Dental Treatment Data in Children Living in Areas with Elevated Fluoride Content in Water
DOI:
https://doi.org/10.6000/Keywords:
Fluorosis, Enamel hypomineralisation, Early diagnostics, Prevention, Caries, EpidemiologyAbstract
Objectives: This study aimed to comprehensively assess the dental status of children aged 5-11 years
residing in areas with naturally fluoridated water. The study included 486 children, selected by age and permanent
residence using randomisation in Kyzyl-Suu and a continuous survey in Orgochor. Dental status was assessed
according to World Health Organization recommendations using the KPUp+kpp and KPUz+kpz indices, while oral
hygiene was evaluated using the Fedorov-Volodkina index.
Methods: The concentration of fluorides in drinking water was determined by the potentiometric method, with multiple
samples collected at different times of day. Statistical processing of the data involved the use of the standard error of the
mean (m), Student's t-test, and quantile-quantile plots to assess distribution normality. The results showed that the
prevalence of caries among children aged 5-11 years ranged from 93.1% to 100%, depending on age group and place of
residence: in Kyzyl-Suu it reached 100% in all groups except 10-11 years (96.0%), while in Orgochor it varied from
93.1% (7 years) to 98.5% (10-11 years), with a clear age-related trend towards a decline in the incidence of deciduous
teeth caries and a simultaneous increase in the intensity of damage to permanent teeth.
Findings: In Orgochor, where the fluoride concentration was 1.44 mg/l, a moderate decrease in caries activity was
observed; however, the incidence of fluorosis reached 27.3%. More than 60% of children had unsatisfactory or poor oral
hygiene, which further aggravated the risk of dental diseases. The relationships identified between fluoride levels,
hygiene conditions, and the prevalence of pathology indicate a complex interdependence of risk factors in the study
population.
Conclusions: The findings underscore the need for comprehensive sanitary control, educational programmes, and
regular monitoring of drinking water quality to prevent dental diseases in paediatric populations.
References
[1] Saad H, Escoube R, Babajko S, Houari S. Fluoride intake
through dental care products: A systematic review. Front Oral
Health 2022; 3: 916372.
https://doi.org/10.3389/froh.2022.916372
[2] Mfundisi KB, Marebole MK, Kaisara K. Fluoride concentration
in selected water sources of Ngamiland and Boteti districts:
Risk of dental fluorosis. J Civil Eng Urban 2024; 14(3S): 158-
63.
https://doi.org/10.54203/jceu.2024.15
[3] Madali B, Inan-Eroglu E, Ozsin-Ozler C, Karahan S, UzamısTekcicek M, Buyuktuncer Z. Development and validation of a
comprehensive food frequency questionnaire related to
dental health in children: A pilot study. Clin Nutr ESPEN
2023; 54: 130-6.
https://doi.org/10.1016/j.clnesp.2023.01.010
[4] Adeghe EP. The multifaceted role of fluoride in preventing
early childhood caries: A comprehensive review. Int J Life Sci
Res Updates 2024; 2(1): 9-17.
https://doi.org/10.53430/ijlsru.2024.2.1.0022
[5] Sanders AE, Divaris K, Godebo TR, Slade GD. Effect of
bottled fluoridated water to prevent dental caries in primary
teeth: Study protocol for a phase 2 RCT (waterBEST). Trials
2024; 25: 167.
https://doi.org/10.1186/s13063-024-08000-4
[6] Demarchi P, Garbarino F, Mascolo A, Silvestrini Biavati F,
Ugolini A. Fluorosis and oral health status in adolescents
living in a high-fluoride groundwater area: Nairobi suburbs
(Kenya). Appl Sci 2023; 13(1): 368.
https://doi.org/10.3390/app13010368
[7] Molczyk-Sieńczak J, Gorzyński R, Kurek J, Gadomska A,
Garstka M, Dominik H, et al. Fluoride prophylaxis: Poison or
simple way to prevent early childhood caries? J Educ Health
Sport 2023; 24(1): 87-98.
https://doi.org/10.12775/JEHS.2023.24.01.009
[8] Kaur D, Kaur K, Sharma A, Goyal H, Pahuja A, Solanki D.
Assessment of fluoride in water and its impact on IQ in
schoolchildren aged 12-13 years. Cureus 2022; 14(10):
e30157.
https://doi.org/10.7759/cureus.30157
[9] Kamchybekova ASh, Cholokova GS, Abykeeva RS,
Tynalieva RA, Tynalieva DM. Prevalence and intensity of
tooth decay in early-age children. Eurasian Health J 2022;
2(2): 143-6.
[10] Li Y, Ma L, Abuduwaili J, Abdyzhapar uulu S. Spatiotemporal
distributions of fluoride and arsenic in rivers and related
health risks in Kyrgyzstan. Water 2021; 11(9): 1893.
https://doi.org/10.3390/w11091893
[11] International Organisation for Standardisation (ISO). ISO
5667-3: 2024: Water quality - Sampling - Part 3: Preservation
and handling of water samples 2024 [cited 2025 Oct 24].
Available from: https: //www.iso.org/standard/82273.html
[12] Thermo Scientific. Orion fluoride ion selective electrode user
guide. Waltham (MA): Thermo Fisher Scientific; 2018.
222 International Journal of Child Health and Nutrition, 2026, Vol. 15, No. 3 Kamchybekova et al.
[13] International Organisation for Standardisation (ISO). GOST
ISO/IEC 17025-2019: General requirements for the
competence of testing and calibration laboratories 2019
[cited 2025 Oct 24]. Available from: https:
//metrcons.ru/info/zakonodatelstvo/standarty/gost-iso-iec17025-2019-mezhgosudarstvennyy-standart-obshchietrebovaniya-k-kompetentnosti-ispytatel/
[14] Shende V, Wagh V. Assessment of dental morbidity in
school-going children (6-10 years): A cross-sectional study.
F1000Res 2024; 13: 236.
https://doi.org/10.12688/f1000research.147105.1
[15] Kostenko YY, Melnyk VS, Horzov LF, Kostenko SB.
Prevalence of main dental diseases in children living in
biogeochemical fluorine and iodine deficiency. Dent Res J
2019; 16(4): 271-5.
[16] Godovanets OI, Kotelban AV. Indicators of permanent teeth
caries prevalence in 12- and 15-year-olds. Her Dent 2020;
36(2): 80-4.
https://doi.org/10.35220/2078-8916-2020-36-2-80-84
[17] Kozma A, Iordan Dumitru AD, Bodnar C, Agop-Forna D.
Tooth decay incidence in children aged 3-6 years. ARS Med
Tomitana 2018; 24(4): 174-8.
https://doi.org/10.2478/arsm-2018-0036
[18] Kaskova LF, Sadovski MO. Oral hygiene, salivation rate and
oral fluid viscosity in 3-6-year-old children considering caries
activity. Ukr Dent Almanac 2022; 3: 52-6.
https://doi.org/10.31718/2409-0255.3.2022.11
[19] Mania L, Nanobashvili K, Sakvarelidze I. Oral health status
and lifestyle behaviors among children aged 7-12 years in
Tbilisi. Caucasus J Soc Sci 2023; 16(1): 101-13.
https://doi.org/10.62343/cjss.2023.235
[20] Jaiswal D, Kalia P, Hiremath S, Singh AK, Pani P, Kumar N.
Oral hygiene status among 12-14-year-old schoolchildren. J
Pharm Bioall Sci 2023; 13(S1): 112-5.
https://doi.org/10.4103/jpbs.JPBS_590_20
[21] Syarah Rulifa N, Asia A. Quality of life related to dental and
oral health in preschool children in Batam. Trisakti Dent J
2023; 5(2): 57-60.
https://doi.org/10.25105/jkgt.v5i2.18842
[22] Celepkolu T, Toptancı IR, Erten Bucaktepe PG, Sen V,
Dogan MS, Kars V, et al. A microbiological assessment of
oral hygiene of 24-72-month-old kindergarten children and
disinfection of their toothbrushes. BMC Oral Health 2014; 14:
94.
https://doi.org/10.1186/1472-6831-14-94
[23] Shalini S, Sharma S, Anand A, Almalki SA, Biswas A,
Sharma M, et al. Prevalence of dental caries, oral hygiene
status, deft index, and oral hygiene habits among children
with special healthcare needs. Cureus 2023; 15(7): e42416.
https://doi.org/10.7759/cureus.42416
[24] Shruthi MN, Anil NS. Comparative study of dental fluorosis
and non-skeletal manifestations in areas with different water
fluoride concentrations in rural Kolar. J Family Med Prim
Care 2018; 7(6): 1222-8.
https://doi.org/10.4103/jfmpc.jfmpc_72_18
[25] Mihalas E, Gavrila L, Sirghe A, Toma V, Decolli Y, Savin C.
Evaluation of fluoride concentration in commercially available
bottled water in Romania: A potential risk factor for dental
fluorosis. Appl Sci 2023; 13(13): 7563.
https://doi.org/10.3390/app13137563
[26] Stepco E, Ferdohleb A, Ciobanu E, Patranac M. Water
pollution with fluoride in the Republic of Moldova and its
impact on oral health. J Health Sci 2023; 24(1): 72-8.
https://doi.org/10.53530/1857-1328.24.1.25
[27] Pandora IP, Vidanti AFZ, Kes TM. Relationship between
fluoride concentration in drinking water and dental fluorosis in
children aged 6-15 years. World J Adv Res Rev 2024; 23(3):
133-40.
https://doi.org/10.30574/wjarr.2024.23.3.2592
[28] Martignon S, Bartlett D, Manton DJ, Martinez-Mier EA,
Splieth C, Avila V. Epidemiology of erosive tooth wear, dental
fluorosis and molar incisor hypomineralization in the
American continent. Caries Res 2021; 55(1): 1-11.
https://doi.org/10.1159/000512483
[29] Sidhu L, Boobalan S. Dental fluorosis: A review. Int J
Community Dent 2023; 11(1): 1-6.
[30] Vasisth D, Mehra P, Yadav L, Kumari V, Bhatia U, Garg R.
Fluoride and its implications on oral health: A review. J
Pharm Bioall Sci 2024; 16(S1): S49-S52.
https://doi.org/10.4103/jpbs.jpbs_929_23
[31] Taher MK, Momoli F, Go J, Hagiwara S, Ramoju S, Hu X, et
al. Systematic review of epidemiological and toxicological
evidence on health effects of fluoride in drinking water. Crit
Rev Toxicol 2024; 54(1): 2-34.
https://doi.org/10.1080/10408444.2023.2295338
[32] Dakhno L, Vyshemyrska T, Burlakov P, Storozhenko K, Flis
P. Feasibility of cone-beam CT in children for diagnostics, 3D
cephalometry and orthodontic planning: A review. Georg
Med News 2022; 323: 54-60.
[33] Dakhno LA, Vyshemyrska T, Burlakov P, GoncharukKhomyn M, Rashchenko N. New three-dimensional
cephalometric analysis using medium FOV CBCT scans:
Normality values for children aged 7-12 years. J Int Dent
Med Res 2023; 16(4): 1687-700.
[34] Pontigo-Loyola AP, Mendoza-Rodriguez M, de la RosaSantillana R, Rivera-Pacheco MG, Islas-Granillo H,
Casanova-Rosado JF, et al. Control of dental caries in
children and adolescents using fluoride: Overview of
community-level fluoridation methods. Pediatr Rep 2024;
16(2): 243-53.
https://doi.org/10.3390/pediatric16020021
[35] Collantes Acuña J, Figueroa Díaz MJ, Gualpa Arequipa KS.
Dental management of dental fluorosis in children. LatArXiv
Preprints 2024; 105: 1-8.
https://doi.org/10.62059/LatArXiv.preprints.105
[36] Chaqqanov FX. Medical aspects of comprehensive
prevention and treatment of fluorosis in children living in an
endemic area. Eur Int J Multidiscip Res Manag Stud 2024;
4(12): 255-61.
https://doi.org/10.55640/eijmrms-04-12-46
[37] Dovramadjiev T, Pavlova D, Filchev R, Dimova R, Dimov D,
Kavaldzhieva K, et al. Technological and human approach in
complete restoration of dental teeth jaws with biocompatible
materials. Lect Notes Netw Syst 2023; 645: 497-506.
https://doi.org/10.1007/978-981-99-0769-4_43
[38] Alamoudi RM, Martaa FM, Alqahtani FA, Alshahri AM,
Aboqraihah MN, Alharbi RE, et al. Fluoride use in pediatric
dentistry: Balancing benefits and risks. Int J Community Med
Public Health 2025; 12(2): 1021-5.
https://doi.org/10.18203/2394-6040.ijcmph20250048
[39] Yaremchuk NI, Oshurko AP, Oliinyk IY. Dynamics of
morphological rearrangement of mandibular bone tissue after
loss of masticatory teeth. Pol Merkur Lek 2023; 51(2): 120-7.
https://doi.org/10.36740/Merkur202302103
[40] Babayeva NN. Modern aspects of professional oral hygiene:
Plaque removal in smokers. Azerbaijan Med J 2010; 2: 141-
2.
[41] Postic SD. Influence of balanced occlusion in complete
dentures on the decrease in the reduction of an edentulous
ridge. Vojnosanit Pregl 2012; 69(12): 1055-60.
https://doi.org/10.2298/VSP110716017P
[42] Postic SD. Specific occlusal scheme for partially edentulous
patients with TMD signs: Preliminary report. J Stomatol Oral
Maxillofac Surg 2018; 119(4): 337-47.
https://doi.org/10.1016/j.jormas.2018.04.009
[43] Trifkovic B, Budak I, Vukelic D, Puskar T, Jevremovic D,
Todorovic A, et al. Analysis of accuracy and precision of
optical 3D digitisation devices in dental CAD/CAM systems.
Maejo Int J Sci Technol 2017; 11(1): 45-57.
Dental Treatment Data in Children Living in Areas International Journal of Child Health and Nutrition, 2026, Vol. 15, No. 3 223
[44] Nowak R, Nowak-Gospodarowicz I, Rekas M, Ali MJ. Virtual
reality and mixed reality-assisted endoscopic DCR in
extremely complex lacrimal obstructions. Laryngoscope
2024; 134(8): 3508-15.
https://doi.org/10.1002/lary.31399
[45] Nowak R, Rekas M, Ali MJ. Long-term quality of life following
minimally invasive conjunctivodacryocystorhinostomy with
StopLoss Jones tube. Ophthal Plast Reconstr Surg 2022;
38(2): 170-5.
https://doi.org/10.1097/IOP.0000000000002017
[46] Orgoványi P, Karches T. GIS-based model parameter
enhancement for urban water utility networks. Urban Sci
2024; 8(2): 35.
https://doi.org/10.3390/urbansci8020035
[47] Montayev S, Ongayev M, Begalieva R, Ryskaliev M,
Denizbayev S, Sorption treatment and desalination of
mineralized water using Opoka to reduce hardness and
chloride content. Int J Des Natur Ecodyn 2024; 19(5): 1733-
40.
https://doi.org/10.18280/ijdne.190527
[48] Nowak R, Rekas M, Ali MJ. Long-term outcomes of
StopLoss™ Jones tube (SLJT) and minimally invasive
conjunctivodacryocystorhinostomy. Graefes Arch Clin Exp
Ophthalmol 2022; 260(1): 327-33.
https://doi.org/10.1007/s00417-021-05347-1
[49] Logvynenko I, Dakhno L, Bursova V. Effectiveness of topical
dexamethasone during sagittal split osteotomy of the
mandible in reducing postoperative neurosensory symptoms.
BMC Surg 2025; 25(1): 76.
https://doi.org/10.1186/s12893-025-02803-1
[50] Flis PS, Ivanova KV, Dakhno LO. Prevalence of
malocclusions in children aged 6-13 years living in Kyiv and
Kyiv region. Ukr Dent Almanac 2021; 4: 42-7.
Published
Issue
Section
License
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .
