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APHA Scientific Session and Event Listing

Jayanth V. Kumar, DDS, MPH, Bureau of Dental Health, Oral Health Surveillance and Research Unit, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237, 518-474-1961, jvk01@health.state.ny.us

A committee convened by the National Research Council reviewed research on the occurrence of enamel fluorosis at different concentrations of fluoride in drinking water, with emphasis on severe enamel fluorosis and water fluoride concentrations at or near the current maximum contaminant level goal (MCLG) of 4 mg/L and the secondary maximum contaminant level (SMCL) of 2 mg/L. Evidence on dental caries in relation to severe enamel fluorosis, aesthetic and psychological effects of enamel fluorosis, and effects of fluoride on dentin fluorosis and delayed tooth eruption were also reviewed.

Studies show that severe enamel fluorosis occurs at an appreciable frequency among children in United States communities with water fluoride concentrations at or near the current MCLG of 4 mg/L. The committee found strong evidence of an approximate population threshold in the United States, such that the prevalence of severe enamel fluorosis would be reduced to nearly zero by bringing the water fluoride levels in these communities down to below 2 mg/L. The committee observed that moderate fluorosis occurs at the present SMCL, however, the degree to which moderate enamel fluorosis might go beyond a cosmetic effect was not clear. Regarding the hypothesis of a causal link between severe enamel fluorosis and increased caries risk, the committee concluded that such a link is plausible and the evidence is mixed but supportive. Based on the occurrence of severe enamel fluorosis, the committee concluded that the present MCLG of 4mg/L should be lowered. In addition, several recommendations were made for future research.

Learning Objectives:

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Presenting author's disclosure statement:

Any relevant financial relationships? No