title: Risk factors for enamel fluorosis in a fluoridated population.
abstract: The purpose of this case-control investigation was to investigate the possible association between mild-to-moderate enamel fluorosis and exposure during early childhood to infant formula, fluoride toothpaste, and/or fluoride supplements. Analysis was performed on 401 residents of fluoridated communities in Connecticut, who were 12-16 years old and born prior to 1980. The case and control subjects for this study were selected on the basis of a clinical examination given in 1991. Subject fluorosis status was determined using the Fluorosis Risk Index. Risk factor exposure was ascertained via a mailed questionnaire with a response rate of 89% and a questionnaire reliability of 87%. Logistic regression analyses, which adjusted for confounding variables, revealed that mild-to-moderate enamel fluorosis on early forming (Fluorosis Risk Index (FRI) classification I) enamel surfaces was strongly associated with both milk-based (odds ratio (OR) = 3.34, 95% confidence interval (CI) 1.38-8.07) and soy-based (OR = 7.16, 95% CI 1.35-37.89) infant formula use, as well as with frequent brushing (OR = 2.80, 95% CI 1.15-6.81). A very strong association was observed with inappropriate fluoride supplement use (OR = 23.74, 95% CI 3.43-164.30). Respectively similar associations were observed between mild-to-moderate enamel fluorosis on later forming (FRI classification II) enamel surfaces and frequent brushing and fluoride supplement use, but not with infant formula use.
authors.affiliation: Department of Behavioral Sciences and Community Health, School of Dental Medicine, University of Connecticut Health Center, Farmington 06030.
authors.forename: D G
authors.initials: DG
authors.lastname: Pendrys
authors.forename: R V
authors.initials: RV
authors.lastname: Katz
authors.forename: D E
authors.initials: DE
authors.lastname: Morse
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D005457:Fluoridation; D005459:Fluorides / Q000009:adverse effects* / Q000627:therapeutic use; D009050:Fluorosis, Dental / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007223:Infant; D007225:Infant Food; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014100:Toothpastes / Q000009:adverse effects
chemical_list: D014100:Toothpastes; D005459:Fluorides