RISK-FACTORS FOR ENAMEL FLUOROSIS IN A FLUORIDATED POPULATION

The purpose of this case-control investigation was to investigate the possible association between mile-to moderate enamel fluorosis and exp osure during early childhood to infant formula, fluoride toothpaste, a nd/or fluoride supplements. Analysis was performed on 401 residents of fluoridated communities in Connecticut, who were 12-16 years old and born prior to 1980. The case and control subjects for this study were selected on the basis of a clinical examination given in 1991. Subject fluorosis status was determined using the Fluorosis Risk Index. Risk factor exposure was ascertained via a mailed questionnaire with a resp onse rate of 89% and a questionnaire reliability of 87%. Logistic regr ession analyses, which adjusted for confounding variables, revealed th at mild-to-moderate enamel fluorosis on early forming (Fluorosis Risk Index (FRI) classification I) enamel surfaces was strongly associated with both milk-based (odds ratio (OR) = 3.34, 95% confidence interval (CI) 1.38-8.07) and soy-based (OR = 7.16, 95% CI 1.35-37.89) infant fo rmula use, as well as with frequent brushing (OR = 2.80, 95% CI 1.15-6 .81). A very strong association was observed with inappropriate fluori de supplement use (OR = 23.74, 95% CI 3.43-164.30). Respectively simil ar associations were observed between mild-to-moderate enamel fluorosi s on later forming (FRI classification II) enamel surfaces and frequen t brushing and fluoride supplement use, but not with infant formula us e.