DENTAL FLUOROSIS IN A RURAL NIGERIAN COMMUNITY: IS THE WATER TO BLAME?

DENTAL FLUOROSIS IN A RURAL NIGERIAN COMMUNITY: IS THE WATER TO BLAME? ENVIRONMENTAL PROJECT TOPICS AND MATERIALS

ABSTRACT

Drinking water can contain fluoride which is effective in preventing dental caries at concentration of ≤1.5 mg/L however at concentrations ≥1.5 mg/L, it could lead to dental fluorosis. Dental fluorosis is a disorder that occurs due to excessive fluoride intake during the mineralization of the teeth, resulting in an uneven distribution of brown and yellow coloration. I assessed fluoride levels in 19 samples of natural water sources (such as boreholes, streams, and wells) and commercial drinking water sources (such as sachet and bottled water products) in Zing Local Government Area, Taraba State, northeastern Nigeria, I then determined the prevalence of dental fluorosis in 135 children, aged 10 to 17 years, who were born in Zing. Using cross tabulations and logistic regression modelling, I evaluated factors that might influence whether a child had dental fluorosis, such as dental care habits and drinking water source. Fluorosis occurred in 111 respondents. Fluoride levels exceeded the World Health Organization permissible limit of 1.0mg/L for tropical environments in most borehole samples, while most stream and well samples did not exceed this limit. The regression model showed that odds of a child having dental fluorosis were higher for those children who drank borehole water compared to those who do not (OR = 8.522), while the odds of having fluorosis decreases for children who drink from stream water (OR = 0.203). Consequently, community boreholes may need to be de-fluoridated and there should be community awareness about the sources of water with high fluoride concentrations.

Keywords: Boreholes, dental fluorosis, drinking water, fluoride, Nigeria, streams, wells

CHAPTER ONE

INTRODUCTION

Water is a very important basic requirement for human life and that is why water quality is an important factor and a key area of concentration in public health. Fluoride, is an important element considered to be beneficial at low concentrations and toxic at high concentrations when present in water. Fluoride is toxic as a result of its strong affinity for calcium, this gives it the ability to react with structures that are made of calcium such as teeth and bones. The World Health Organization (WHO) guideline for permissible fluoride concentration in drinking water is set at 1.5 mg/L (WHO, 2011). However, the WHO has emphasized the need for national authorities to set national fluoride standards taking into consideration climatic condition, fluoride intake from alternative sources, and daily water intake (Lennon, Whelton, O’Mullane, & Ekstrand, 2005).

Common techniques used to detect fluoride levels include fluoride ion selective electrode method, calorimetric methods, ion chromatography methods, and use of photometer (Agency for Toxic Substances and Disease Registry, 2001).

DENTAL FLUOROSIS IN A RURAL NIGERIAN COMMUNITY: IS THE WATER TO BLAME? ENVIRONMENTAL PROJECT TOPICS AND MATERIALS