Urinary fluoride levels in Jamaican children in 2008, after 21 years of salt fluoridation.

RATIONALE: In 1984, the DMFT12 in Jamaican children was 6.7 (very severe). In 1987, national salt fluoridation was implemented (250 mg F-/kg salt). In 1995, a national survey showed a substantial decrease of caries severity (DMFT12 of 1.8). OBJECTIVES: To see whether the favorable exposure of fluoride was continued. METHODS: Assessment of urinary fluoride parameters based on WHO guidelines. Children were sampled in two urban and two rural sites. Valid nocturnal and daytime urinary collections were obtained from 128 children (mean age 4.7 y). A questionnaire administered to parents provided information on oral hygiene practice, and use of fluoride via salt, dentifrices or supplements. RESULTS: Excretion rate values extrapolated to 24 h were 271 in urban and 330 microgF/24 h in rural, F-concentrations were in the range of 1.13 and 1.30. Almost all children were reported to use toothpaste, most with 600 to 1000 ppm F; 65% of children use more than the recommended amount of toothpaste. Fluoridated salt was consumed by 98% of the children. There was no other apparent usage of fluorides. CONCLUSIONS: Urinary excretion results point to a suboptimal exposure of fluoride, whereas concentrations would suggest an optimal or slightly higher intake. Dentifrices with 500 ppm F should be made available in order to minimize the risk of enamel fluorosis.

Methodological and biological factors explaining the reduction in dental caries in Jamaican school children between 1984 and 1995

OBJECTIVE: To assess the methods used and results found in two surveys, one conducted in 1984 and the other in 1995, that indicated a large reduction in the prevalane and severity of dental caries among children in Jamaica, with special attention focused on methodological differences between the two surveys and the biological factors that may explain the large reduction in caries. METHODS: In 1984 a modified "pathfinder" methodology was used to measure the prevalence and severity of dental caries in 6-, 12-, and 25-year-old children in Jamaica. A similar survey was conducted in 1995. A comparison of the two surveys showed an 84 percent reduction in the severity of dental caries at age 12. Both surveys used the same diagnostic criteria and clincal procedures, but the 1984 survey included a higher proprtion of rural residents than did the 1995 one. RESULTS: The data show an epidemiological transition between 1984, when dental caries was highly prevalent and severe, and 1995, when the disease was less prevalent and was concentrated in a smaller proportion of the population. CONCLUSIONS: Most of the reduction in dental caries between 1984 and 1995 is attributable to the introduction, in 1987, of salt flouridation. While the 1995 survey included fewer rural areas than the 1984 survey did, that does not invalidate the observed reduction in dental caries. The use of flouride toothpaste and dietary flouride supplements as well as access to dental health promotion and preventive and curative services do not seem to be major contributors to the reductions observed. (AU)

Urinary fluoride excretion in Jamaica in relation to fluoridated salt

The purpose of this study was to compare the urinary fluoride levels in subtropical Jamaican just before the beginning of salt fluoridation (250mg/kg salt) in 1987 and again 20 months later. Four age groups were studied in three locations with low to intermediate fluoridation as compared with 23.7-67.4 æg/h 20 months after the beginning of the sale of fluoridated salt. The fluoride excretions obtained from 24-hour collections ranged from 169 to 485 æg/24h in 1987 and increased to 304-657 æg/24 h in 1989. In 1987, the morning fluoride excretions approximated those of French and Swiss children who had a low fluoride intake, but the fluoride levels of 1989 were similar to the data obtained from children who had an intake of 1.2-1.7 mg F/day or consumed fluoridated water (AU)

Periodontitis in 13 year-old Jamaica children

The goal of this study was to determine if the Community Periodontal Index and Treatment Need (CPITN) screening method can detect an adolescent group at high risk for alveolar bone due to periodontitis. Forty-five Jamaican children, aged 13 years, with a pocket depth exceeding 3.5 mm on at least on index tooth were identified by CPITN for this cohort study. Current periodontal disease was noted by the presence of bleeding upon probing (97.8 percent) and subgingival calculus (41.5 percent) around the index teeth. Digital imaging software was used to analyze the radiographs and indicated alveolar bone loss greater than 2 mm in 93.3 of subjects and greater than 3 mm in 42.2 percent. The CPITN screening method was shown to be valuable as a tool for identifying this high-risk population (AU)

Periodontitis in 13-year-old Jamaican children

The goal of this study was to determine if the Community Periodontal Index and Treatment Need (CPITN) screening method can detect an adolescent group at high risk for alveolar bone loss due to periodontitis. Forty-five Jamaican children, age 13 years, with a pocket depth exceeding 3.5mm on at least on index tooth were identified by CPITN for this cohort study. Current periodontal disease was noted by the presence of bleeding upon probing (97.8 percent) and subgingival calculus (41.5 percent) around the index teeth. Digital imaging software was used to analyze the radiographs and indicated alveolar bone loss greater than 2mm in 93.3 percent of subjects and greater than 3mm in 42.2 percent. The CPITN screening method was shown to be valuable as a tool for identifying this high-risk population.(AU)

Periodontitis in Jamaican children 13 years of age - abstract

A cohort study of forty-five Jamaican children, aged 13 years, was conducted to examine the periodontal findings of an epidemiology survey of the previous year. All subjects had, in the field survey, at least one index tooth probed to a depth exceeding 3.5 mm, indicating loss of epithelia attachment. A World Health Organization designed peridontal probe was used to assess sulcular bleeding, calculus and probing depth on six index teeth. Anterior and posterior teeth were radiographed. Active peridontal disease is indicated by the presence of bleeding upon probing (97.8 percent) and subgingival calculus (41.5 percent) in the sites with indicated loss of junctional epithelium. Digital imaging software used to analyse the radiographs indicated alveolar bone loss greater than 2 mm in 93.3 percent of subjects and greater than 3 mm in 42.2 percent. The insignificant difference (p=.08) between alveolar bone loss in molar versus premolar sites is strongly suggestive of a generalized form of periodontitis (AU)