title: "Borderline" fluorotic region in Serbia: correlations among fluoride in drinking water, biomarkers of exposure and dental fluorosis in schoolchildren.
abstract: This study explores relation between dental fluorosis occurrence in schoolchildren, residents of Ritopek, a small local community near Belgrade, and fluoride exposure via drinking water. Additionally, fluoride levels were determined in children's urine and hair samples, and efforts were made to correlate them with dental fluorosis. Dental fluorosis and caries prevalence were examined in a total of 52 schoolchildren aged 7-15 years (29 boys and 23 girls). Fluoride levels in three types of samples were analyzed using composite fluoride ion-selective electrode. Results showed high prevalence of dental fluorosis (34.6 %) and low prevalence of dental caries (23.1 %, mean DMFT 0.96) among children exposed to wide range of water fluoride levels (0.11-4.14 mg/L, n = 27). About 11 % of water samples exceeded 1.5 mg/L, a drinking-water quality guideline value for fluoride given by the World Health Organization (2006). Fluoride levels in urine and hair samples ranged between 0.07-2.59 (n = 48) and 1.07-19.83 mg/L (n = 33), respectively. Severity of dental fluorosis was positively and linearly correlated with fluoride levels in drinking water (r = 0.79). Fluoride levels in urine and hair were strongly and positively correlated with levels in drinking water (r = 0.92 and 0.94, respectively). Fluoride levels in hair samples appeared to be a potentially promising biomarker of fluoride intake via drinking water on one hand, and severity of dental fluorosis on the other hand. Based on community fluorosis index value of 0.58, dental fluorosis revealed in Ritopek can be considered as "borderline" public health issue.
authors.affiliation: Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia. evicaa@pharmacy.bg.ac.rs.
authors.forename: Evica
authors.initials: E
authors.lastname: Antonijevic
authors.affiliation: Clinic for Preventive and Paediatric Dentistry, School of Dental Medicine, University of Belgrade, Dr Subotica 11, Belgrade, 11000, Serbia.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Mandinic
authors.affiliation: Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia.
authors.forename: Marijana
authors.initials: M
authors.lastname: Curcic
authors.affiliation: Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia.
authors.forename: Danijela
authors.initials: D
authors.lastname: Djukic-Cosic
authors.affiliation: Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia.
authors.forename: Nemanja
authors.initials: N
authors.lastname: Milicevic
authors.affiliation: Clinic for Preventive and Paediatric Dentistry, School of Dental Medicine, University of Belgrade, Dr Subotica 11, Belgrade, 11000, Serbia.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Ivanovic
authors.affiliation: Clinic for Preventive and Paediatric Dentistry, School of Dental Medicine, University of Belgrade, Dr Subotica 11, Belgrade, 11000, Serbia.
authors.forename: Momir
authors.initials: M
authors.lastname: Carevic
authors.affiliation: Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia.
authors.forename: Biljana
authors.initials: B
authors.lastname: Antonijevic
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000652:urine*; D002648:Child; D003731:Dental Caries / Q000453:epidemiology; D060766:Drinking Water / Q000032:analysis*; D005260:Female; D005459:Fluorides / Q000032:analysis* / Q000652:urine; D009050:Fluorosis, Dental / Q000453:epidemiology*; D006197:Hair / Q000737:chemistry*; D006801:Humans; D008297:Male; D015995:Prevalence; D055771:Serbia / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D060766:Drinking Water; D005459:Fluorides
keywords: Dental fluorosis; Drinking water; Hair fluoride; Schoolchildren; Urine fluoride