Dental News - High fluoride levels in African groundwater put oral health at risk

Dental Tribune International

Tue. 8 May 2012

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DURHAM, N.C., USA: Researchers have suggested that the dental health of about 8 million people living in the Main Ethiopian Rift is jeopardized by high levels of naturally occurring fluoride in their groundwater. Their studies revealed a 100 percent prevalence of dental fluorosis in the teeth of the local residents. Furthermore, they found that additional milk intake may reduce the severity of this disease.

Researchers from Duke University's Nicholas School of the Environment in North Carolina carried out two field studies in April and May 2010 and March 2011, analyzing 148 water samples from two drainage basins in the rift to assess the link between fluoride concentration in drinking water and its impact on dental health in the local community.

They discovered that wells in the rift generally displayed high levels of fluoride, a phenomenon related to the geological circumstances in the region. The rift is composed of volcanic materials and fluviolacustrine sediments, which release toxic elements into the water, including fluoride. The analysis of water from 12 wells frequented by the residents showed that fluoride concentrations ranged from 7.8 to 18 mg/L, far exceeding the WHO 2008 guideline limit of 1.5 mg/L.

According to the organization, fluoride can have a negative effect on tooth enamel and may cause dental fluorosis at concentrations of between 0.9 and 1.2 mg/L. The researchers examined the teeth of 200 local residents aged 7 to 40 and found evidence of dental fluorosis in all of the individuals. About 60 percent of all teeth displayed fractures and loss of the outmost enamel, which is indicative of severe dental fluorosis, while the remaining 40 percent displayed mild to moderate dental fluorosis, characterized by a chalky white appearance without the loss of enamel to varying degrees.

People's average daily intake of fluoride from drinking groundwater in the community was also found to be significantly higher than the recommended WHO value of 6 mg/day, resulting in intakes of between 4 and 54 mg/day. The organization notes that elevated fluoride intake can also have serious effects on skeletal tissue when drinking water containing 3 to 6 mg/L of fluoride.

The researchers hypothesized that certain dietary patterns, such as cow milk consumption, may notably reduce the severity of dental fluorosis. In the East African region, people live mostly on a diet of cereals such as maize and wheat, while dairy products and meat are limited. "This limited, cereal-based diet includes little dietary calcium and vitamin D, which may partly limit the negative impacts of high fluoride consumption," the researchers said.

The study was published online on Apr. 6 in the Environment International journal ahead of print.

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