Prevalence and extent of enamel defects in the permanent teeth of 8‐year‐old Nigerian children

摘要

Abstract Objectives Enamel formation is a vulnerable developmental process, susceptible to environmental influences such as excessive systemic fluoride (F) exposure and infant/childhood disease. This study determined prevalence and extent of developmental enamel defects ( DDE ) and dental fluorosis in 8‐year‐old Nigerians and explored associations with key predictors. Methods A sample of 322 healthy 8‐year‐olds (155 males, 167 females) from primary schools in lower and higher water F areas of (i) rural and (ii) urban parts of Oyo State in south‐west Nigeria (n = 4 areas) (in which the mean ( SD ) F concentration of community water supplies ranged from 0.07 (0.02) to 2.13 (0.64) mg F/L) were dentally examined using modified DDE ( mDDE ) and Thylstrup and Fejerskov ( TF ) indices. Drinking waters, cooking waters and toothpaste samples were analysed for F concentration using a F ion‐selective electrode (F‐ ISE ). Information on infant/childhood diseases, infant feeding and tooth cleaning practices was obtained from parents/legal guardians. Data were analysed using ANOVA , chi‐square tests, Spearman correlation and binary logistic regression as appropriate. Results Mean ( SD ) F concentration of actual drinking and actual cooking waters consumed by participants was 0.25 (0.20) and 0.24 (0.14) mg F/L respectively in the urban higher F area; 1.11 (1.00) and 1.16 (1.02) mg F/L, respectively in the rural higher F area ( P .05). Overall, mouth prevalence of DDE in the permanent dentition was 61.2% with a mean ( SD ) of 2.4 (2.2) index teeth affected. Dental fluorosis mouth prevalence was 29.8% with a mean of 2.1 (3.7) teeth affected. Prevalence and extent of DDE and dental fluorosis were greater in higher F than lower water F areas ( P .001). A weak positive correlation was seen between extent of dental fluorosis and drinking water F concentration (ρ = 0.28). The absence of infant/childhood disease was associated with a lower risk of DDE being present ( P = .001), with an odds ratio of 0.43 (95% CI = 0.26, 0.71). Gender was a statistically significant ( P = .014) predictor for dental fluorosis with females having a higher risk OR 1.94 (95% CI = 1.14, 3.28) of dental fluorosis than males. Conclusions In these Nigerian 8‐year‐olds (n = 322), mouth prevalence of DDE was 61.2% (mean ( SD ) teeth affected = 2.4 (2.2)), and a key positive predictor was a history of infant/childhood disease. With 29.8% of these children exhibiting dental fluorosis (mean ( SD ) teeth affected = 2.1(3.7)), drinking water F concentration was identified as a positive predictor, along with gender, with females more at risk of dental fluorosis than males.