Dental Flourosis in a rural Nigerian Community: Is the water to blame?

Abstract

Drinking water can contain fluoride which is effective in preventing dental caries at concentration of ≤1.5 mg/L however at concentrations ≥1.5 mg/L, it could lead to dental fluorosis. Dental fluorosis is a disorder that occurs due to excessive fluoride intake during the mineralization of the teeth, resulting in an uneven distribution of brown and yellow coloration. I assessed fluoride levels in 19 samples of natural water sources (such as boreholes, streams, and wells) and commercial drinking water sources (such as sachet and bottled water products) in Zing Local Government Area, Taraba State, northeastern Nigeria, I then determined the prevalence of dental fluorosis in 135 children, aged 10 to 17 years, who were born in Zing. Using cross tabulations and logistic regression modelling, I evaluated factors that might influence whether a child had dental fluorosis, such as dental care habits and drinking water source. Fluorosis occurred in 111 respondents. Fluoride levels exceeded the World Health Organization permissible limit of 1.0mg/L for tropical environments in most borehole samples, while most stream and well samples did not exceed this limit. The regression model showed that odds of a child having dental fluorosis were higher for those children who drank borehole water compared to those who do not (OR = 8.522), while the odds of having fluorosis decreases for children who drink from stream water (OR = 0.203). Consequently, community boreholes may need to be de-fluoridated and there should be community awareness about the sources of water with high fluoride concentrations.