Risk-Benefit Balance in the Use of Fluoride among Young Children

This study aimed to evaluate the risk-benefit balance of several fluoride exposures. Fluoride exposure history of randomly selected children was collected for calculation of exposure to fluoridated water, toothpaste, and other fluoride sources. We evaluated the risk-benefit balance of fluoride exposure by comparing dental fluorosis on maxillary central incisors, recorded at the time of the study with the use of the Thylstrup and Fejerskov Index, and deciduous caries experience, recorded at age six years, of the same group of South Australian children who were from 8 to 13 years old in 2002–03. Population Attributable Risk for fluorosis and Population Prevented Fraction for caries were estimated. Fluorosis prevalence was found to be 11.3%; caries prevalence, 32.3%; mean dmfs, 1.57 (SD 3.3). Exposure to fluoridated water was positively associated with fluorosis, but was negatively associated with caries. Using 1000-ppm-F toothpaste (compared with 400- to 550-ppm-F toothpaste) and eating/licking toothpaste were associated with higher risk of fluorosis without additional benefit in caries protection. Evaluation of the risk-benefit balance of fluoride exposure provides evidence to assist in the formulation of appropriate guidelines for fluoride use.

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A Catch in `a Catch in the Reye'

PEDIATRICS ◽

10.1542/peds.82.4.676a ◽

1988 ◽

Vol 82 (4) ◽

pp. 676-677

Author(s):

PATRICK L. REMINGTON ◽

KEVIN SULLIVAN ◽

JAMES S. MARKS

Keyword(s):

Risk Factor ◽

Relative Risk ◽

Small Proportion ◽

Population Attributable Risk ◽

Attributable Risk ◽

Reye Syndrome ◽

History Of ◽

The Relationship

To the Editor.— The "Catch in the Reye"1 is not in the data but rather in the authors' interpretation. They incorrectly surmise that finding that only one in 20 patients with Reye syndrome had taken aspirin makes it unlikely that aspirin is a risk factor for Reye syndrome. This conclusion ignores the relationship between the prevalence of a risk factor (such as aspirin), the relative risk (RR), and the population attributable risk (PAR). In a population in which aspirin use is uncommon, such as Australia, only a small proportion of all patients with Reye syndrome will have a history of aspirin use.

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Relationship between Obesity and Dental Caries in Saudi Male Adolescents

International Journal of Dentistry ◽

10.1155/2020/8811974 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Asim Al-Ansari ◽

Muhammad Nazir

Keyword(s):

Public Health ◽

Dental Caries ◽

Odds Ratio ◽

Caries Experience ◽

Caries Prevalence ◽

Male Adolescents ◽

Untreated Caries ◽

History Of ◽

The Mean ◽

History Of Obesity

Introduction. Obesity and dental caries are global public health problems. There are conflicting reports about the relationship between caries and obesity. Therefore, the study aimed to investigate the association between obesity and dental caries among male adolescents. Materials and Methods. This cross-sectional study included a sample of 258 male students’ aged 12 to 15 years from schools in Dammam/Al-Khobar, Saudi Arabia. The study involved measuring caries prevalence and DMFT estimates, assessing body mass index (BMI), and administering a self-completion questionnaire. Independent samples Student’s t-test, one-way ANOVA test, Pearson’s correlation test, and bivariate and multivariate logistic regression analyses were performed. Results. Caries prevalence of the sample was 79.8%, and the mean score of DMFT was 3.55 ± 2.94. The mean BMI of participants was 23.42 ± 6.82 and 18% were obese (BMI > 30). The obese participants had a higher mean DMFT score (4.46 ± 3.54) than nonobese participants (3.35 ± 2.77) (P=0.021). Similarly, the mean untreated caries was higher in obese (4.17 ± 3.22) than in nonobese participants (3.01 ± 2.66) (P=0.010). In the logistic regression analysis, after controlling for father’s education, family history of obesity, meals per day, fast food per week, and physical activity in the final model, the participants with high caries experience (DMFT = 5–15) were 2.21 times more likely to have obesity than those with low caries experience (DMFT = 0–4) (P=0.04). No/school education of father (odds ratio 3.54, P=0.011), family history of obesity (odds ratio 3.27, P=0.002), and not performing physical activity (odds ratio 4.37, P=0.002) were significantly associated with an increased likelihood of obesity. Conclusion. The prevalence of caries and obesity was high in male adolescents in Saudi Arabia. Obesity was significantly associated with untreated caries and caries experience. Children with high caries experience were more likely to have obesity than children with low caries experience. Preventive programs and policies should address public health issues related to caries and obesity in male teenagers.

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Fluoride Revolution and Dental Caries: Evolution of Policies for Global Use

Journal of Dental Research ◽

10.1177/0022034519843495 ◽

2019 ◽

Vol 98 (8) ◽

pp. 837-846 ◽

Cited By ~ 11

Author(s):

H.P. Whelton ◽

A.J. Spencer ◽

L.G. Do ◽

A.J. Rugg-Gunn

Keyword(s):

Dental Caries ◽

Public Perception ◽

Tooth Development ◽

Dental Fluorosis ◽

Fluoride Concentration ◽

Caries Prevention ◽

World Health ◽

Caries Experience ◽

Water Fluoridation ◽

Fluoride Exposure

Epidemiological studies over 70 y ago provided the basis for the use of fluoride in caries prevention. They revealed the clear relation between water fluoride concentration, and therefore fluoride exposure, and prevalence and severity of dental fluorosis and dental caries. After successful trials, programs for water fluoridation were introduced, and industry developed effective fluoride-containing toothpastes and other fluoride vehicles. Reductions in caries experience were recorded in many countries, attributable to the widespread use of fluoride. This is a considerable success story; oral health for many was radically improved. While previously, water had been the only significant source of fluoride, now there are many, and this led to an increase in the occurrence of dental fluorosis. Risks identified for dental fluorosis were ingestion of fluoride-containing toothpaste, water fluoridation, fluoride tablets (which were sometimes ingested in areas with water fluoridation), and infant formula feeds. Policies were introduced to reduce excessive fluoride exposure during the period of tooth development, and these were successful in reducing dental fluorosis without compromising caries prevention. There is now a much better understanding of the public perception of dental fluorosis, with mild fluorosis being of no aesthetic concern. The advantages of water fluoridation are that it provides substantial lifelong caries prevention, is economic, and reduces health inequalities: it reaches a substantial number of people worldwide. Fluoride-containing toothpastes are by far the most important way of delivering the beneficial effect of fluoride worldwide. The preventive effects of conjoint exposure (e.g., use of fluoride toothpaste in a fluoridated area) are additive. The World Health Organization has informed member states of the benefits of the appropriate use of fluoride. Many countries have policies to maximize the benefits of fluoride, but many have yet to do so.

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Recommending 1000 ppm fluoride toothpaste for caries prevention in children

Proceedings of Singapore Healthcare ◽

10.1177/2010105820963291 ◽

2020 ◽

pp. 201010582096329

Author(s):

Shijia Hu ◽

Wen Pui Bien Lai ◽

Wanyi Lim ◽

Ruixiang Yee

Keyword(s):

Healthcare Professional ◽

Young Children ◽

Oral Hygiene ◽

Dental Fluorosis ◽

Fluoride Concentration ◽

Local Context ◽

Caries Prevalence ◽

Caries Risk ◽

Fluoride Toothpaste ◽

High Caries Risk

The caries prevalence among Singapore children remains high, with almost 50% affected by the age of 6 years. Among oral hygiene homecare, toothpastes with a minimum fluoride concentration of 1000 ppm or greater have been shown to be more effective at preventing caries. Previous concerns with dental fluorosis have led to the marketing of non-fluoride and low-fluoride toothpastes specifically for children. In the local context, many parents start their children on these products due to ingestion concerns and recommendations of the product, rather than on sound advice from a healthcare professional. The latest recommendation is to use a smear size of 1000 ppm or greater fluoride toothpaste in children under 3 years of age with high caries risk. For children aged 3 years and older, a pea size of 1000 ppm or greater fluoride toothpaste should be used. As medical physicians are typically the first healthcare encounter for many children, they are well positioned to provide recommendations on the concentration and amount of fluoride toothpaste to be used in young children.

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451. Evaluation of Exposure History in Healthcare Personnel with Coronavirus 2019 Disease

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.644 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S293-S293

Author(s):

Sandra Silva ◽

Thriveen Mana ◽

Davinder Bhullar ◽

Beatrice Tabor ◽

Curtis Donskey

Keyword(s):

High Risk ◽

Risk Exposure ◽

Healthcare Personnel ◽

Administrative Personnel ◽

Asymptomatic Carriage ◽

Moderate Disease ◽

Control And Prevention ◽

History Of ◽

Exposure History ◽

Atypical Presentations

Abstract Background During the Coronavirus Disease 2019 (COVID-19) pandemic, many healthcare personnel (HCP) have developed COVID-19. However, there is uncertainty regarding whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was acquired at work versus in the community. Methods We conducted a cohort study to examine exposure history of personnel with COVID-19 infection or asymptomatic carriage in a VA healthcare system. High-risk exposures were classified based Centers for Disease Control and Prevention criteria. Results Of 578 personnel tested, 49 (8%) had nasopharyngeal swabs with positive PCR results, including 45 (92%) with and 4 (8%) without COVID-19 symptoms. Of the 49 cases, 21 (43%) had a documented high-risk exposure at work, including 14 exposures to COVID-19 patients and 7 exposures to colonized or infected personnel. Exposures to infected patients most often were a result of delays in recognition of COVID-19 due to atypical presentations. Exposures to personnel with COVID-19 most often involved activities such as meals when facemasks were not worn. Most cases occurred among nurses (26, 53%) and administrative personnel (10, 20%); only 3 physicians developed COVID-19. No cases occurred in personnel working on COVID-19 wards. All personnel had mild or moderate disease. Conclusion Forty-three percent of healthcare personnel with COVID-19 had prior high-risk exposures at work. Improved detection of patients with atypical presentations and efforts to reduce high-risk contacts among personnel may reduce the risk for acquisition of SARS-CoV-2. Disclosures All Authors: No reported disclosures

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Secular trends of population attributable risk of overweight and obesity for hypertension among Chinese adults from 1991 to 2011

Scientific Reports ◽

10.1038/s41598-021-85794-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jian Gou ◽

Huiying Wu

Keyword(s):

Population Attributable Risk ◽

Attributable Risk ◽

Secular Trends ◽

Overweight And Obesity ◽

Regression Coefficients ◽

Chinese Adults ◽

Intervention Effect ◽

Obesity Epidemic ◽

The Past ◽

Increasing Trend

AbstractWe determined if the increasing trend in hypertension can be partly attributed to increasing prevalence of overweight/obesity in China over the past two decades. Data were collected from 1991 to 2011 and the population attributable risk (PAR), which is used to estimate the intervention effect on hypertension if overweight/obese, were eliminated. Linear regression was used to evaluate the secular trends. The age-standardized prevalence of overweight and obesity increased by 26.32% with an overall slope of 1.27% (95% CI: 1.12–1.43%) per year. Hypertension also increased by 12.37% with an overall slope of 0.65% (95% CI: 0.51–0.79%) per year. The adjusted ORs of overweight/obesity for hypertension across the survey years remained unchanged; however, the trend in PAR increased steadily from 27.1 to 44.6% with an overall slope of 0.81% (95% CI: 0.34–1.28%) per year (P = 0.006). There was no significant gender difference in the slopes of increasing PAR, as measured by regression coefficients (β = 0.95% vs. β = 0.63% per year, P = 0.36). Over the past two decades, the increase in the prevalence of hypertension in China was partly attributed to the overweight/obesity epidemic, which highlights the importance of controlling weight and further reducing the burden of hypertension.

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Suicide Prevention in HIV Treatment Centres: Population Attributable Risk Analysis of Treating Common Mental Disorders

AIDS and Behavior ◽

10.1007/s10461-020-03116-5 ◽

2021 ◽

Author(s):

Jason Bantjes ◽

Ashraf Kagee

Keyword(s):

Mental Disorders ◽

Risk Analysis ◽

Suicide Prevention ◽

Common Mental Disorders ◽

Population Attributable Risk ◽

Attributable Risk ◽

Hiv Treatment

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Young children's selective trust in informants

Philosophical Transactions of the Royal Society B Biological Sciences ◽

10.1098/rstb.2010.0321 ◽

2011 ◽

Vol 366 (1567) ◽

pp. 1179-1187 ◽

Cited By ~ 121

Author(s):

Paul L. Harris ◽

Kathleen H. Corriveau

Keyword(s):

Young Children ◽

Reliable Information ◽

The Past ◽

Selective Trust ◽

History Of ◽

Scientific Conception

Young children readily act on information from adults, setting aside their own prior convictions and even continuing to trust informants who make claims that are manifestly false. Such credulity is consistent with a long-standing philosophical and scientific conception of young children as prone to indiscriminate trust. Against this conception, we argue that children trust some informants more than others. In particular, they use two major heuristics. First, they keep track of the history of potential informants. Faced with conflicting claims, they endorse claims made by someone who has provided reliable care or reliable information in the past. Second, they monitor the cultural standing of potential informants. Faced with conflicting claims, children endorse claims made by someone who belongs to a consensus and whose behaviour abides by, rather than deviating from, the norms of their group. The first heuristic is likely to promote receptivity to information offered by familiar caregivers, whereas the second heuristic is likely to promote a broader receptivity to informants from the same culture.

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