Fluoride concentration of drinking waters and prevalence of fluorosis in iran: a systematic review.
ABSTRACT The aim of the present study was to systematically review fluoride concentration of drinking waters and prevalence of fluorosis in Iran through systematically evaluating results of studies conducted in this regard.
In this systematic review study, the required data was collected using keywords including drinking water fluoride, fluoride concentration, Fluorosis, dent*, Iran*, and their Persian equivalents through PubMed, ScienceDirect, IranMedex, SID, MEDLIB, and Magiran databases. Out of 617 articles, 29 articles were finally considered after excluding the remaining articles which were not related to the study objectives. Following precise studying and extraction, the relevant data were summarized in extraction tables and analyzed manually. Excel 2007 software was used to draw diagrams.
4434 samples of surface, ground, and tap water resources collected within 236 months during all seasons in 17 provinces of Iran were used in 29 articles determining fluoride concentrations of drinking water. Average fluoride concentration was estimated to be 0.43 ± 0.17 ppm with zero and 3.06 as minimal and maximal values. The least concentration was seen in tap water. Fluoride concentration of only three provinces was in accordance with the global standard. According to estimations, prevalence of fluorosis was 61% with only 1% as severe fluorosis.
Despite lower than standard concentrations of fluoride in drinking water, a relatively high level of fluorosis was seen in Iran.
SourceAvailable from: Tayebeh Malek Mohammadi[Show abstract] [Hide abstract]
ABSTRACT: SUMMARY: The fluoride (F) content and distribution pattern of groundwater, the main drinking water source, in 35 villages and towns in the Zarand area in Kerman Province of Iran were assessed using the F ion chromatography method. The average groundwater F concentration was 1.80 mg/L (range: 0.33–3.51 mg/L) and in 22 sites the F concentration exceeded 1.5 mg/L, the maximum F drinking water level recommended by the World Health Organization (WHO). Exposure to excess dietary F may lead to chronic disease with detrimental health effects, including dental and skeletal fluorosis, and providing safe water for domestic use is recommended. Keywords: Dental fluorosis; Distribution pattern; Drinking water; Groundwater; Iran.
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ABSTRACT: Background: Water fluoride level is unknown in many regions of Iran. Besides, only few noncontrolled studies world-wide have assessed the effect of water fluoride on dental fluorosis and caries. We aimed to measure the fluoride level of 76 water supplies in 54 cities and evaluate the effect of fluoride on dental caries and fluorosis in a large multi-project study. Materials and Methods: In the first phase (cross-sectional), fluoride levels of 76 water tanks in 54 cities/villages in five provinces of Iran were randomly evaluated in five subprojects. In the second phase (retrospective cohort), 1127 middle school children (563 cohort and 564 control subjects) in the high and low ends of fluoride concentration in each subproject were visited. Their decayed, missing and filled teeth (DMFT) and fluorosis states were assessed. The data were analyzed using Chi-square, Mann-Whitney U and independent-samples t-test (α = 0.05). Results: Mean fluoride level was 0.298 ± 0.340 mg/L in 54 cities/villages. Only eight water tanks had fluoride levels within the normal range and only one was higher than normal and the rest (67 tanks) were all at low levels. Overall, a significant association was observed between fluoride level and fluorosis. However, this was not the case in all areas, as in 2 of 5 provinces, the effect of fluoride on fluorosis was not confirmed. In 4 of the 5 areas studied, there was a significant link between fluoride level and DMFT. Conclusion: Extremely low fluoride levels in Iran cities are an alarming finding and need attention. Higher fluoride is likely to reduce dental caries while increasing fluorosis. This finding was not confirmed in all the areas studied. Key Words: Community fluorosis index, Dean’s fluorosis index, dental caries, dental fluorosis, water fluorideDental research journal 01/2015; 12(1):31-37. DOI:10.4103/1735-3327.150310
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ABSTRACT: Fluorosis occurs due to excessive fluorine entry into the body. Dental, skeletal and non-skeletal fluorosis are different types of fluorosis. Dental fluorosis is a developmental disturbance of dental enamel caused by excessive exposure to high concentration of fluoride during tooth development. The over exposure to fluorine may occur at any age, but it is higher in young age group. Prevalence of dental fluorosis varies in different parts of the world and there is wide geographic variation in prevalence of dental fluorosis in different geographic locations of the world. Like dental fluorosis, skeletal fluorosis also has different distribution in different parts of the world.