Association between dental fluorosis prevalence and inflammation levels in school-aged children with low-to-moderate fluoride exposure. (1st March 2023)

• Record Type: Journal Article
• Authors: Tang, Huayang; Wang, Mengru; Li, Gaochun; Wang, Mengwei; Luo, Chen; Zhou, Guoyu; Zhao, Qian; Dong, Lixin; Liu, Hongliang; Cui, Yushan; Liu, Li; Zhang, Shun; Wang, Aiguo
• Is Part Of: Environmental pollution. Volume 320(2023)
• Publication Date: 2023-03-01
• Subjects: Fluoride -- Inflammation -- Dental fluorosis -- Interleukin-1β -- C-reactive protein; BMI body mass index -- CRP C-reactive protein -- 95% CI 95% confidence interval -- DF dental fluorosis -- IL-1β interleukin-1β -- IQR interquartile range -- LBW low birth weight -- PR prevalence ratio -- SD standard deviations -- WHO World Health Organization; Pollution -- Periodicals; Pollution -- Environmental aspects -- Periodicals; Environmental Pollution -- Periodicals; Pollution -- Périodiques; Pollution -- Aspect de l'environnement -- Périodiques; Pollution -- Effets physiologiques -- Périodiques; Pollution; Pollution -- Environmental aspects; Periodicals; Electronic journals; 363.73
• DOI: 10.1016/j.envpol.2022.120995
• Languages: English
• ISSNs: 0269-7491

Abstract

Abstract: Inflammation mediates the neurological deficits caused by fluoride. Thus, whether inflammation is the underlying mechanism of dental fluorosis (DF) in school-aged children is worth exploring. A cross-sectional study was conducted to investigate the association between inflammation and the prevalence and severity of DF with low-to-moderate fluoride exposure. Fasting morning urine and venous blood samples were collected from 593 children aged 7–14 years. The fluoride content in the water and urine samples was measured using a fluoride ion-selective electrode assay. The levels of interleukin-1β (IL-1β) and C-reactive protein (CRP) were detected using an enzyme-linked immunosorbent assay. The Dean's index was used when performing dental examinations. Regression, stratified, and mediation analyses were performed to analyze the association between fluoride exposure, inflammation, and DF prevalence. In the adjusted regression models, the prevalence of mild DF was 1.723-fold (95% confidence interval [CI] :1.612, 1.841) and 1.594-fold (1.479, 1.717) greater than that of normal DF for each 1 mg/L increase in water and urinary fluoride content, respectively. The prevalence of mild DF increased by 3.3% for each 1 pg/mL increase in the IL-1β level and by 26.0% for each 1 mg/L increase in the CRP level. Stratified analysis indicated a weaker association between fluoride concentration and DF prevalence in boys than in girls, and susceptibility in the boys was reflected by the association of IL-1β with very mild and moderate DF prevalence. For every 1 mg/L increase in water and urinary fluoride levels, the proportion of IL-1β-mediated effects on the prevalence of mild DF was 10.0% (6.1%, 15.8%) and 8.7% (4.8%, 15.2%), respectively, and the proportion of CRP-mediated effects was 9.2% (5.5%, 14.9%) and 6.1% (3.3%, 11.0%), respectively. This study indicates that the DF prevalence may be sex-specific. Inflammatory factors may partially mediate the increased prevalence of mild DF in school-aged children with low-to-moderate fluoride exposure. Graphical abstract: Image 1 Highlights: Fluoride exposure is positively related to DF prevalence, as well as inflammatory markers. IL-1β and CRP are positively related to DF prevalence and severity. IL-1β and CRP partially mediate the elevated prevalence of DF with fluoride exposure. Gender modifies the associations of DF prevalence with IL-1β and fluoride exposure.