# Dietary Fluoride Exposure During Early Childhood and Its Association with Dental Fluorosis in a Sample of Mexican Adolescents

## TL;DR

This study found that early childhood fluoride intake in Mexico City is higher than recommended, leading to mild dental fluorosis in many adolescents.

## Contribution

The study identifies early childhood dietary fluoride exposure as a significant predictor of dental fluorosis in adolescence.

## Key findings

- Fluoride intake during early childhood exceeded recommended levels in Mexican adolescents.
- Mild dental fluorosis was prevalent, with 62% of adolescents showing TFI 2.
- Fluorosis in upper central incisors was associated with dietary exposure during the first two years of life.

## Abstract

Dental fluorosis indicates past fluoride intake. People living in Mexico City are exposed to fluoridated salt, which contributes significantly to fluoride intake. This study aimed to (1) estimate fluoride intake during early childhood and fluorosis prevalence in permanent teeth in adolescence and (2) identify intake windows associated with higher fluorosis scores in upper central incisors (UCIs). We included 432 participants from the ELEMENT project (Early-Life Exposures in Mexico to Environmental Toxicants), with data on fluoride intake at ages 1–5 and fluorosis (TFI) at adolescence. Median intakes ranged from 0.56 at age 1 to 1.14 mg/day at age 5, exceeding recommendations. All adolescents had some level of fluorosis, predominantly mild (62% with TFI 2). For every 0.1 mg of daily fluoride intake at age 1, the odds of higher TFI in UCIs were 1.08 [95% CI: 1.00–1.17]. At age 2, the odds were marginally significant [OR: 1.07; 95% CI: 1.00–1.16]. In conclusion, for participants of ELEMENT: (1) fluoride intake during early childhood exceeded recommendations and the prevalence of mild fluorosis in adolescence was high, and (2) fluorosis in UCIs was associated with dietary exposure during the first two years of life and may be used in future ELEMENT studies as exposure biomarkers.