Assessment of Caries Index and Fluoride Intake in a Pediatric Middle Eastern Population

To assess the fluoride concentration in water sources and its association with caries index in children living in Tripoli, Lebanon.

The concentration of fluoride was measured in tap and bottled water using ion chromatography. For tap water, eight water sources were evaluated before and after domestic distribution during June and November 2016. For bottled water, seven brands available on the market were tested. Caries were recorded in 402 children using DMFT/dmft indices. A questionnaire was distributed to parents to gather information about sociodemographic characteristics, the source of water consumed, the consumption of fluoride supplements, fluoridate salt, tea and sweets, and the frequency of toothbrushing.

The fluoride concentration in tap water was not significantly different from the optimal concentration (p value > 0.05). However, the amount of fluoride in bottled water (0.14 ± 0.698 mg/L) was significantly lower than the optimal amount of fluoride recommended by the World Health Organization for decay prevention (0.5-1 mg/L) (p value < 0.001). The prevalence of caries was elevated in children aged 5 years (90.5%) and 12 years (89.6%). The carious indices were lower in children who consume tap water, tea, and fluoridated salt and those who consume less sweet.

Additional studies covering all Lebanese regions should be performed to develop a national policy concerning fluoride-based scientific evidences.

Pedodontists should take in consideration the source of water consumed by the patient before prescribing a fluoride supplementation to avoid an overconsumption. They should promote effective oral hygiene methods and nutritional education and encourage regular tea consumption as an affordable source of fluoride to prevent caries.