly higher compared to non-MVAs injuries. We suggest enforcing legislation and regulations on road safety such as the use of compulsory seat belts.     

Associations among dental caries experience,fluorosis, and fluoride exposure from drinking water sources in Saudi Arabia

Objectives: a) To correlate fluoride levels in drinking water sources with caries experience and dental fluorosis in Saudi Arabia, and suggest appropriate fluoride concentration for drinking water in the country. Methods: Fluoride levels were determined from 3,629 samples obtained from drinking water sources in 11 regions of Saudi Arabia. Based on the fluoride concentrations, a stratified sample of subjects aged 6‐7, 12‐13, and 15‐18 years was obtained from the regions. A total of 12,200 selected subjects were examined for dental caries according to the World Health Organization criteria, and dental fluorosis, using Thylstrup and Fejerskov classification. Results: There was an inverse relationship between fluoride exposure and caries experience, but the prevalence of dental fluorosis increased with increase in fluoride concentration. There was no significant difference in caries experience or in the prevalence of dental fluorosis when fluoride levels increased from 0.3 ppm to 0.6 ppm. In contrast, caries experience was lower, while severity of fluorosis was significantly higher at fluoride levels above 0.6 ppm. Conclusions: a) Fluoride levels in drinking water sources in Saudi Arabia correlate significantly with caries experience and prevalence of dental fluorosis. b) Appropriate fluoride concentration for drinking water in Saudi Arabia may be about 0.6 ppm.     

Dental fluorosis prevalence in Saudi Arabia

AimIn order to improve the understanding of dental fluorosis prevalence in Saudi Arabia and have a good idea of the quality of the studies that have been conducted, a systematic review was conducted to evaluate the prevalence of dental fluorosis among people who live in Saudi Arabia.MethodsOnline databases EMBASE and MEDLINE and the Cochrane Library were searched, without any restriction regarding age. In addition, there were no study design filters applied to the search engine. Study selection and data extraction were conducted in duplicate. Studies were included if they were conducted in Saudi Arabia on any population (adults and children) and collected dental fluorosis data. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies. A narrative synthesis was conducted.ResultsSeven cross-sectional studies were identified. Areas of weakness in study design/conduct were low response rates, and identification and handling of confounding factors. Statistical pooling of data was not appropriate due to substantial heterogeneity, due in part to variation in sample size, variation of water fluoridation concentration, index used, targeted population and age group. Seven studies present dental fluorosis at any level. The proportion of dental fluorosis prevalence at any level ranged from 0.00 to 0.91. Six studies explored the prevalence of dental fluorosis of aesthetic-only level of concern. The proportion of dental fluorosis in this category ranged from 0.07 to 0.76.ConclusionThe proportion of dental fluorosis at any level ranged from 0.00 to 0.91 and fluorosis at aesthetics level ranged from 0.07 to 0.76. However, current data does not provide a complete assessment of dental fluorosis across Saudi Arabia. Existing studies are limited in terms of the population covered. The included studies had methodological flaws.     

Dental caries in preschoolchildren in Gizan, Saudi Arabia

Abstract 296 preschoolchildren attending the pediatric clinic at Gizan Hospital were examined over a period of 3 months. Caries was recorded using the criteria described by WHO. One third of the children had untreated caries and none of the children had received any restorative dental care. A strategy for development of preventive dental services for this age group is discussed.     

Fluoride content of still bottled waters available in the North-East of England, UK

OBJECTIVE: The aims of this study were to measure the fluoride content of still bottled waters on sale in the UK and to estimate and compare the fluoride intake from tap and bottled water for British children. METHODS: Three bottles of 25 commercial brands of bottled water were purchased from supermarkets, grocery stores and health shops in the North-East of England. All samples were still spring, mineral or distilled waters, sold in plastic bottles. The fluoride content of all samples was determined, in duplicate, using a Fluoride Ion Selective Electrode. RESULTS: The mean (+/- SD) fluoride content of the bottled waters was 0.08 (+/- 0.08) mg L(-1) with a range from 0.01-0.37 mg L(-1) which is below the accepted standard for optimally fluoridated water. The mean fluoride intake for 4-18-year-olds when the source of water intake is solely fluoridated tap water was estimated to be 0.26 mg F per day; compared with 0.16 mg F per day, when a combination of tap and bottled water is consumed. CONCLUSIONS: Bottled water, from those sampled, is unlikely to make an important contribution to total fluoride intake in British diets. Consumption of bottled water containing a negligible amount of fluoride in preference to fluoridated tap water might result in less than optimal fluoride ingestion in young people.     

Periodontal disease prevalence and dental needs among schoolchildren in Saudi Arabia

Abstract The study population consisted of 1174 intermediate Saudi schoolchildren; 601 girls and 573 boys, aged 13, 14 and 15 years. Periodontal disease was assessed by the method recommended by WHO and data were computerized by using IBM 3033, SAS package. Boys had significantly higher debris, calculus deposits and intense gingivitis counts than girls by sex and age. But for advanced periodontal involvement, the result shows no significant differences by sex and age. There was a position correlation between debris, calculus and periodontal diseases There was a highly significant difference between girls and boys. The results of this study suggest the need for an oral health program for the entire community.     

Oral lichen planus among 4277 patients from Gizan, Saudi Arabia

This paper reports on the prevalence of oral lichen planus among 4277 Saudi patients, aged 18-73 yr, seen in the dental department of King Fahd Central Hospital, Gizan, Saudi Arabia, between 1982 and 1987, 63% of the patients were males. Oral mucosal lesions consistent with lichen planus were identified both clinically and histologically in 72 patients (40 males and 32 females). The average age of the affected group was 49 yr. No correlation was evident between lichen planus and tobacco habits in this study, nor was there any association with diabetes or hypertension. The average period of follow-up was 3.2 yr, during which four cases developed malignant transformation of the oral lesions. The prevalence of oral lichen planus in this study was 1.7%, which is higher than the prevalence figures reported earlier for the population of Saudi Arabia.     

Fluoride concentration of bottled drinking waters.

The use of bottled water and beverages may be a significant source of systemic fluoride and can therefore be considered as a risk factor for dental fluorosis in young children. The aim of this study was to determine the fluoride content of commercially available bottled drinking waters and to report on the accuracy of the labelling of fluoride concentration. Thirty brands of bottled water, classified as either spring (N = 19) or mineral (N = 11) water were evaluated. A fluoride ions-elective and a fluoride reference electrode were used to measure the fluoride concentrations. The average reading for each brand was compared with the fluoride content printed on the label. Only 56.7% (N = 17) of brands tested mention the fluoride concentration on the label, but 73.3% (N = 22) had a tested fluoride concentration of less than 0.3 ppm. Of the 8 brands testing higher than 0.3 ppm fluoride, 1 did not have the fluoride concentration labelled, while for another the tested fluoride concentration was much higher than the concentration printed on the label. When prescribing fluoride supplements, dentists should be aware of the fluoride content of bottled waters used by child patients, especially brands with a concentration higher than 0.3 ppm.     

Fluoride in still bottled water in Australia

Background: This study measured the fluoride content in a range of still bottled waters available in Australia. Increasing decay rates in children have prompted speculation that bottled water consumption may be impacting on dental caries rates. International studies have demonstrated that the fluoride levels in bottled water are often negligible, however there is little information about the fluoride content of still bottled water in Australia. Methods: One hundred different brands (300 samples) of still bottled water were obtained in Australia and tested using ion chromatography and an ion‐selective electrode method. Results: The tested fluoride levels ranged from <0.1 to 1.6 mg/L. Nine per cent of the samples reported fluoride levels within the range recommended for reticulated water in Australia, providing a dental health benefit. One per cent of samples recorded fluoride values greater than this range, from 1.2 to 1.6 mg/L. The majority of samples (91%) recorded fluoride levels below 0.6 mg/L. Conclusions: Better information about the fluoride levels in bottled water is of value, particularly for communities lacking access to a fluoridated drinking water supply.     

Managing dental caries in children in Saudi Arabia

This paper describes oral health among children in Saudi Arabia, the dental health system in the country, and some possible solutions and recommendations to improve the oral health status.     

Fluoride content of commercially‐available bottled water in Bangkok,Thailand

Aim: To determine the fluoride content of commercially‐available bottled water in Bangkok. Methods: Thirty brands of bottled water (17 bottled plain water and 13 bottled mineral water) were obtained from supermarkets in Bangkok. Two randomly‐selected samples of each brand were purchased 6 months apart. A 5‐mL sample was mixed with 5 mL of total ionic‐strength adjusting buffer III. The fluoride content of each sample was determined in triplicate by a fluoride ion‐selective electrode. Fluoride standards ranging in concentration from 0.01 to 1.00 ppm were used to calibrate the measurements. Data were analyzed by Statistical Package for the Social Sciences software, version 13.0. Results: The fluoride content of bottled water in Bangkok ranged from 0.03 to 0.72 ppm, with a mean ± standard deviation of 0.17 ± 0.16 ppm. The mean fluoride content of bottled mineral water was slightly higher than that of bottled plain water, but the difference was not statistically significant. Conclusions: Most commercially‐available bottled water in Bangkok contains negligible amounts of fluoride. This serves as baseline data for dentists prescribing a fluoride supplement to make the utmost use of the fluoride caries preventive effect, while avoiding adverse effects, such as dental fluorosis.     

Analysis of the pattern of maxillofacial injuries in Saudi Arabia: A systematic review

ObjectivesMaxillofacial trauma (MFT) is a serious health problem and in Saudi Arabia is mainly caused by road traffic accidents (RTAs). MFT commonly associated with injuries to the face, head, and jaws and may cause soft tissue lacerations and bruises. MFT can also cause fatal blood loss and airway obstruction. The objective of this review was to determine the prevalence of MFT, identify the major causative factors in males and females in the main cities of Saudi Arabia.Materials and methodsWe performed literature searches of all published studies describing MFT from KSA during the last 20 years.ResultsIn Saudi Arabia, males are more prone to MFT than females, although the male: female ratio of MFT varies between different cities. Specifically, Aseer has the highest male: female ratio (10:1), followed by AlHofuf (8.3:1) while AlQurayyat had the least gender ratios of MFT (2:1). Most cases of MFT are associated with RTAs, which accounted for (63%–90.3%) in Medina, (89.1%) in Aseer, (86.1% –87.1%) in Riyadh, (67%–73.1%) in Jeddah, (71%) in Khamis Mushait, (64.2%) in Makkah and (63.3%) in Al-Hofuf. The least percentage of RTA resulting into MFT was recorded in AlQurayyat (24%).ConclusionMaxillofacial trauma is a serious health problem in Saudi Arabia. RTAs remain the major cause of maxillofacial injuries especially among males, thus strict implementation of traffic rules is a must to minimize maxillofacial injuries and its physical and psychological impact.     

Caries experience of urban and rural children in Saudi Arabia

OBJECTIVE: Caries experience and restorative treatment needs often are reported to be higher in urban than rural areas in developing countries. The purpose of this study was to compare caries experience in 12- and 13-year-old children in urban and rural areas of Saudi Arabia, a young, oil-rich, developing country. METHODS: A random sample of 1,873 schoolchildren aged 12-13 years from urban and adjoining rural areas of 10 administrative regions in the Kingdom of Saudi Arabia were examined for dental caries. Questionnaires also were administered to elicit information on the frequency of snacking as well as consumption of sweets and soft drinks. RESULTS: No statistically significant differences were found between urban and rural children in caries experience in permanent teeth (mean DMFT = 2.69 in urban areas; 2.65 in rural areas), frequency of snacking, or frequency of consumption of sweets and soft drinks. The percentage of DMFT found to be D was equally high (> 89%) in both urban and rural areas, indicating a high level of restorative treatment need. CONCLUSION: In Saudi Arabia, an economically prosperous developing country, exposure to cariogenic diet in urban and rural areas does not differ. Also, a difference in caries experience in urban and rural areas often reported for developing countries does not apply to Saudi Arabia.