LONGITUDINAL STUDY--FLUORIDE EXPOSURE & DENTAL FLUORIDE

Summary

Principal Investigator: S M Levy
Affiliation: University of Iowa
Country: USA
Abstract: Several recent studies have reported an increase in the prevalence of dental fluorosis in the United States, thought to be due to the widespread adoption of various preventive dentistry initiatives using fluoride. Several retrospective studies have found associations between dental fluorosis and these fluoride exposures, especially water fluoridation and fluoride tablets and drops. In this study, a methodology will be developed and implemented for use in longitudinal studies to record dietary and non-dietary fluoride exposures on a 3 month basis in a 'birth cohort' from the time of birth until the age of 3 to 4 years (and in a subsequent study until age 8 years). 1530 mothers with newborns will be recruited from post-partum wards of hospitals. The parents will provide data on infant and childhood exposures and ingestion of fluoride every 3 months during the study, with an additional report at 6 weeks of age (due to frequent feeding habit changes during the first 3 months of life). Data on fluoride intake have not previously been collected in this manner and will be valuable in characterizing the multiple fluoride exposures among infants and young children in the U.S. Composite indexes of exposures to both individual and various combinations of fluoride sources over time will be developed. Total dietary fluoride intake will be estimated. Dental caries and dental fluorosis of the primary teeth will be assessed at age 3 to 4. The distributions of fluoride exposures and intake will be characterized. Multivariate relationships will be investigated among prevalence and severity of primary tooth dental fluorosis and dental caries and the various fluoride exposures. A subsequent study will follow the cohort to age 7 to 8 allowing longitudinal data on fluoride exposures to be collected from birth to age 7 to 8. Then, relationships between primary and permanent tooth dental fluorosis will be assessed and the strength of the associations between the prevalence and severity of permanent tooth dental fluorosis and the "prospectively-collected" data on fluoride exposures would be assessed. The study results will increase current understanding about the delicate balance between the optimal use of fluorides for caries prevention and increased risks of dental fluorosis so that fluoride can continue to be used appropriately for maximum public health caries prevention with minimal risk of dental fluorosis.
Funding Period: 1991-09-01 - 1996-08-31
more information: NIH RePORT

Top Publications

  1. ncbi Diet quality in young children is influenced by beverage consumption
    Teresa A Marshall
    Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, N335 Dental Science Building, Iowa City, IA 52242, USA
    J Am Coll Nutr 24:65-75. 2005
  2. ncbi Fluoride intake levels in relation to fluorosis development in permanent maxillary central incisors and first molars
    Liang Hong
    Department of Dental Public Health and Behavioral Science, School of Dentistry, University of Missouri Kansas City, Kansas City, MO, USA
    Caries Res 40:494-500. 2006
  3. ncbi Comparison of the intakes of sugars by young children with and without dental caries experience
    Teresa A Marshall
    Department of Preventive and Community Dentistry, College of Dentistry, N 335, Dental Science Building, University of Iowa, Iowa City, Iowa 52242 1010, USA
    J Am Dent Assoc 138:39-46. 2007
  4. ncbi Fluoride assay methodology for carbonated beverages
    Judith R Heilman
    Dows Institute for Dental Research, University of Iowa, Iowa City, USA
    J Dent Child (Chic) 73:136-9. 2006
  5. ncbi Effects of toothbrush size and dentifrice type/brand on pea-sized and larger amounts of dentifrice
    Patita Bhuridej
    Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
    Int Dent J 57:71-6. 2007
  6. ncbi An investigation of bottled water use and caries in the mixed dentition
    Barbara Broffitt
    Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City 52242, USA
    J Public Health Dent 67:151-8. 2007
  7. ncbi Dental caries and childhood obesity: roles of diet and socioeconomic status
    Teresa A Marshall
    Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA 52242 1010, USA
    Community Dent Oral Epidemiol 35:449-58. 2007
  8. doi Relative esthetic importance of orthodontic and color abnormalities
    Jessica Lawson
    College of Dentistry, University of Iowa, Iowa City, Iowa 52242, USA
    Angle Orthod 78:889-94. 2008
  9. doi Relative validity of the Iowa Fluoride Study targeted nutrient semi-quantitative questionnaire and the block kids' food questionnaire for estimating beverage, calcium, and vitamin D intakes by children
    Teresa A Marshall
    Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, N335 Dental Science Bldg, Iowa City, IA 52242, USA
    J Am Diet Assoc 108:465-72. 2008
  10. doi Measuring activity in children and adolescents using self-report: PAQ-C and PAQ-A
    Kathleen F Janz
    Department of Health and Sports Studies, University of Iowa, Iowa City, IA 52242, USA
    Med Sci Sports Exerc 40:767-72. 2008

Scientific Experts

Detail Information

Publications31

  1. ncbi Diet quality in young children is influenced by beverage consumption
    Teresa A Marshall
    Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, N335 Dental Science Building, Iowa City, IA 52242, USA
    J Am Coll Nutr 24:65-75. 2005
    ..Replacement of milk with sugar-containing beverages could affect calcium intake and overall diet quality...
  2. ncbi Fluoride intake levels in relation to fluorosis development in permanent maxillary central incisors and first molars
    Liang Hong
    Department of Dental Public Health and Behavioral Science, School of Dentistry, University of Missouri Kansas City, Kansas City, MO, USA
    Caries Res 40:494-500. 2006
    ..The study suggests that fluorosis prevalence is related to elevated fluoride intake when averaged over the first 3 years of life, but is even more strongly related to fluoride intake that is elevated for all of the first 3 years of life...
  3. ncbi Comparison of the intakes of sugars by young children with and without dental caries experience
    Teresa A Marshall
    Department of Preventive and Community Dentistry, College of Dentistry, N 335, Dental Science Building, University of Iowa, Iowa City, Iowa 52242 1010, USA
    J Am Dent Assoc 138:39-46. 2007
    ..Relationships among sugars and dental caries in contemporary societies are unclear. The authors describe young children's intakes of nonmilk extrinsic (NME) and intrinsic/milk sugars and relate those intakes to dental caries...
  4. ncbi Fluoride assay methodology for carbonated beverages
    Judith R Heilman
    Dows Institute for Dental Research, University of Iowa, Iowa City, USA
    J Dent Child (Chic) 73:136-9. 2006
    ....
  5. ncbi Effects of toothbrush size and dentifrice type/brand on pea-sized and larger amounts of dentifrice
    Patita Bhuridej
    Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
    Int Dent J 57:71-6. 2007
    ..To assess the effects of toothbrush size and dentifrice type/brand on amounts of dentifrice being placed when trying to replicate pictures with different amounts of dentifrice, including a pea-sized amount...
  6. ncbi An investigation of bottled water use and caries in the mixed dentition
    Barbara Broffitt
    Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City 52242, USA
    J Public Health Dent 67:151-8. 2007
    ..Because the majority of commercial bottled water is low in fluoride, there is the potential for an increase in dental caries. In these secondary data analyses, associations between bottled water use and dental caries were explored...
  7. ncbi Dental caries and childhood obesity: roles of diet and socioeconomic status
    Teresa A Marshall
    Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA 52242 1010, USA
    Community Dent Oral Epidemiol 35:449-58. 2007
    ..Our objective was to determine (a) if caries and obesity were associated in a pediatric population and (b) if so, then to explore diet and socioeconomic status as additional risk factors...
  8. doi Relative esthetic importance of orthodontic and color abnormalities
    Jessica Lawson
    College of Dentistry, University of Iowa, Iowa City, Iowa 52242, USA
    Angle Orthod 78:889-94. 2008
    ..To assess the relative importance of an orthodontic esthetic index, dental fluorosis and nonfluoride opacities, with respect to parents' satisfaction with their children's dental esthetics...
  9. doi Relative validity of the Iowa Fluoride Study targeted nutrient semi-quantitative questionnaire and the block kids' food questionnaire for estimating beverage, calcium, and vitamin D intakes by children
    Teresa A Marshall
    Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, N335 Dental Science Bldg, Iowa City, IA 52242, USA
    J Am Diet Assoc 108:465-72. 2008
    ....
  10. doi Measuring activity in children and adolescents using self-report: PAQ-C and PAQ-A
    Kathleen F Janz
    Department of Health and Sports Studies, University of Iowa, Iowa City, IA 52242, USA
    Med Sci Sports Exerc 40:767-72. 2008
    ....
  11. doi Subjective and objective measures of physical activity in relationship to bone mineral content during late childhood: the Iowa Bone Development Study
    K F Janz
    Department of Health and Sport Studies, University of Iowa, Iowa City, IA 52242, USA
    Br J Sports Med 42:658-63. 2008
    ..This study compared accelerometry to self-report for the assessment of physical activity (PA) in relation to bone mineral content (BMC). In addition, we compared the ability of these measures to assess PA in boys versus girls...
  12. doi Considerations on optimal fluoride intake using dental fluorosis and dental caries outcomes--a longitudinal study
    John J Warren
    Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA 52242 1010, USA
    J Public Health Dent 69:111-5. 2009
    ....
  13. pmc Sustained effect of early physical activity on body fat mass in older children
    Kathleen F Janz
    Department of Health and Sport Studies, University of Iowa, Iowa City, Iowa 52242, USA
    Am J Prev Med 37:35-40. 2009
    ..Physical activity is assumed to reduce excessive fatness in children. This study examined whether the benefits of early childhood moderate-to-vigorous physical activity (MVPA) on fatness are sustained throughout childhood...
  14. pmc Association between enamel hypoplasia and dental caries in primary second molars: a cohort study
    L Hong
    Department of Dental Public Health and Behavioral Science, School of Dentistry, University of Missouri Kansas City, Kansas City, MO 64108 2784, USA
    Caries Res 43:345-53. 2009
    ..Enamel hypoplasia appears to be a significant risk factor for caries and should be considered in caries risk assessment...
  15. ncbi Associations between dental fluorosis of the permanent and primary dentitions
    Steven M Levy
    Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, 328 Dental Science Building, North Iowa City, IA 52242, USA
    J Public Health Dent 66:180-5. 2006
    ..Relatively little is known about associations between primary and permanent tooth fluorosis. In this study, associations between dental fluorosis of the permanent and primary dentitions were assessed...
  16. ncbi Oral health behaviors of children in low and high socioeconomic status families
    Abed Al Hadi Hamasha
    Department of Preventive Dentistry, Jordan University of Science and Technology, Irbid
    Pediatr Dent 28:310-5. 2006
    ..This prospective longitudinal study compared the patterns of oral health behaviors between low and high socioeconomic status (SES) families participating in the Iowa Fluoride Study for a period of 9 years...
  17. ncbi Timing of fluoride intake in relation to development of fluorosis on maxillary central incisors
    Liang Hong
    Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA 52242 1010, USA
    Community Dent Oral Epidemiol 34:299-309. 2006
    ..This study reports the relationships of fluoride intake during the first 48 months of life with fluorosis on early-erupting permanent teeth...
  18. ncbi Percentile distributions of bone measurements in Iowa children: the Iowa Bone Development Study
    Marcia C Willing
    Department of Pediatrics, Roy J and Lucille A Carver College of Medicine, Iowa City, IA 52242, USA
    J Clin Densitom 8:39-47. 2005
    ..Gender, age, and height are useful clinical predictors of BMD and BMC in young children...
  19. ncbi Patterns of dietary fluoride supplement use in children from birth to 96 months of age
    Abed Al Hadi Hamasha
    Faculty of Dentistry, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan
    J Public Health Dent 65:7-13. 2005
    ..This paper reports on fluoride supplement use from birth to age 96 months...
  20. ncbi Longitudinal patterns of vitamin and mineral supplement use in young white children
    Julie M Eichenberger Gilmore
    Preventive and Community Dentistry, University of Iowa College of Dentistry, N 342 DSB, Iowa City, IA 52242, USA
    J Am Diet Assoc 105:763-72; quiz 773-4. 2005
    ....
  21. ncbi Tracking of activity and sedentary behaviors in childhood: the Iowa Bone Development Study
    Kathleen F Janz
    Department of Health and Sport Studies, University of Iowa, Iowa City, 52242, USA
    Am J Prev Med 29:171-8. 2005
    ..This study examined the tracking of activity and sedentary behavior in relation to adiposity during middle childhood...
  22. ncbi Patterns of fluoride mouthrinse and gel use by children 6 to 96 months of age
    Abed A Hamasha
    Department of Preventive Dentistry, Jordan University of Science and Technology, Irbid, Jordan
    Pediatr Dent 27:217-20. 2005
    ..The purpose of this paper was to report longitudinally on parental reports of mouthrinse/gel use at home and at preschool/elementary school until age 8...
  23. ncbi Association of amoxicillin use during early childhood with developmental tooth enamel defects
    Liang Hong
    Department of Preventive and Community Dentistry, Dows Institute for Dental Research, University of Iowa, Iowa City, IA 52242, USA
    Arch Pediatr Adolesc Med 159:943-8. 2005
    ..It has been speculated that amoxicillin use could be associated with dental enamel defects...
  24. ncbi Validation evidence for the Netherlands physical activity questionnaire for young children: the Iowa bone development study
    Kathleen F Janz
    Department of Health and Sports Studies, The University of Iowa, IA 52242, USA
    Res Q Exerc Sport 76:363-9. 2005
  25. ncbi Effects of nonnutritive sucking habits on occlusal characteristics in the mixed dentition
    John J Warren
    Department of Preventive and Community Dentistry, University of Iowa, Iowa City, Iowa, USA
    Pediatr Dent 27:445-50. 2005
    ..The purpose of this study was to report on the relationship between certain occlusal traits in the mixed dentition and longitudinal sucking behaviors...
  26. ncbi Factors associated with parents' esthetic perceptions of children's mixed dentition fluorosis and demarcated opacities
    Steven M Levy
    University of Iowa College of Public Health, Department of Preventive and Community Dentistry, USA
    Pediatr Dent 27:486-92. 2005
    ....
  27. ncbi Longitudinal study of non-cavitated carious lesion progression in the primary dentition
    John J Warren
    Dental Science Bldg, The University of Iowa, Iowa City, IA 52242 1010, USA
    J Public Health Dent 66:83-7. 2006
    ..This study reports changes in non-cavitated tooth surface diagnoses after a 4-year period...
  28. ncbi Use of the fluorosis risk index in a cohort study: the Iowa fluoride study
    Steven M Levy
    Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa 52242 1010, USA
    J Public Health Dent 66:92-6. 2006
    ..Several studies have used the Fluorosis Risk Index (FRI) to assess risk factors for dental fluorosis. This study reports fluorosis prevalence estimates in a birth cohort using the FRI in different ways...
  29. ncbi Fluoride dentifrice ingestion and fluorosis of the permanent incisors
    Michael R Franzman
    Department of Periodontics, University of Iowa, Iowa City 52242, USA
    J Am Dent Assoc 137:645-52. 2006
    ..Fluoride dentifrice is a primary means of preventing childhood caries, but it is also an important risk factor for fluorosis. The authors examine the influence of fluoride dentifrice ingestion on fluorosis of the permanent incisors...
  30. ncbi Physical activity augments bone mineral accrual in young children: The Iowa Bone Development study
    Kathleen F Janz
    Department of Health and Sport Studies, The University of Iowa, Iowa City, Iowa 52242, USA
    J Pediatr 148:793-9. 2006
    ..This 3-year follow-up study examined associations between physical activity and bone mineral content (BMC) and whether physical activity augments BMC accrual...
  31. pmc Associations of fluoride intake with children's bone measures at age 11
    Steven M Levy
    Department of Preventive and Community Dentistry, College of Dentistry, Carver College of Medicine, Iowa City, IA, USA
    Community Dent Oral Epidemiol 37:416-26. 2009
    ..Relationships between fluoride intake and bone health continue to be of interest, as previous studies show conflicting results...