Total fluoride intake and urinary excretion in 4-year-old Iranian childrenresiding in low-fluoride areas

Knowledge of levels of fluoride ingestion and excretion is important in pla nning optimum fluoride therapy for young children. In previous literature, it has been assumed that only about one-third of ingested fluoride is excre ted in young children. The aims of the present study were (a) to measure to tal fluoride intake, urinary fluoride excretion and fluoride balance, and ( b) to investigate the effect of air temperature on fluoride intake and urin ary fluoride excretion, in young children. Children (4 years old) living in a city, a small town and rural areas of Fars province, iran, where drinkin g water contained 0.30-0.39 mg F/l, were invited to participate. Selection of subjects was by random sampling of kindergartens or health centres. The children were surveyed twice, once in summer and once in winter. Diet was o btained by 3 d diaries with interview. Samples of most foods and drinks wer e analysed for fluoride content. Ingestion of fluoride from toothpaste was estimated for each child. Each child's urine was collected over 24 h and an alysed for fluoride content. Seventy-eight of the 116 volunteers completed all aspects of the study, which was conducted in 1995-6. For all children, the mean fluoride ingestion from diet was 0.390 (SD 0.122) mg/d or 0.028 (S D 0.008) mg/kg body weight per d. Fluoride ingestion from diet was higher i n summer and higher in rural areas. The mean ingestion of fluoride from all sources was 0.426 (SD 0.126) mg/d and the mean fluoride urinary excretion was 0.339 (SD 0.100) mg/d. The difference between ingestion and urinary exc retion was +0.087 (SD 0.143) mg, equivalent to 80 % excretion. Faecal excre tion was not estimated. The results indicate fluoride retention at 4 years to be much lower than previously assumed.