title: Risk factors for enamel fluorosis in a nonfluoridated 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 fluoride supplements, fluoride toothpaste, and/or infant formula use in nonfluoridated communities. Analysis was performed on 460 10- to 13-year-old children, born after 1979, who were residents of six nonfluoridated communities in Massachusetts and Connecticut. The fluorosis status of the subjects was determined on the basis of a clinical dental examination using the Fluorosis Risk Index (FRI). Risk factor exposure was ascertained via a mailed questionnaire with a response rate of 90% and a questionnaire reliability of 87%. Logistic regression analyses revealed a moderate association between mild-to-moderate enamel fluorosis on early forming (FRI classification I) enamel surfaces and both fluoride supplement use (odds ratio (OR) = 2.25, 95% confidence interval (CI) 1.08-4.69) and early toothbrushing habits (OR = 2.56, 95% CI 1.34-4.88). There was a strong association between mild-to-moderate fluorosis on later forming (FRI classification II) enamel surfaces and both supplement use (OR = 7.97, 95% CI 2.98-21.33) and early toothbrushing habits (OR = 4.23, 95% CI 1.72-10.41). Infant formula was not found to be associated with fluorosis on either FRI classification I or II surfaces.
authors.affiliation: Department of Behavioral Sciences and Community Health, School of Dental Medicine, University of Connecticut Health Center, Farmington 06030, USA.
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; D005457:Fluoridation; D005459:Fluorides / Q000008:administration & dosage; D009050:Fluorosis, Dental / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D016015:Logistic Models; D008404:Massachusetts / Q000453:epidemiology; D015588:Observer Variation; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014100:Toothpastes
chemical_list: D014100:Toothpastes; D005459:Fluorides