RISK-FACTORS FOR ENAMEL FLUOROSIS IN OPTIMALLY FLUORIDATED CHILDREN BORN AFTER THE US MANUFACTURERS DECISION TO REDUCE THE FLUORIDE CONCENTRATION OF INFANT FORMULA

This case-control study investigated risk factors for enamel fluorosis in optimally fluoridated children, born after the US infant formula i ndustry voluntarily reduced the fluoride content of their products, An alysis was performed on 233 children, aged 10-14 years. Case-control s tatus was determined using the Fluorosis Risk Index (FRI), Risk factor exposure was ascertained via a mailed questionnaire. Logistic regress ion analyses revealed a strong association between mild-to-moderate en amel fluorosis on early forming (FRI classification I) enamel surfaces and both fluoride supplement use (odds ratio (OR) = 5.95, 95% confide nce interval (CI) 1.06-33.53), and early fluoride toothpaste use (OR = 6.35, 95% CI 1.21-33.40), The authors found a suggestive, but nonsign ificant, association between fluorosis on these enamel surfaces and in fant formula in the form of powdered concentrate (OR = 4.33, 95% CI 0. 73-25.66). There was a strong association between mild-to-moderate flu orosis on later forming (FRI classification II) enamel surfaces and in fant formula use in the form of powdered concentrate (OR = 10.77, 95% CI 1.89-61.25), fluoride supplement use (OR = 10.83, 95% CI 1.90-61.55 ), and early fluoride toothpaste use (OR = 8.37, 95% CI 1.68-41.72), N o association was observed between the use of ready to feed infant for mula and enamel fluorosis.