As of 2005[update] surveys conducted by the National Institute of Dental Research in the USA between 1986 and 1987[7] and by the Center of Disease Control between 1999 and 2002[8] are the only national sources of data concerning the prevalence of dental fluorosis.
NIDR and CDC findings Deans Index 1987 2002
Questionable fluorosis 17% 11.8%
Very mild fluorosis 19%
Mild fluorosis 4% 5.83%
Moderate fluorosis 1% 0.59%
Severe fluorosis 0.3%
Total 22.3% 37.2%
The U.S. Center of Disease Control found a 9% higher prevalence of dental fluorosis in American children than was found in a similar survey 20 years ago. In addition, the survey provides further evidence that African Americans suffer from higher rates of fluorosis than Caucasian Americans.
The condition is more prevalent in rural areas where drinking water is derived from shallow wells or hand pumps. It is also more likely to occur in areas where the drinking water has a fluoride content greater than 1 ppm (part per million), and in children who have a poor intake of calcium.
Dietary reference intakes for fluoride[7] Age group Reference weight kg (lb) Adequate intake (mg/day) Tolerable upper intake (mg/day)
Infants 0-6 months 7 (16) 0.01 0.7
Infants 7-12 months 9 (20) 0.5 0.9
Children 1-3 years 13 (29) 0.7 1.3
Children 4-8 years 22 (48) 1.0 2.2
Children 9-13 years 40 (88) 2.0 10
Boys 14-18 years 64 (142) 3.0 10
Girls 14-18 years 57 (125) 3.0 10
Males 19 years and over 76 (166) 4.0 10
Females 19 years and over 61 (133) 3.0 10
If the water supply is fluoridated at the level of 1 ppm, one must consume one litre of water in order to take in 1 mg of fluoride. It is thus improbable a person will receive more than the tolerable upper limit from consuming optimally fluoridated water alone.
Fluoride consumption can exceed the tolerable upper limit when someone drinks a lot of fluoride containing water in combination with other fluoride sources, such as swallowing fluoridated toothpaste, consuming food with a high fluoride content, or consuming fluoride supplements. The use of fluoride supplements as a prevention for tooth decay is rare in areas with water fluoridation, but was recommended by many dentists in the UK until the early 1990s. Coal burning can pollute air with fluoride: indoor air with approximately 60 µg F/m³ and drinking water with 3.6 mg F/L are similarly toxic to developing permanent teeth.[9]
Dental fluorosis can be prevented by lowering the amount of fluoride intake to below the tolerable upper limit
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