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Urinary fluoride excretion in small children following short-term fluoride supply with tablets or domestic salt
Insights
Fluoride (F) salt supplementation in children significantly increased urinary F excretion, comparable to tablet doses. This suggests fluoridated salt is a viable option for caries prevention in larger populations.
Area of Science:
- Public Health
- Dental Health
- Environmental Health
Background:
- Urinary fluoride (F) excretion is a key indicator of fluoride intake and metabolism.
- Previous studies have examined fluoride excretion in children, with limited comparisons to adults.
- Fluoridated salt (F-salt) is a potential public health intervention for caries prevention.
Purpose of the Study:
- To investigate urinary fluoride excretion in children following ingestion of fluoride tablets and fluoridated salt.
- To compare fluoride excretion patterns between children and adults.
- To assess the suitability of domestic fluoridated salt for large-scale clinical testing.
Main Methods:
- Measurement of 24-hour urinary fluoride (F) levels in children of various ages and settings (institution vs. families).
- Administration of fluoride tablets (NaF) and meals prepared with fluoridated salt (500 mg F/kg NaCl).
- Comparison of urinary F concentrations and percentage of F dose excreted over time in children and adults.
Main Results:
- 24-h urinary F levels increased significantly in children consuming F-salt, with higher levels observed in institutionalized children.
- Children consuming two F-salted meals daily showed elevated urinary F, but not with one meal.
- Urinary F concentrations in children after NaF tablets matched those of children on long-term tablet use; dose excretion percentages were similar in children and adults.
Conclusions:
- Ingestion of F-salt leads to increased urinary F excretion in children, indicating systemic absorption.
- The fluoride absorption and excretion profile from F-salt is comparable to NaF tablets in children and adults.
- Domestic salt containing approximately 500 parts/10^6 F is suitable for larger-scale clinical trials in Sweden.
Abstract:
Urinary fluoride (F) excretion has been studied in small children, with some comparisons with adults, following ingestion of F tablets or fluoridated salt (F-salt) containing 500 mg F/kg NaCl. 24-h urinary F in 7- to 8-year-old children in an institution and in 2- to 12-year-old children in families rapidly increased to average levels of about 0.85 and 0.55 parts/10(6), respectively, when the children had their meals spiced with F-salt. Children in families also showed significantly elevated urinary F excretion with two F-salted meals a day but not with one a day. After taking 0.5 mg F in the form of NaF tablets a group of children without previous F supply attained within 1 d a 24-h urinary F concentration which was about the same as that in children who had been taking caries-preventive tablet doses for years. The percentage of a single F dose excreted in the urine within 4 h after the ingestion of F tablets or an F-salted standard meal was about the same in preschool children and middle-aged adults. F quantities of the order 1.5-2 mg could be ingested by a child eating a meal comprising strongly F-salted dishes, and the urine could reach concentrations around 3 parts/10(6) F during the following 2-4 h. The results obtained support the concept that domestic salt containing about 500 parts/10(6) F is suitable for clinical testing on a larger scale under Swedish conditions. Calculations of F supplies to children aged 2 months-7 years with different diets and water and salt F contents are presented as diagrams.