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“Borderline” fluorotic region in Serbia: correlations among fluoride in drinking water, biomarkers of exposure and dental fluorosis in schoolchildren

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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.

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Acknowledgments

We are sincerely thankful to all children and parents who participated in this study. We would like to thank to Dr. Dobrica Petrovic and Dr. Ljiljana Jovanovic, specialists of Preventive and Paediatric Dentistry, Health service, Grocka, and Mr. Dragoljub Gacic, Head of primary school “Nikola Tesla,” Vinca, for technically and disinterestedly support in this study. Also, we would like to thank Dr. Jovan Andjelkov for helping during the field work.

Funding

This study is part of the Project No. III46009 granted by Ministry of Education, Science and Technological Development of the Republic of Serbia.

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Authors and Affiliations

  1. Department of Toxicology “Akademik Danilo Soldatović”, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia

    Evica Antonijevic, Marijana Curcic, Danijela Djukic-Cosic, Nemanja Milicevic & Biljana Antonijevic

  2. Clinic for Preventive and Paediatric Dentistry, School of Dental Medicine, University of Belgrade, Dr Subotica 11, Belgrade, 11000, Serbia

    Zoran Mandinic, Mirjana Ivanovic & Momir Carevic

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  1. Evica Antonijevic
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  2. Zoran Mandinic
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  3. Marijana Curcic
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  4. Danijela Djukic-Cosic
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  5. Nemanja Milicevic
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  6. Mirjana Ivanovic
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  8. Biljana Antonijevic
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Correspondence to Evica Antonijevic.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Antonijevic, E., Mandinic, Z., Curcic, M. et al. “Borderline” fluorotic region in Serbia: correlations among fluoride in drinking water, biomarkers of exposure and dental fluorosis in schoolchildren. Environ Geochem Health 38, 885–896 (2016). https://doi.org/10.1007/s10653-015-9769-x

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