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Fluoride Exposure in Community Prevention Programmes for Oral Health Using Nail Clippings and Spot Urine Samples: A
Fatemeh Eskandari1, Elizabeth Adjoa Kumah1,2, Liane Azevedo3
1School of Health and Life Sciences, Teesside University, Middlesbrough, UK.
Caries Research
|September 6, 2023
Summary
Spot urine and nail clippings show moderate to strong correlations with fluoride intake, serving as potential non-invasive biomarkers for population surveillance. Further research is needed to confirm their validity due to limited high-quality studies.
Area of Science:
- Environmental Health
- Biomarkers
- Public Health Surveillance
Background:
- Accurate quantification of population fluoride exposure is challenging.
- Non-invasive biomarkers like spot urine and nail clippings are gaining attention for fluoride surveillance.
- Robust consensus on the accuracy of these biomarkers for estimating fluoride exposure is lacking.
Approach:
- Systematic review and meta-analysis synthesizing evidence on fluoride exposure and biomarker concentrations.
- Searched nine databases, search engines, and grey literature up to September 2022.
- Included 44 studies with 694,578 participants; 25 studies were meta-analyzed using a random effects model.
Key Points:
- Moderate correlation (0.674) between fluoride intake and spot urine fluoride concentration across all age groups.
- Strong correlation (0.938) between fluoride intake and nail clipping fluoride concentration across all age groups.
- Strong positive correlation (0.929) between fluoride intake and spot urine fluoride/creatinine ratio in children.
Conclusions:
- Spot urine and nail clippings demonstrate potential as non-invasive biomarkers for population fluoride exposure assessment.
- Scarcity of high-quality studies necessitates further research to establish the definitive validity of these biomarkers.
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