Investigation of dental fluorosis and dental caries among children in drinking water-borne endemic fluorosis areas of Shaanxi province in 2023
Objective To understand the prevalence of dental fluorosis and dental caries and urinary fluoride levels in children aged 8-12 after the water-improvement in drinking water-borne endemic fluorosis in Shaanxi province,and to provide the scientific basis for comprehensive prevention and control in the later stage.Methods From April to October 2023,11 drinking water-borne endemic fluorosis counties in 7 cities were chosen by random sampling.In each county five villages were chosen as the investigated villages.To investigate the operation of water improvement projects and water fluorine content in per village,and dental fluorosis and dental caries were examined in all children aged 8-12 in the village,and 50 children were randomly selected according to the age group to collect instant urine samples to determine urinary fluoride concentration.The dental fluorosis was determined by"Diagnosis of Dental Fluorosis"(WS/T 208-2011).Dental caries was determined by"Oral Health Surveys:Basic Methods.5th ed".Urinary fluoride was determined by"Determination of Fluoride in Urine-Ion Selective Electrode Method"(WS/T 89-2015).Results The monitoring villages had all completed water improvement project,and all of the water-improved projects were operating normally.Totally 81 endemic fluorosis villages were investigated,all of which had been constructed the water-improved projects and operated normally.The range of water fluoride was 0.10-3.15 mg/L.There were 6 villages with excessive water fluoride levels,accounting for 7.41％.Totally 7 008 children aged 8-12 were investigated and 399 with dental fluorosis,and the detection rate of dental fluorosis was 5.69％,and the dental fluorosis index was 0.09.The patients were mainly very light and mild.The detection rate of children with fluorosis in villages without qualified water fluoride content was higher than that in villages with qualified water fluoride content(P＜0.01).With the increase of age,the detection rate of dental fluorosis in children was on the rise(P＜0.001).The rate of dental caries in children aged 8-12 was 22.29％.In all water fluoride content groups,the dental caries rates in 0.3-0.6 mg/L groups was 30.60％,which were higher than other groups.Totally 2 275 children's urine samples were detected,the urinary fluoride concentration ranged from 0.10 to 7.96 mg/L,and the geometric mean was 1.17 mg/L.The urinary fluoride concentration in villages without qualified water fluoride content was higher than that in villages with qualified water fluoride content(P＜0.001).Conclusion The prevalence rate of children dental fluorosis is lower than the national control standard,and the caries rate is higher in some areas.There still are villages with excessive water fluoride after water-improvement.In the future,it is necessary to strengthen the later management and upgrading of water-improving project.Continuously increasing health education on fluorosis knowledge,increase the education of children's oral health knowledge.
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