RISK-FACTORS FOR ENAMEL FLUOROSIS IN A NONFLUORIDATED POPULATION

The purpose of this case-control investigation was to investigate the possible association between mild-to-moderate enamel fluorosis and exp osure during early childhood to fluoride supplements, fluoride toothpa ste, and/or infant formula use in nonfluoridated communities. Analysis was performed on 460 10- to 13-year-old children, born after 1979, wh o were residents of six nonfluoridated communities in Massachusetts an d Connecticut. The fluorosis status of the subjects was determined on the basis of a clinical dental examination using the Fluorosis Risk In dex (FRI). Risk factor exposure was ascertained via a mailed questionn aire with a response rate of 90% and a questionnaire reliability of 87 %. Logistic regression analyses revealed a moderate association betwee n mild-to-moderate enamel fluorosis on early forming (FRI classificati on I) enamel surfaces and both fluoride supplement use (odds ratio (OR ) = 2.25, 95% confidence interval (CI) 1.08-4.69) and early toothbrush ing habits (OR = 2.56, 95% CI 1.34-4.88). There was a strong associati on between mild-to-moderate fluorosis on later forming (FRI classifica tion II) enamel surfaces and both supplement use (OR = 7.97, 95% CI 2. 98-21.33) and early toothbrushing habits (OR = 4.23, 95% CI 1.72-10.41 ). Infant formula was not found to be associated with fluorosis on eit her FRI classification I or II surfaces.