title: Dental fluorosis and lumbar spine bone mineral density in adults, ages 20 to 49 years: results from the 2003 to 2004 National Health and Nutrition Examination Survey.
abstract: OBJECTIVE
  Osteoporosis is an urgent public health concern. Many factors influence bone mineral density (BMD), a criterion used to diagnose osteoporosis. The purpose of this study was to determine if dental fluorosis may be a marker for osteoporosis. The association between dental fluorosis and BMD at the lumbar spine was examined.
  
  
  METHODS
  Using a cross-sectional design with 1,805 adults, ages 20 to 49 years, from the 2003 to 2004 National Health and Nutrition Examination Survey, an analysis of the association between dental fluorosis and BMD was performed, using chi-square and multivariable logistic regression. Other variables included predisposing factors (gender, age and race/ethnicity), enabling factors (marital status, education, poverty status and health insurance) and lifestyle/behavioral factors (perceived health status, smoking, alcohol intake, physical activity and body mass index).
  
  
  RESULTS
  Overall, 13.5% had fluorosis; 6.8% with fluorosis and 9.8% without fluorosis had low lumbar spine BMD. Multivariable analysis found there was not a statistically significant association between fluorosis and lumbar spine BMD (adjusted odds ratio=0.82; 95% CI (0.43. 1.56)).
  
  
  CONCLUSIONS
  Dental fluorosis and lumbar spine BMD were not found to be associated in a sample of adults.
authors.forename: R Constance
authors.initials: RC
authors.lastname: Wiener
authors.forename: Usha
authors.initials: U
authors.lastname: Sambamoorthi
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D003430:Cross-Sectional Studies; D009050:Fluorosis, Dental; D006801:Humans; D009749:Nutrition Surveys
keywords: NHANES; bone mineral density; fluorosis; lumbar spine; osteopenia; osteoporosis