Risk factors for enamel fluorosis in optimally fluoridated children born after the US manufacturers' decision to reduce the fluoride concentration of infant formula

David G. Pendrys, Ralph Katz

Research output: Contribution to journalArticle

Abstract

This case-control study investigated risk factors for enamel fluorosis in optimally fluoridated children, born after the US infant formula industry voluntarily reduced the fluoride content of their products. Analysis was performed on 233 children, aged 10-14 years. Case-control status was determined using the Fluorosis Risk Index (FRI). Risk factor exposure was ascertained via a mailed questionnaire. Logistic regression analyses revealed a strong association between mild-to-moderate enamel fluorosis on early forming (FRI classification I) enamel surfaces and both fluoride supplement use (odds ratio (OR) = 5.95, 95% confidence interval (CI) 1.06-33.53), and early fluoride toothpaste use (OR = 6.35, 95% CI 1.21-33.40). The authors found a suggestive, but nonsignificant, association between fluorosis on these enamel surfaces and infant formula in the form of powdered concentrate (OR = 4.33, 95% CI 0.73-25.66). There was a strong association between mild- to-moderate fluorosis on later forming (FRI classification II) enamel surfaces and infant formula use in the form of powdered concentrate (OR = 10.77, 95% CI 1.89-61.25), fluoride supplement use (OR = 10.83, 95% CI 1.90- 61.55), and early fluoride toothpaste use (OR = 8.37, 95% CI 1.68-41.72). No association was observed between the use of ready to feed infant formula and enamel fluorosis.

Original languageEnglish (US)
Pages (from-to)967-974
Number of pages8
JournalAmerican Journal of Epidemiology
Volume148
Issue number10
StatePublished - Nov 15 1998

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Infant Formula
Dental Enamel
Fluorides
Odds Ratio
Confidence Intervals
Toothpastes
Case-Control Studies
Industry
Logistic Models
Regression Analysis

Keywords

  • Dental enamel
  • Epidemiologic methods
  • Fluoride
  • Mottled enamel
  • Risk

ASJC Scopus subject areas

  • Epidemiology

Cite this

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abstract = "This case-control study investigated risk factors for enamel fluorosis in optimally fluoridated children, born after the US infant formula industry voluntarily reduced the fluoride content of their products. Analysis was performed on 233 children, aged 10-14 years. Case-control status was determined using the Fluorosis Risk Index (FRI). Risk factor exposure was ascertained via a mailed questionnaire. Logistic regression analyses revealed a strong association between mild-to-moderate enamel fluorosis on early forming (FRI classification I) enamel surfaces and both fluoride supplement use (odds ratio (OR) = 5.95, 95{\%} confidence interval (CI) 1.06-33.53), and early fluoride toothpaste use (OR = 6.35, 95{\%} CI 1.21-33.40). The authors found a suggestive, but nonsignificant, association between fluorosis on these enamel surfaces and infant formula in the form of powdered concentrate (OR = 4.33, 95{\%} CI 0.73-25.66). There was a strong association between mild- to-moderate fluorosis on later forming (FRI classification II) enamel surfaces and infant formula use in the form of powdered concentrate (OR = 10.77, 95{\%} CI 1.89-61.25), fluoride supplement use (OR = 10.83, 95{\%} CI 1.90- 61.55), and early fluoride toothpaste use (OR = 8.37, 95{\%} CI 1.68-41.72). No association was observed between the use of ready to feed infant formula and enamel fluorosis.",
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