title: Considerations on optimal fluoride intake using dental fluorosis and dental caries outcomes--a longitudinal study.
abstract: OBJECTIVE
  The "optimal" intake of fluoride has been widely accepted for decades as between 0.05 and 0.07 mg fluoride per kilogram of body weight (mg F/kg bw) but is based on limited scientific evidence. The purpose of this paper is to present longitudinal fluoride intake data for children free of dental fluorosis in the early-erupting permanent dentition and free of dental caries in both the primary and early-erupting permanent teeth as an estimate of optimal fluoride intake.
  
  
  METHODS
  Data on fluoride ingestion were obtained from parents of 602 Iowa Fluoride Study children through periodic questionnaires at the ages of 6 weeks; 3, 6, 9, 12, 16, 20, 24, 28, 32, and 36 months; and then at 6-month intervals thereafter. Estimates of total fluoride intake at each time point were made by summing amounts from water, dentifrice, and supplements, as well as other foods and beverages made with, or containing, water. Caries data were obtained from examinations of children at ages 5 and 9 years, whereas fluorosis data were obtained from examinations of children only at age 9 years.
  
  
  RESULTS
  The estimated mean daily fluoride intake for those children with no caries history and no fluorosis at age 9 years was at, or below, 0.05 mg F/kg bw for nearly all time points through the first 48 months of life, and this level declined thereafter. Children with caries had generally slightly less intakes, whereas those with fluorosis generally had slightly higher intakes.
  
  
  CONCLUSIONS
  Given the overlap among caries/fluorosis groups in mean fluoride intake and extreme variability in individual fluoride intakes, firmly recommending an "optimal" fluoride intake is problematic.
authors.affiliation: Department of Preventive & Community Dentistry, University of Iowa, Iowa City, IA 52242-1010, USA. john-warren@uiowa.edu
authors.forename: John J
authors.initials: JJ
authors.lastname: Warren
authors.forename: Steven M
authors.initials: SM
authors.lastname: Levy
authors.forename: Barbara
authors.initials: B
authors.lastname: Broffitt
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Cavanaugh
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kanellis
authors.forename: Karin
authors.initials: K
authors.lastname: Weber-Gasparoni
mesh_terms: D015331:Cohort Studies; D003731:Dental Caries / Q000503:physiopathology*; D005459:Fluorides / Q000008:administration & dosage*; D009050:Fluorosis, Dental / Q000503:physiopathology*; D006801:Humans; D008137:Longitudinal Studies; D017063:Outcome Assessment, Health Care; D011795:Surveys and Questionnaires
chemical_list: D005459:Fluorides