Validation of fingernail fluoride concentration as a predictor of risk for dental fluorosis.
The aim of this study was to validate the use of fingernail fluoride concentrations at ages 2-7 years as predictors of the risk for developing dental fluorosis in the permanent dentition. Fifty-six children of both genders (10-15 years of age) had their incisors and premolars examined for dental fluorosis using the Thylstrup-Fejerskov index. Fingernail fluoride concentrations were obtained from previous studies when children were 2-7 years of age. Data were analyzed by unpaired t test, ANOVA, and Fisher's exact test when the fingernail fluoride concentrations were dichotomized (≤ 2 or >2 µg/g). Children with dental fluorosis had significantly higher fingernail fluoride concentrations than those without the condition, and the concentrations tended to increase with the severity of fluorosis (r(2) = 0.47, p < 0.0001). Using a fingernail fluoride concentration of 2 µg/g at ages 2-7 years as a threshold, this biomarker had high sensitivity (0.84) and moderate specificity (0.53) as a predictor for dental fluorosis. The high positive predictive value indicates that fingernail fluoride concentrations should be useful in public health research, since it has the potential to identify around 80% of children at risk of developing dental fluorosis.
Department of Biological Sciences, Bauru Dental School, University of São Paulo, Bauru, Brazil. mbuzalaf@fob.usp.br
M A R
MA
Buzalaf
C S
CS
Massaro
M H C
MH
Rodrigues
R
R
Fukushima
J P
JP
Pessan
G M
GM
Whitford
F C
FC
Sampaio
D000293:Adolescent; D000367:Age Factors; D001641:Bicuspid / Q000473:pathology; D015415:Biomarkers / Q000032:analysis; D002327:Cariostatic Agents / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D005457:Fluoridation; D005459:Fluorides / Q000032:analysis*; D009050:Fluorosis, Dental / Q000145:classification / Q000209:etiology*; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007180:Incisor / Q000473:pathology; D008297:Male; D009262:Nails / Q000737:chemistry*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014881:Water Supply / Q000032:analysis
D015415:Biomarkers; D002327:Cariostatic Agents; D005459:Fluorides