Fluoride removal and its impact on oral health in Sri Lanka's dry zone: Discussion and recommendation

Fifty percent of the dry zone areas in Sri Lanka have fluoride levels above 1 ppm. This paper discusses the ground conditions and recommends an appropriate range of fluoride in drinking water which can support preventive practices for improving the oral health of children 8-years old and younger. In efforts to address the Chronic Kidney Disease of Unknown etiology (CKDU), water treatment to reduce contaminant level in potable water has been implemented. Such treatment would also remove fluoride and has resulted in potable water with various fluoride levels, depending on concentrations in the raw water. While it is important to reduce fluoride levels, it is important to have appropriate residual levels for prevention of dental caries. It needs, however, to be noted fluoride in excess can cause dental fluorosis. In Sri Lanka's dry zone areas increasing prevalence of dental fluorosis with decreasing prevalence of dental caries has been noted. Consumption of tea and powdered milk could increase total intake of fluoride. Fluoridated toothpaste, when used properly, may, however, result in negligible intake of fluoride. Sri Lanka's hot tropical climate which results in substantial intake of fluids reinforces the need to consider reduction in water fluoride. Consideration of local studies and international standards indicate fluoride levels should be in the range of 0.225–0.500 ppm. In the range of 0.225–0.500 ppm, the prevalence of dental fluorosis and caries was only 14% and 8%, respectively, in an endemic district. When fluoride levels are above 0.500 ppm, the issue of dental fluorosis shall need to be addressed. When levels are below 0.225 ppm, oral health care services shall need to be directed at preventing dental caries.     

茶防龋研究进展

从流行病学和临床效果、防龋物质及作用机制、模拟实验和动物实验几个方面对国内外茶防龋研究进行综述,提出研究中亟待解决的问题,预示了茶防龋今后的发展方向和前景。     

一种赤腹松鼠种群数量的估计方法

赤腹松鼠剥食树皮的行为对林木危害严重,根据野外长期的观察和研究发现,赤腹松鼠在剥落树皮上遗留下来的上门齿齿印间距具有个体差异,可以用作个体识别的依据.对2003年监测样地内赤腹松鼠在剥落树皮上的齿印间距测量记录,并统计分析以估计赤腹松鼠的个体数量.结果表明:种群数量与危害率的相关系数为0.876,P=0.01,表现出很强的正相关关系;显示在较小面积内,该方法可以用来估计赤腹松鼠的个体数量.同时对该方法的基本条件和局限进行了讨论.图2表4参10     

Dental Fluorosis in Wild Deer: Its Use as a Biomarker of Increased Fluoride Exposure

The relationships between age (range: 3 to 14 yr), mandibular bone fluoride level (marker of accumulated internal dose, range: 597 to 4680 mg F^- kg^-1> dry wt) and intensity of dental fluorosis (reflecting fluoride exposure during enamel formation) were studied in a sample of 53 fluorosed red deer from a fluoride-polluted area in the Czech-German border region (Ore mountains and their southern foreland). Assessment of the severity of dental fluorosis was performed for the 3 permanent premolars and 3 molars of one hemimandible per animal by using an ordinal measurement scale. For statistical analysis, the maximum tooth score of fluorosis (MTS) and the dental lesion index of fluorosis (DLI, sum of the six tooth scores per individual) were used. In the sample, both MTS (r_s = 0.850) and DLI (r_s = 0.813) were highly significantly (p <0.00001) correlated with bone fluoride content. A weaker correlation existed between age and bone fluoride content (r_s = 0.322, p <0.05). The results demonstrate that in case of regional, long-term fluoride pollution, dental fluorosis (measured as MTS or DLI) can be used as a sensitive biomarker of fluoride exposure in deer and thus as an indicator of the level of environmental contamination by fluorides. In many countries, skulls and mandibles of wild deer are regularly and continuously collected by hunters. Assessment of the prevalence and severity of dental fluorosis in this material offers the opportunity for an efficient large-scale biomonitoring of environmental pollution by fluorides at very low cost.     

Exposure to Methyl Methacrylate and Its Subjective Symptoms Among Dental Technicians,Tehran, Iran

Exposure to methyl methacrylate (MMA), total dust and health symptoms were investigated in 20 dental laboratories located in Tehran, Iran. Time-weighted average (TWA) of MMA and peak concentrations were determined, using XAD-2 tubes followed by GC-ID analysis. Total dusts were evaluated gravimetrically. Health symptoms were asked using a questionnaire. TWA for technicians with direct and indirect exposure to MMA were 327.28 ± 79.42 and 282.9 ± 41.84 mg/m³ , respectively. Peak concentration of MMA for those technicians were 337.0 ± 36.81 and 328.88 ± 45.40 mg/m³, respectively.

There were no significant differences between TWA of MMA and peak concentration in different weekly workdays; however, within-day variations were observed (P < .05).

TWA of MMA and peak concentration correlation with the laboratory volume were 0.61-0.65. Dust exposure of technicians was 2.35 ± 2.70 mg/m³. Cough and skin dryness were the common health symptoms. Smoking and asbestos exposure history were factors influencing cough prevalence (p < .05).

It is concluded that the current Short-Term Exposure Limit (STEL) is not low enough to protect technicians against the adverse effects caused by MMA.     

我国部分城市和地区居民尿氟含量与饮用水氟含量的相关性

对中国22个城市、2个直辖市和饮水氟含量极高的河北省霸州地区4个村庄的饮用水氟含量与当地18岁左右居民尿氟含量进行相关性分析。结果表明,全国大部分城市饮用水氟含量处于低水平。而包括氟中毒地区在内的全国部分城市和地区饮用水氟含量与尿氟含量存在正相关关系,表明相对其它摄取氟元素渠道来说,饮用水仍然是中国居民氟的主要摄入来源。     

Determining the age of cyclomorphic rodents: Functional-ontogenetic determination,ecological aspects

Functional-ontogenetic determination of age-dependent dental changes (ADCs) in voles has been demonstrated. The relationship between ADCs and the functional state of animals has been analyzed. A scheme and a table for determining individual chronological and biological ages in the bank vole (Clethrionomys glareolus Sch.) are proposed, which markedly improve the accuracy of results. Cases of rodent maturation and breeding in winter are considered.     

Variability of Musculoskeletal Strain on Dentists: An Electromyographic and Goniometric Study

Introduction. Dentists and hygienists are strongly affected by musculoskeletal disorders (MSDs). As workstation concepts are supported by subjective arguments only, the aim of this study was to use objective measurements to compare the variability of strain in various concepts: a dental chair equipped with a cart or an over-the-patient delivery system without an assistant, and Dr Daryl Beach’s concept with an assistant. Methods. Goniometric and electromyographic recordings were made on 8 subjects, during a scaling operation. The electrical activity of their trapezius and lumbar muscles was compared, as were their cervical and lumbar ranges of motion. Results. The results showed that there was a wide variability depending on the workstation. However, the Beach concept tended to reduce physical strain on most parameters: duration of left lumbar muscle activity (2% compared to 15% of time spent in >10% maximal voluntary contraction, MVC), time spent in cervical side bending (4% compared to 30%), cervical flexion of >20° (9% compared to 40%), and left trapezius activity (9% of time spent >10% MVC compared to 28%). Conclusion. Practitioners and students should adjust their workstations to reduce the prevalence of MSDs.     

The Correlation Between Symptoms,Frequent Use of Dental Polymers,and Evaluation of Health Risk

Dental personnel are at risk as they manually handle polymer products containing monomers and additives that cause irritation and induce allergy. Gloves and face masks can be easily penetrated by monomers. A total of 587 dental personnel and a referent group (585) in the 2 most northern regions of Sweden were included in a questionnaire study (response rate 76%). Questions were asked regarding symptoms of atopy, asthma, conjunctivitis, atopic dermatitis, hand dermatitis, and hay fever/rhinitis. The dental personnel were asked to give the name of polymer products used in their practice and the frequency of use. They were also asked to risk evaluate 5 different types of polymer materials on a scale from 1 to 5. Analysis was done to find if the occurrence of a symptom was associated with a high risk evaluation of a polymer material, or with frequent use of a certain polymer product. Significantly more dentists reported symptoms of atopic dermatitis and conjunctivitis compared to referents and chair assistants. Results show that dental personnel with symptoms risk evaluated most materials significantly higher than dental personnel without symptoms. Further, the occurrence of some symptoms was associated with frequent use of 8 polymer products.     

Dental Workers,Musculoskeletal CumulativeTrauma,and Carpal Tunnel Syndrome: Who is at Risk? A Pilot Study

A pilot study was conducted at a dental clinic to identify (a) the prevalence of musculoskeletal cumulative trauma disorders (MCTD), (b) associated symptoms (with special attention paid to carpal tunnel syndrome [CTS]), and (c) practitioners at risk. Videotapes, two questionnaires, a medical record review, and interviews were used. Forty-five dental workers participated and were classified into three categories: (a) dentists, (b) dental assistants and special assistants (DA/SA), and (c) dental hygienists and dental assistant-expanded function (DH/DAEF). Categorical data were analyzed using the chi- square statistic and risk ratios. The Fisher exact probability test was used for categorical data with a small cell. One or more symptoms associated with CTS were noted by 75.6% of the dental workers, 11% reported diagnosed CTS, and 53% reported back and shoulder pain. Both psychosocial factors and job demands appear to be associated with MCTD. All three categories of dental workers reported MCTD symptoms, and the DH/DAEF group was found to be at greatest risk for developing upper extremity symptoms, CTS, and back pain.