Drinking water preferences, perceptions and fluoride knowledge in an urban pediatric population

Objective: As a first step to examine adequacy of fluoride intake in children, we assessed drinking water preferences, perceptions of the quality of tap and bottled water, and knowledge of fluoride content in an inner city population. Methods: Parents of children and adolescents seen at an inner city clinic in Philadelphia completed an anonymous survey on drinking water preferences, perceptions of taste, clarity, safety and purity of tap and bottled water, and knowledge of fluoride content. Adolescents rated the importance of water on health and beauty. Results: 132 participated: mean age 10.2, SD 2.8 ys (1mo-21ys), 73% AA, 11% Latino, 85% Medicaid. Half (51%) the children and adolescents drank both tap and bottled water, 35% only bottled, 14% only tap (36% filtered, 21% boiled). Among infants drinking formula (n=47), 38% used bottled water, 19% tap water (44% boiled). Taste, clarity, purity and safety ratings were consistently higher for bottled than tap water (ie taste: OK/very good 84% bottled vs 62% tap- no difference for filtered or not). A third of parents (38%) were not aware of low fluoride content in bottled water. Adolescents believed water was important for health (95%), skin (89%), beauty (75%), and weight (75%). Conclusion: Bottle water drinking is prevalent among infants, children and adolescents seen at an inner city clinic and parents are not aware of the low fluoride content in bottled water. Perceptions of the attributes of public tap water affects water-drinking preferences and consumption patterns and may potentially adversely affect fluoride intake in children.