Risk factors of dental fluorosis and fluoride content in drinking water in the far north region of Cameroon

Abstract

Introduction: Dental fluorosis is a developmental disturbance of enamel that results from ingesting high amounts of fluoride during tooth mineralization. Consumption of untreated fluoridated groundwater remains the leading cause of dental fluorosis. Materials and Methods: A descriptive, cross-sectional study conducted between January and September 2021 on individuals who have lived for at least 6 years in the Far North Region of Cameroon using structured questionnaires and oral examination. The Thylstrup and Fejerskov index (TFI) was used to evaluate the severity of dental fluorosis. Fluoride contents of drinking water were analyzed using fluoride electrodes. Results and Discussion: A total of 1971 persons, with a mean age of 17.15 years ± 16.18 standard deviation [SD], were recruited, with 85.64% born in the study area. The prevalence of dental fluorosis was 89.1%. Fluorosis was first observed between the ages of 1 and 10 years; 1781 (90.01%) perceived dental fluorosis as normal, and 1772 (89.90%) did not know the cause of it in their community. A TFI score of 0 was recorded by 10.9% of the population, with higher scores of 3.04 (±2.3 SD) in females and 3.31 (±2.45) among illiterates. 3.49 (±2.3 SD) among farmers and 3.06 (±2.31 SD) for those who lived in their own homes. Sources of drinking water included boreholes 61.6%, 47.4% wells, 2.2% bottled water, while 80% used toothpaste for brushing. One out of five commercial bottled water brands had higher than normal fluoride content (1.60 mgF/L), pipe borne water 1.7 mgF/L, wells 1.90 mgF/L, boreholes 2.80 mgF/L whereas 51.2% of the population presented with mild fluorosis and 23.7% severe fluorosis. Conclusion: The prevalence of dental fluorosis was extremely high. Consumption of groundwater, which is water from boreholes and wells, was the major risk factor for dental fluorosis.