title: The risk of fluorosis in students exposed to a higher than optimal concentration of fluoride in well water.
abstract: OBJECTIVE
  In December 1991 the residents of the community of Rigolet, Labrador, Canada, discovered that they were exposed to higher than 2.0 ppm fluoride in the drinking water from the new town well, which became operational in December 1983. In 1993 an investigation of the occurrence of fluorosis in children exposed to the high-fluoride water during different ages of life was carried out.
  
  
  METHODS
  A dental examination for fluorosis was conducted using Pendrys' Fluorosis Risk Index. Out of 84 students in Rigolet, 74 were examined and the parents of 60 students agreed to be interviewed. Out of the 60 students, 48 lived all of their first six years of life in Rigolet.
  
  
  RESULTS
  Of the 48 children with life-long residence, the odds ratio of fluorosis on enamel zones that began forming during the first year of life was 8.31 (95% CI = 1.84, 38.59) for children exposed since birth or during the first year of life relative to those exposed after 1 year of age. The odds that a child had a maxillary central incisor with fluorosis were 5.69 (95% CI = 1.34, 24.15) times higher if exposure occurred during the first yea of life compared with exposure after 1 year of age. Only those exposed to the high-fluoride water during the first year of life developed fluorosis on the mandibular central incisors.
  
  
  CONCLUSIONS
  Within the limitations of this small population study, age relative to the date when the new water well became operational was a significant risk factor in development of fluorosis. The first year of life was a significant period for developing fluorosis on the mandibular and maxillary central incisors.
authors.affiliation: Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada. ismaildl@ac.dal.ca
authors.forename: A I
authors.initials: AI
authors.lastname: Ismail
authors.forename: J G
authors.initials: JG
authors.lastname: Messer
mesh_terms: D000367:Age Factors; D000566:Amelogenesis / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003743:Dental Enamel / Q000473:pathology; D005459:Fluorides / Q000009:adverse effects* / Q000032:analysis; D009050:Fluorosis, Dental / Q000209:etiology*; D006801:Humans; D007180:Incisor; D007223:Infant; D008334:Mandible; D008437:Maxilla; D009523:Newfoundland and Labrador; D016017:Odds Ratio; D012307:Risk Factors; D014881:Water Supply / Q000032:analysis*
chemical_list: D005459:Fluorides