Advertisement

Brick tea consumption is a risk factor for dental caries and dental fluorosis among 12-year-old Tibetan children in Ganzi

  • Rui Zhang
  • Li Cheng
  • Tao Zhang
  • Ting Xu
  • Meng Li
  • Wei Yin
  • Qingling Jiang
  • Yingming YangEmail author
  • Tao HuEmail author
Original Paper

Abstract

Brick tea contains high concentration of fluoride. The aim of the present work was to explore whether and how the brick tea is a risk factor for dental caries and dental fluorosis among Tibetan children in Ganzi. A cross-sectional study was conducted with 368 12-year-old Tibetan children in Ganzi. Dental caries was measured by DMFT index, and dental fluorosis severity was measured by Dean’s Index. Community Fluorosis Index was used to estimate public health significance of dental fluorosis. Oral health-related behaviors and awareness, dietary habits and socioeconomic status were determined by a questionnaire. Bivariate and multivariate analyses were used to determine risk factors associated with dental caries and dental fluorosis. Dental caries prevalence was 37.50%, mean DMFT was 0.84 ± 1.53, while dental fluorosis prevalence was 62.23%. Community Fluorosis Index was 1.35, indicating a medium prevalent strength of dental fluorosis. Dental fluorosis was associated with mother’s regular consumption of brick tea and residence altitude, and dental caries was associated with mother’s regular consumption of brick tea. Mother’s regular consumption of brick tea was a risk factor for both dental fluorosis and dental caries among children. Reducing mother’s brick tea consumption during pregnancy and lactation may improve oral health status of their children.

Keywords

Brick tea Dental caries Dental fluorosis Risk factor Epidemiology 

Notes

Acknowledgements

This survey was funded by grants from Special Project Funds of Chengdu Science and Technology Bureau (2015-HM01-00501-SF), National Natural Science Foundation of China (81400507), and China Oral Health Foundation (2016054). We appreciate Ganzi Tibetan Autonomous Prefecture People’s Hospital for their support.

Authors contribution

RZ, LC, TZ, TX, ML, WY and YY performed data collection. RZ, CL and QJ performed data analysis. RZ and CL performed results interpretation and drafted the manuscript. All authors reviewed/edited the manuscript and approved the final version.

Compliance with ethical standards

Conflict of interests

The authors declare that there is no conflict of interest regarding the publication of this article.

References

  1. Aguilar-Diaz, F. D. C., Morales-Corona, F., Cintra-Viveiro, A. C., & Fuente-Hernandez, J. (2017). Prevalence of dental fluorosis in Mexico 2005-2015: a literature review. Salud Publica de Mexico, 59(3), 306–313.  https://doi.org/10.21149/7764.CrossRefGoogle Scholar
  2. Akosu, T. J., Zoakah, A. I., & Chirdan, O. A. (2009). The prevalence and severity of dental fluorosis in the high and low altitude parts of Central Plateau, Nigeria. Community Dental Health, 26(3), 138–142.Google Scholar
  3. Americano, G. C., Jacobsen, P. E., Soviero, V. M., & Haubek, D. (2017). A systematic review on the association between molar incisor hypomineralization and dental caries. International Journal of Paediatric Dentistry, 27(1), 11–21.  https://doi.org/10.1111/ipd.12233.CrossRefGoogle Scholar
  4. Bronckers, A. L., Lyaruu, D. M., & DenBesten, P. K. (2009). The impact of fluoride on ameloblasts and the mechanisms of enamel fluorosis. Journal of Dental Research, 88(10), 877–893.  https://doi.org/10.1177/0022034509343280.CrossRefGoogle Scholar
  5. Buzalaf, M. A., & Whitford, G. M. (2011). Fluoride metabolism. Monographs in Oral Science, 22, 20–36.  https://doi.org/10.1159/000325107.CrossRefGoogle Scholar
  6. Campus, G., Congiu, G., Cocco, F., Sale, S., Cagetti, M. G., Sanna, G., et al. (2014). Fluoride content in breast milk after the use of fluoridated food supplement. A randomized clinical trial. American Journal of Dentistry, 27(4), 199–202.Google Scholar
  7. Cao, J., Bai, X., Zhao, Y., Liu, J., Zhou, D., Fang, S., et al. (1996). The relationship of fluorosis and brick tea drinking in Chinese Tibetans. Environmental Health Perspectives, 104(12), 1340–1343.CrossRefGoogle Scholar
  8. Cao, J., Zhao, Y., & Liu, J. (2002). Fluoride in the environment and brick-tea-type fluorosis in Tibet. Huan Jing Ke Xue, 23(6), 97–100.Google Scholar
  9. Cao, J., Zhao, Y., Liu, J., Xirao, R., & Danzeng, S. (2001). Varied ecological environment and fluorosis in Tibetan children in the nature reserve of Mount Qomolangma. Ecotoxicology and Environmental Safety, 48(1), 62–65.  https://doi.org/10.1006/eesa.2000.1988.CrossRefGoogle Scholar
  10. Cao, J., Zhao, Y., Liu, J., Xirao, R., Danzeng, S., Daji, D., et al. (2003). Brick tea fluoride as a main source of adult fluorosis. Food and Chemical Toxicology, 41(4), 535–542.CrossRefGoogle Scholar
  11. Costa Sde, M., Abreu, M. H., Vargas, A. M., Vasconcelos, M., Ferreira e Ferreira, E., & Castilho, L. S. (2013). Dental caries and endemic dental fluorosis in rural communities, Minas Gerais, Brazil. Rev Bras Epidemiol, 16(4), 1021–1028.CrossRefGoogle Scholar
  12. Das, K., & Mondal, N. K. (2016). Dental fluorosis and urinary fluoride concentration as a reflection of fluoride exposure and its impact on IQ level and BMI of children of Laxmisagar, Simlapal Block of Bankura District, W.B., India. Environmental Monitoring and Assessment, 188(4), 218.  https://doi.org/10.1007/s10661-016-5219-1.CrossRefGoogle Scholar
  13. Denbesten, P., & Li, W. (2011). Chronic fluoride toxicity: dental fluorosis. Monographs in Oral Science, 22, 81–96.  https://doi.org/10.1159/000327028.CrossRefGoogle Scholar
  14. Do, L. G., Levy, S. M., & Spencer, A. J. (2012). Association between infant formula feeding and dental fluorosis and caries in Australian children. Journal of Public Health Dentistry, 72(2), 112–121.  https://doi.org/10.1111/j.1752-7325.2011.00290.x.CrossRefGoogle Scholar
  15. Do, L. G., Miller, J., Phelan, C., Sivaneswaran, S., Spencer, A. J., & Wright, C. (2014). Dental caries and fluorosis experience of 8-12-year-old children by early-life exposure to fluoride. Community Dentistry and Oral Epidemiology, 42(6), 553–562.  https://doi.org/10.1111/cdoe.12106.CrossRefGoogle Scholar
  16. do Nascimento, H. A., Soares Ferreira, J. M., Granville-Garcia, A. F., de Brito Costa, E. M., Almeida Cavalcante, A. L., & Sampaio, F. C. (2013). Estimation of toothpaste fluoride intake in preschool children. Brazilian Dental Journal, 24(2), 142–146.  https://doi.org/10.1590/0103-6440201302087.CrossRefGoogle Scholar
  17. Do, L. G., & Spencer, A. (2007). Oral health-related quality of life of children by dental caries and fluorosis experience. Journal of Public Health Dentistry, 67(3), 132–139.CrossRefGoogle Scholar
  18. Fan, Z., Gao, Y., Wang, W., Gong, H., Guo, M., Zhao, S., et al. (2016). Prevalence of Brick Tea-Type Fluorosis in the Tibet Autonomous Region. Journal of Epidemiology, 26(2), 57–63.  https://doi.org/10.2188/jea.JE20150037.CrossRefGoogle Scholar
  19. Faraji, H., Mohammadi, A. A., Akbari-Adergani, B., Vakili Saatloo, N., Lashkarboloki, G., & Mahvi, A. H. (2014). Correlation between Fluoride in Drinking Water and Its Levels in Breast Milk in Golestan Province, Northern Iran. Iranian Journal of Public Health, 43(12), 1664–1668.Google Scholar
  20. Fejerskov, O., Larsen, M. J., Richards, A., & Baelum, V. (1994). Dental tissue effects of fluoride. Advances in Dental Research, 8(1), 15–31.  https://doi.org/10.1177/08959374940080010601.CrossRefGoogle Scholar
  21. Ganta, S., Yousuf, A., Nagaraj, A., Pareek, S., Sidiq, M., Singh, K., et al. (2015). Evaluation of fluoride retention due to most commonly consumed estuarine fishes among fish consuming population of Andhra Pradesh as a contributing factor to dental fluorosis: A cross-sectional study. Journal of Clinical and Diagnostic Research, 9(6), ZC11-15.  https://doi.org/10.7860/JCDR/2015/12271.6035.CrossRefGoogle Scholar
  22. Hassunuma, R. M., Zen Filho, E. V., Ceolin, D. S., Cestari, T. M., Taga, R., & de Assis, G. F. (2007). Ultrastructural and immunohistochemical study of the influence of fluoride excess on the development of rat incisor tooth buds. Journal of Applied Oral Science, 15(4), 292–298.CrossRefGoogle Scholar
  23. Hong, L., Levy, S. M., Broffitt, B., Warren, J. J., Kanellis, M. J., Wefel, J. S., et al. (2006). Timing of fluoride intake in relation to development of fluorosis on maxillary central incisors. Community Dentistry and Oral Epidemiology, 34(4), 299–309.  https://doi.org/10.1111/j.1600-0528.2006.00281.x.CrossRefGoogle Scholar
  24. Hou, R., Mi, Y., Xu, Q., Wu, F., Ma, Y., Xue, P., et al. (2014). Oral health survey and oral health questionnaire for high school students in Tibet, China. Head & Face Medicine, 10, 17.  https://doi.org/10.1186/1746-160X-10-17.CrossRefGoogle Scholar
  25. Irigoyen, M. E., Molina, N., & Luengas, I. (1995). Prevalence and severity of dental fluorosis in a Mexican community with above-optimal fluoride concentration in drinking water. Community Dentistry and Oral Epidemiology, 23(4), 243–245.CrossRefGoogle Scholar
  26. Jeremias, F., de Souza, J. F., Silva, C. M., Cordeiro Rde, C., Zuanon, A. C., & Santos-Pinto, L. (2013). Dental caries experience and molar-incisor hypomineralization. Acta Odontologica Scandinavica, 71(3–4), 870–876.  https://doi.org/10.3109/00016357.2012.734412.CrossRefGoogle Scholar
  27. Jha, S. K., Mishra, V. K., Sharma, D. K., & Damodaran, T. (2011). Fluoride in the environment and its metabolism in humans. Reviews of Environmental Contamination and Toxicology, 211, 121–142.  https://doi.org/10.1007/978-1-4419-8011-3_4.CrossRefGoogle Scholar
  28. Kassebaum, N. J., Bernabe, E., Dahiya, M., Bhandari, B., Murray, C. J., & Marcenes, W. (2015). Global burden of untreated caries: a systematic review and metaregression. Journal of Dental Research, 94(5), 650–658.  https://doi.org/10.1177/0022034515573272.CrossRefGoogle Scholar
  29. Kawai, K., Urano, M., & Ebisu, S. (2000). Effect of surface roughness of porcelain on adhesion of bacteria and their synthesizing glucans. Journal of Prosthetic Dentistry, 83(6), 664–667.CrossRefGoogle Scholar
  30. Krisdapong, S., Prasertsom, P., Rattanarangsima, K., & Sheiham, A. (2013a). Impacts on quality of life related to dental caries in a national representative sample of Thai 12- and 15-year-olds. Caries Research, 47(1), 9–17.  https://doi.org/10.1159/000342893.CrossRefGoogle Scholar
  31. Krisdapong, S., Prasertsom, P., Rattanarangsima, K., & Sheiham, A. (2013b). School absence due to toothache associated with sociodemographic factors, dental caries status, and oral health-related quality of life in 12- and 15-year-old Thai children. Journal of Public Health Dentistry, 73(4), 321–328.  https://doi.org/10.1111/jphd.12030.CrossRefGoogle Scholar
  32. Levy, S. M., Broffitt, B., Marshall, T. A., Eichenberger-Gilmore, J. M., & Warren, J. J. (2010). Associations between fluorosis of permanent incisors and fluoride intake from infant formula, other dietary sources and dentifrice during early childhood. Journal of the American Dental Association, 141(10), 1190–1201.CrossRefGoogle Scholar
  33. Li, Q., Liu, Z., Huang, J., Luo, G., Liang, Q., Wang, D., et al. (2013). Anti-obesity and hypolipidemic effects of Fuzhuan brick tea water extract in high-fat diet-induced obese rats. Journal of the Science of Food and Agriculture, 93(6), 1310–1316.  https://doi.org/10.1002/jsfa.5887.CrossRefGoogle Scholar
  34. Liu, P., Chen, J., Yang, X., Liu, Y., Ji, D., Qin, S., et al. (2015a). Investigation of drinking- tea- type endemic fluorosis in Sichuan Province in 2010–2013. Journal of Preventive Medicine Information. http://en.cnki.com.cn/Article_en/CJFDTotal-YFYX201508017.htm.
  35. Liu, M., Li, Y. C., Liu, S. W., Wang, L. J., Liu, Y. N., Yin, P., et al. (2016). Burden of disease attributable to high- sodium diets in China, 2013. Zhonghua Yu Fang Yi Xue Za Zhi, 50(9), 759–763.  https://doi.org/10.3760/cma.j.issn.0253-9624.2016.09.003.CrossRefGoogle Scholar
  36. Liu, Z., Lin, Y., Zhang, S., Wang, D., Liang, Q., & Luo, G. (2015b). Comparative proteomic analysis using 2DE-LC-MS/MS reveals the mechanism of Fuzhuan brick tea extract against hepatic fat accumulation in rats with nonalcoholic fatty liver disease. Electrophoresis, 36(17), 2002–2016.  https://doi.org/10.1002/elps.201500076.CrossRefGoogle Scholar
  37. Lo, E. C., Jin, L. J., Zee, K. Y., Leung, W. K., & Corbet, E. F. (2000). Oral health status and treatment need of 11-13-year-old urban children in Tibet, China. Community Dental Health, 17(3), 161–164.Google Scholar
  38. Lockner, F., Twetman, S., & Stecksen-Blicks, C. (2017). Urinary fluoride excretion after application of fluoride varnish and use of fluoride toothpaste in young children. International Journal of Paediatric Dentistry.  https://doi.org/10.1111/ipd.12284.CrossRefGoogle Scholar
  39. Maguire, A., & Zohoori, F. V. (2013). Fluoride balance in infants and young children in the U.K. and its clinical relevance for the dental team. British Dental Journal, 214(11), 587–593.  https://doi.org/10.1038/sj.bdj.2013.531.CrossRefGoogle Scholar
  40. Marya, C. M., Ashokkumar, B. R., Dhingra, S., Dahiya, V., & Gupta, A. (2014). Exposure to high-fluoride drinking water and risk of dental caries and dental fluorosis in Haryana, India. Asia-Pacific Journal of Public Health, 26(3), 295–303.  https://doi.org/10.1177/1010539512460270.CrossRefGoogle Scholar
  41. Peng, Y., Xiong, Z., Li, J., Huang, J. A., Teng, C., Gong, Y., et al. (2014). Water extract of the fungi from Fuzhuan brick tea improves the beneficial function on inhibiting fat deposition. International Journal of Food Sciences and Nutrition, 65(5), 610–614.  https://doi.org/10.3109/09637486.2014.898253.CrossRefGoogle Scholar
  42. Pretty, I. A., Tavener, J. A., Browne, D., Brettle, D. S., Whelton, H., & Ellwood, R. P. (2006). Quantification of dental fluorosis using fluorescence imaging. Caries Research, 40(5), 426–434.  https://doi.org/10.1159/000094289.CrossRefGoogle Scholar
  43. Qu, P., Wang, T., Liu, F., Dang, S., Zeng, L., & Yan, H. (2015). Breast-feeding patterns of ethnic groups in rural western China. Public Health Nutrition, 18(18), 3386–3393.  https://doi.org/10.1017/S1368980015000208.CrossRefGoogle Scholar
  44. Ramesh, G., Nagarajappa, R., Raghunath, V., & Manohar, R. (2011). Developmental defects of enamel in children of Davangere District and their relationship to fluoride levels in drinking water. Asia-Pacific Journal of Public Health, 23(3), 341–348.  https://doi.org/10.1177/1010539509340912.CrossRefGoogle Scholar
  45. Robinson, C., Connell, S., Kirkham, J., Brookes, S. J., Shore, R. C., & Smith, A. M. (2004). The effect of fluoride on the developing tooth. Caries Research, 38(3), 268–276.  https://doi.org/10.1159/000077766.CrossRefGoogle Scholar
  46. Sener, Y., Tosun, G., Kahvecioglu, F., Gokalp, A., & Koc, H. (2007). Fluoride levels of human plasma and breast milk. European Journal of Dentistry, 1(1), 21–24.Google Scholar
  47. Thylstrup, A., & Fejerskov, O. (1978). Clinical appearance of dental fluorosis in permanent teeth in relation to histologic changes. Community Dentistry and Oral Epidemiology, 6(6), 315–328.CrossRefGoogle Scholar
  48. Toyama, Y., Nakagaki, H., Kato, S., Huang, S., Mizutani, Y., Kojima, S., et al. (2001). Fluoride concentrations at and near the neonatal line in human deciduous tooth enamel obtained from a naturally fluoridated and a non-fluoridated area. Archives of Oral Biology, 46(2), 147–153.CrossRefGoogle Scholar
  49. Wang, L., Cheng, L., Yuan, B., Hong, X., & Hu, T. (2017). Association between socio-economic status and dental caries in elderly people in Sichuan Province, China: a cross-sectional study. British Medical Journal Open, 7(9), e016557.  https://doi.org/10.1136/bmjopen-2017-016557.CrossRefGoogle Scholar
  50. Wondwossen, F., Astrom, A. N., Bjorvatn, K., & Bardsen, A. (2004). The relationship between dental caries and dental fluorosis in areas with moderate- and high-fluoride drinking water in Ethiopia. Community Dentistry and Oral Epidemiology, 32(5), 337–344.  https://doi.org/10.1111/j.1600-0528.2004.00172.x.CrossRefGoogle Scholar
  51. World Health Organization. (2013). Oral health surveys: Basic methods (5th ed.). Geneva: World Health Organization.Google Scholar
  52. Yin, W., Yang, Y. M., Chen, H., Li, X., Wang, Z., Cheng, L., et al. (2017). Oral health status in Sichuan Province: findings from the oral health survey of Sichuan, 2015–2016. International Journal of Oral Science, 9(1), 10–15.  https://doi.org/10.1038/ijos.2017.6.CrossRefGoogle Scholar
  53. Zhu, L., Petersen, P. E., Wang, H. Y., Bian, J. Y., & Zhang, B. X. (2005). Oral health knowledge, attitudes and behaviour of adults in China. International Dental Journal, 55(4), 231–241.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  • Rui Zhang
    • 1
  • Li Cheng
    • 1
  • Tao Zhang
    • 1
  • Ting Xu
    • 1
  • Meng Li
    • 1
  • Wei Yin
    • 1
  • Qingling Jiang
    • 2
  • Yingming Yang
    • 1
    Email author
  • Tao Hu
    • 1
    Email author
  1. 1.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Preventive Dentistry, West China Hospital of StomatologySichuan UniversityChengduChina
  2. 2.West China School of Public HealthSichuan UniversityChengduChina

Personalised recommendations