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PubMedDate not supplied

Fluoride concentrations of unstimulated whole and labial gland saliva in young adults after fluoride intake with milk.

Following a fluoride depletion period 6 subjects repeatedly rinsed with 30-ml volumes of milk with or without added fluoride (5 ppm). Rinsing time was timed according to the measurements on how long it took to drink 200 or 500 ml milk. Rinsing with fluoridated milk for a total interval of 20 and 60 s, respectively, did not influence significantly the fluoride concentration of unstimulated centrifuged whole saliva 45 min later. Neither the urinary fluoride concentration nor the fluoride excretion were significantly affected by rinsing with fluoridated milk during the first hour. However, intake of 1 or 2.5 mg of fluoride with 200 and 500 ml milk, respectively, resulted in significant elevations in whole saliva fluoride levels 45 min later. In addition, the fluoride excretions into urine produced during 60 min after the fluoride intakes were significantly elevated and those reflected the ingested dose of fluoride. The intake of either 1 or 2.5mg fluoride with milk did not significantly influence the fluoride level of unstimulated labial gland saliva collected simultaneously with whole saliva.

Adult↗
PubMedDate not supplied

Remineralisation of enamel lesions with daily applications of a high-concentration fluoride gel and a fluoridated toothpaste: an in situ study.

The inhibition of enamel demineralisation and the enhancement of remineralisation are positively but not linearly related to the concentration of fluoride, especially when high fluoride concentrations are used. The aim of this in situ experiment was to determine the maximum amount of enamel remineralisation that can be achieved with daily applications of very high concentrations of fluoride. For this purpose we compared the efficacy of a daily application of fluoridated topical gel (12500 ppm F, partly as NaF, Olafluor and Dectafluor, pH 4.5) in combination with a fluoridated toothpaste (1450 ppm F as NaF), with fluoridated toothpaste alone. Participants (n = 26, with partial dentures) were fitted with a demineralised enamel specimen (mean mineral loss of 1674 vol%.micro m) and were instructed to use one of the two fluoride treatments. After 4 weeks of treatment, the specimens were retrieved, a section was cut and analysed with microradiography. The remainder of each of the specimens was used for analysis of the 'loosely bound' and 'bound' fluoride. Fluoride was measured with gas-liquid chromatography. After 4 weeks in the mouth, the original lesion was reduced in size by 54% in the toothpaste + gel group (n = 14) and by 44% in the toothpaste-only group (n = 12), but the difference between the groups was not statistically significant. The mineral content profiles showed remineralisation of the lesions throughout the depth of the lesion. The enhancement of remineralisation by the high amounts of fluoride was most pronounced in the surface layer. For both the 'loosely bound' and 'bound' fluoride, a statistically significant increase in fluoride concentration could be found in the toothpaste + gel group. In the 4-week in situ period the use of high amounts of fluoride resulted in a maximum remineralisation rate. This is illustrated by an increase in remineralisation and higher fluoride concentrations in the toothpaste + gel group compared to the toothpaste-only group.

Dental Enamel↗
PubMed1976

Influence of dietary fluoride restriction on regulation of plasma nd soft tissue fluoride contents.

The adjustments in total fluoride concentration in plasma, bones, liver, and muscle were examined when rats were given a diet of very low fluoride content following a dietary regimen of elevated fluoride intake. The animals received a diet containing 34 ppm of fluoride and water with 50 ppm added fluoride in the 28-day initial period and in the depletion period they were given a diet containing only 0.21 ppm of fluoride and distilled water. The findings indicated a 12-fold increase in the fluoride content of the humeri after 28 days of high-flurodie intake with a greater increment by the epiphyses than by the diaphyses. During 21 days of the depletion period the skeletal fluoride was reduced by only 7.7% indicating a marked retention of fluoride during processes of bone remodeling and growth. The plasma, muscle, and liver total fluoride contents were significantly increased at the end of the period of high-fluoride intake, but these concentrations were found to be restored to base-line levels in 3-7 days of the depletion period. By comparison of the distribution of total fluoride with injected radiofluoride between tissue and plasma waters, it was concluded that muscle and liver contain bound fluoride that does not exchange completely with ionic fluoride.

Animals↗
PubMed2001

Effects of fluoride chewing gum on stimulated salivary flow rate and fluoride content.

BACKGROUND: The purposes of this study were to measure the stimulated salivary flow rates generated by sorbitol gum, fluoride gum and paraffin wax control, and to assess the salivary fluoride clearance pattern in fluoride chewing gum. METHOD: Six healthy subjects were instructed to chew paraffin wax control and sorbitol gum and fluoride gum (0.1 mg F/stick) 5 times per day for the experimental periods--21 days. Stimulated saliva samples were collected for each subject at 7, 14, 21 days at 3 pm after chewing of the gum. The saliva was collected at 1, 3, 5, and 8 minutes after the subject started chewing the wax or gum. Flow rates for each group and salivary fluoride content of the fluoride chewing gum were measured. RESULTS: The overall mean salivary flow rates for the control, sorbitol gum and fluoride gum were 1.7 +/- 0.6, 2.0 +/- 0.6, and 2.1 +/- 0.7 ml/min respectively. The mean stimulated flow rate for fluoride gum was found significantly higher than that of the control (p = 0.002). However, no significant differences appeared between the control and sorbitol gum (p = 0.104), and sorbitol gum and fluoride gum (p = 0.563). The mean fluoride concentrations at different intervals during eight minutes of chewing fluoride gum were between 1.8 and 4.2 ppm. CONCLUSION: Chewing fluoride-containing chewing gum releases fluoride at a low concentration in saliva. Fluoride chewing gum combining a salivary stimulator and caries prevention agent is a perspective method of caries prevention.

Adult↗
PubMed1988

Fluoride distribution in the enamel of the mesio-lingual cusps of pairs of erupted and unerupted third molars of man with a low fluoride background.

The enamel fluoride concentrations at different depths were determined at 5 different sites on the mesio-lingual cusps of 16 pairs of erupted and unerupted third molars. Six successive acid etchings were done on each of the 5 sites. The 16 subjects (18 to 33 years) were living continuously since birth in a low fluoride area (F less than 0.10 ppm). They did not take any systemic fluoride since birth nor did they practise any other anti-caries fluoride program than brushing their teeth once or twice a day with fluoride-containing dentrifrices with about 1,000 ppm fluoride. The fluoride level in the etch solution was measured with the use of an adapted fluoride selective electrode. Statistically significant differences (p less than 0.05) were found in the mean etch depth between the erupted and unerupted molars, to a depth of approximately 5 micron. The mean enamel fluoride concentrations of the erupted and unerupted molars also differed significantly to a depth of approximately 5 micron. There was no influence of fluoride from the oral environment on enamel levels of approximately 10 micron and deeper. Over an exposure period of 1 to 16 years, sixty percent more enamel fluoride (at a depth of approximately 2 micron) was found in the erupted enamel relative to the unerupted enamel (with a low background fluoride) as a result of tooth brushing with fluoride-containing dentifrices. More enamel fluoride was found near the incisal edge than near the cervical margin of 14 of the 16 subjects independently of the age of the subjects.

Acid Etching, Dental↗
PubMed2001

Evaluation of fluoride release from commercially available fluoride varnishes.

BACKGROUND: The authors conducted a study to evaluate the fluoride released from two fluoride varnishes: Duraphat (Colgate-Palmolive Co., New York) and Duraflor (Pharmascience Inc., Montreal). Fluoride-release information for these commercially available dental products has not been available to clinicians treating children at risk of developing dental caries. METHODS: The authors painted enamel slabs from primary molar teeth with 30 milligrams of two varnishes: nine samples received Duraphat, nine received Duraflor and five samples served as controls. The samples were immersed in buffered calcium phosphate solution (pH, 6.0) to simulate the oral environment, and the amount of fluoride released was measured weekly for six months. RESULTS: From week 4 to the end of the study, Duraphat released significantly more fluoride than Duraflor. Duraflor continued releasing fluoride until week 19, while Duraphat released fluoride until week 28. The authors found greater variability in the release of fluoride from the Duraflor samples than from the Duraphat samples. Two-thirds of the fluoride was released from both products by the end of the study. CONCLUSIONS: Both varnishes released fluoride for five to six months. However, the two products exhibited differences in their release kinetics. CLINICAL IMPLICATIONS: These findings show that either of the fluoride varnishes may maintain a high level of fluoride in plaque fluid around primary teeth over a long period, but that the availability of fluoride may vary among tubes of the same product and between the two products themselves.

Biological Availability↗
PubMed1994

Comparison of serum fluoride levels after administration of monofluorophosphate-calcium carbonate or sodium fluoride: differences in peak serum concentrations.

Fluoride salts are widely used in Europe in the treatment of established osteoporosis with crush fractures for their ability to increase trabecular bone mass. However, in the United States fluorides are still regarded as an experimental drug. In a prospective, randomized study we compared the fluoride pharmacokinetics of enteric-coated sodium fluoride and disodium monofluorophosphate calcium carbonate (MFP-Ca) over the period of 76 h. Twenty subjects (12 females, 8 males), aged 35-80 years, free of gastrointestinal disorders, renal impairment, and liver disease and without prior fluoride intake entered the study. Ten subjects received NaF (11.3 mg fluoride) twice a day and the other ten MFP-Ca (13.2 mg fluoride) twice a day. During the study period of 76 h the patient's usual food intake was not changed. Serum fluoride levels were determined using an ion sensitive electrode. After intake of a single drug preparation of MFP-Ca or NaF, MFP-Ca showed a significantly shorter lag time of absorption and a significantly higher maximal serum fluoride concentration than NaF (P < 0.01). A comparison of fluoride cumulative characteristics of both drugs showed virtually identical serum fluoride levels before intake of the morning dose on all 4 study days, whereas serum fluoride concentrations measured 4 h afterwards were significantly higher for MFP-Ca than for NaF. These data provide evidence of high "peak" serum fluoride levels for MFP-Ca, whereas only small peak-to-trough fluctuations are seen for NaF.

Adult↗
PubMed1998

Urinary fluoride levels and prevalence of dental fluorosis in three Brazilian cities with different fluoride concentrations in the drinking water.

Urine samples from three daytime periods were collected from 545 5-50-year-old residents of three different Brazilian cities: Garça had fluoridated drinking water since 1973, Bauru since 1975 and Itápolis was not fluoridated. Dental fluorosis was examined in 985 5-24-year-olds using the Thylstrup-Fejerskov index (TF). The subjects were asked to estimate their daily intake of liquids and frequency of beverage consumption. The analysis of 94 water samples showed high variations in the fluoride content of the drinking water. The mean fluoride concentration of the water samples in Garça was 0.9 mg/L (range 0.75-1.2), in Bauru 0.64 mg/L (range 0.01-1.3), and in Itápolis 0.02 mg/L. Mean urinary fluoride concentration was 1.31 mg/L (s 0.61) in Garça, 0.88 mg/L (s 0.49) in Bauru, and 0.39 mg/L (s 0.21) in Itápolis. Self-reported daily liquid intake was not related to urinary fluoride concentration. The mean prevalence of fluorosis was 13.3% in Garça, 6.8% in Bauru, and 1.7% in Itápolis, with mainly categories TF 1 and TF 2 being recorded. Subjects with dental fluorosis tended to show a higher mean urinary fluoride concentration but the difference was not statistically significant. The study showed that fluoride exposure measured by urinary fluoride excretion was within the range expected for the level of fluoride concentration in the drinking water. However, enamel fluorosis tended to be markedly lower than expected. This study revealed that fluoride levels in the two cities with fluoridated drinking water were variable. To optimise anticaries benefits and minimise the risk of fluorosis greater control of the fluoride dosing of the drinking water is required.

Adolescent↗
PubMed1990

The future of water fluoridation and other systemic fluorides.

School and community water fluoridation, salt fluoridation, and use of dietary fluoride supplements have abundant scientific support as effective caries-preventive methods. Because caries has declined greatly in many developed countries from use of topical fluorides, the absolute caries reduction will be considerably smaller when systemic fluoride methods are implemented now than it was 20 to 40 years ago. For countries with most of the population living in cities with communal water supplies, community fluoridation is the most logical approach from the standpoints of cost-effectiveness and total caries-preventive impact. In countries with a mostly rural population without central water supplies, salt fluoridation is more practical. Dietary fluoride supplements can be recommended only for regions where neither water fluoridation nor salt fluoridation is possible, or as a temporary measure. Although divergent views exist concerning the relative caries-preventive effects of pre-eruptive and post-eruptive fluoride administration, the effectiveness of systemic fluoride methods for preventing dental caries remains unchallenged. Persuasive scientific and public health arguments exist to justify implementing and sustaining their use. The future of these methods will be influenced by the findings of new clinical and epidemiological research. Social, political, economic, and educational factors will be of equal, if not greater, importance. Perceptions of the current severity of dental caries as a health problem and of risks associated with preventing the problem may affect the future uses of systemic fluorides more than will recommendations of scientists.

Fluoridation↗
PubMed2000

An in situ study on the comparison of fluoride uptake and bond strength of composite resin on fluoridated enamel.

The aim of this in situ study was to compare the fluoride uptake and composite resin bond strength on enamel fluoridated with Duraphat (2.26 wt% fluoride). Six enamel specimens were prepared from the labial surfaces of 39 bovine incisors. The enamel samples were embedded into epoxy resin, and ground flat (800 grit). One specimen served as negative control (no fluoride treatment). The other samples were fluoridated with Duraphat for 24 hours under moist conditions, and one of them served as positive control. The remaining four samples were inserted in both buccal aspects (with a total of 12 samples originating from 3 teeth) of 13 intraoral mandibular appliances. The appliances were worn by 13 persons for a period of 6 days, 24 hours per day. The samples were also brushed twice a day, in situ, with a fluoride-free toothpaste. During meals, the appliances were stored in saline. After in situ periods of 36, 72, 108, and 144 hours, three samples each were remounted. One specimen was used for analysis of both alkali-soluble and acquired fluoride. The other two specimens served for shear bond strength testing of a light-cured composite resin. While the KOH-soluble fluoride increased significantly (p < 0.001, ANOVA) after application of the fluoride lacquer and decreased slowly with time, both the acquired fluoride and bond strengths of the composite resin did not differ significantly from the non- and fluoridated controls. The application of highly concentrated fluoride lacquers results in an increase of alkali-soluble fluoride, but does not adversely affect enamel bond strength of composite resin.

Acid Etching, Dental↗
PubMed1992

Uptake of KOH-soluble and KOH-insoluble fluoride in sound human enamel after topical application of a fluoride varnish (Duraphat) or a neutral 2% NaF solution in vitro.

The uptake of alkali-soluble fluoride (calcium fluoride-like material and adsorbed fluoride) and alkali-insoluble fluoride (apatitically bound fluoride) on sound human enamel from treatment with Duraphat or a neutral 2% NaF solution was investigated in vitro. Blocks from impacted third molars were used. More fluoride was deposited on the enamel from the neutral 2% NaF solution than from the Duraphat treatment. All the fluoride could be dissolved in alkali. Globules of calcium fluoride-like material were demonstrated by scanning electron microscopy. Chemical analysis showed no measurable increase in the apatitically bound fluoride (alkali-insoluble fluoride) after brief exposures. Duraphat-treated samples submerged in water after the exposure lost only about 50% of the deposited fluoride, whereas samples treated with 2% NaF are known to lose all their fluoride under similar circumstances, a condition which may be related to the favorable clinical effect of Duraphat.

Acid Etching, Dental↗
PubMed1988

Fluoride content in human iliac bone: results in controls, patients with fluorosis, and osteoporotic patients treated with fluoride.

The major part of fluoride ingested is fixed on calcified tissues, mainly in bone tissue, and then is progressively but slowly recycled during bone remodeling. Thus, the measurement of bone fluoride content allows the determination of the extent of bone fluoride retention, and this parameter constitutes a useful complement to bone histology for the diagnosis of skeletal fluorosis and could also be used for the management of fluoride treatment of osteoporosis. A simple method is described to measure the fluoride content in calcined human iliac bone samples. Bone ashes were diluted in perchloric acid, and the measurement of the bone fluoride content was performed using a specific ion electrode combined with a reference electrode. Reference values are given for bone tissue from 76 control subjects (0.08 +/- 0.05% of bone ash), from two groups of 117 and 102 untreated osteoporotic patients (0.05 +/- 0.03% and 0.08 +/- 0.05%, respectively), from 166 sodium fluoride-treated osteoporotic patients (mean bone fluoride content varying from 0.24 to 0.67%, depending on the duration of therapy), and from 96 patients showing typical skeletal fluorosis (mean bone fluoride content varying from 0.56 to 1.33%, depending on the etiology of fluorosis and the relationship with the amount of fluoride ingested as well as with the duration of fluoride exposure). During a prolonged exposure of adult bone tissue to fluoride, the early bone fluoride uptake is variable and depends on the remodeling activity; then it increases rapidly before becoming more or less stable at a maximum level.

Female↗
PubMed2005

Tealeaves may release or absorb fluoride, depending on the fluoride content of water.

As the tea plant (Camellia sinensis) is known to accumulate fluoride from the soil, the tealeaves may contain high concentrations of fluoride, which is easily released during infusion. In this study, we have tested the possible effect of original fluoride concentration in the water on the fluoride release from tea. Moreover, we wanted to test the possible capacity of tealeaves (commercially available tea) to absorb fluoride from high-fluoride water. In low-fluoride water, fluoride is easily released from tealeaves. Depending upon the fluoride content of the water, dried tealeaves are able also to absorb fluoride. Thus, if a cup of tea is made from high-fluoride water, the fluoride concentration of the infusion may actually be lower than the original fluoride concentration of the water.

Absorption↗
PubMed2000

Fluoride release profiles of mature restorative glass ionomer cements after fluoride application.

This study investigates the fluoridation of four conventional glass ionomer cements (GIC) (ChemFil Superior encapsulated, Fuji Cap II, Ketac-Fil and Hi Dense) and three resin-modified GIC (RM-GIC) (Fuji II LC encapsulated, Photac-Fil and Vitremer). The fluoride release of matured restorative GIC was measured as a function of time, after four repeated fluoridations in a 2% NaF aqueous solution for 1 h. This release was corrected for the intrinsic release as determined with a control group. It was demonstrated that application of fluoride is capable of recharging GIC but the subsequent high fluoride release only lasts for one or a few days. Moreover, the fluoride release behaviour depends on the cement formulation. Comparable to the intrinsic release, the net fluoride release after fluoridation is composed of a short- and a long-term process, the former being predominant after fluoridation. The total amount of fluoride released according to the short-term process increases with consecutive fluoridations. This is especially pronounced for the RM-GIC, who exhibit a relatively slow release after fluoridation as compared to the conventional GIC. An explanation for these results is suggested on the basis of the physicochemistry of the setting reaction of the cements and of the fluoridation process.

Capsules↗
PubMed2002

Fluoride uptake and development of artificial erosions in bleached and fluoridated enamel in vitro.

The aim of the present in vitro study was to evaluate the effect of carbamide peroxide (CP) bleaching on fluoride uptake in enamel. Additionally, the susceptibility for erosion in bleached and fluoridated enamel was tested. Each four enamel specimens were prepared from 44 bovine incisors. The four samples gained from each tooth were distributed among four groups (A-D) of 44 specimens each: A: (unbleached/unfluoridated) served for determination of baseline fluoride concentration; B: (unbleached/fluoridated) four times in 2000 ppm NaF solution (2 min); C: (bleached/unfluoridated) four times in 10% CP (8 h); D: (bleached/fluoridated) four times in 10% CP and fluoridation. In 22 specimens of each group both KOH-soluble and structurally bound fluoride were determined in the outermost 30 micro m of the enamel. In the remaining specimens erosions were induced by immersing the samples in 5 mL of 1% citric acid (20 min) and microhardness was evaluated before and after demineralization. Statistical analysis showed that KOH-soluble fluoride uptake was similar for group B and D specimens. Structurally bound fluoride uptake after fluoride application in unbleached samples was significantly higher than in bleached ones. Bleaching only resulted in a highly significant fluoride loss. In all samples erosion caused a significant microhardness loss. The study showed that pre-treatment of enamel with CP followed by fluoridation does not improve erosive resistance. Moreover the study reveals that CP treatment decreases concentration of structurally bound fluoride in enamel which could not be outweighed by fluoridation with 2000 ppm NaF. It is concluded that it is not feasible to improve fluoride uptake in enamel with a pre-treatment with 10% CP.

Analysis of Variance↗
PubMed2001

Calcium neutralizes fluoride bioavailability in a lethal model of fluoride poisoning.

OBJECTIVES: Acute systemic fluoride poisoning can result in systemic hypocalcemia, cardiac dysrhythmias, and cardiovascular collapse. Topical and intraarterial therapy with calcium or magnesium salts reduces dermal injury from fluoride burns. The mechanism of these therapies is to bind and inactivate the fluoride ion. The purpose of this study is to evaluate the effect of calcium and magnesium to decrease the bioavailability of fluoride in a lethal model of fluoride poisoning. METHODS: In preliminary studies, we determined that fluoride 3.6 mM/kg intraperitoneally in the form of sodium fluoride was uniformly and rapidly fatal in a mouse model. Using this fluoride dose, we performed a controlled, randomized, blinded study of low- and high-dose calcium chloride (1.8 and 3.6 mM/kg intraperitoneally, respectively) and magnesium sulfate (3.6 mM/kg intraperitoneally) to decrease the bioavailability of the fluoride ion. After injection with sodium fluoride, animals were immediately treated with injections of sodium chloride (control), calcium chloride (low- or high-dose), or magnesium sulfate. The major outcome was 6-hour survival using a Cox Proportional Hazard model. RESULTS: All untreated animals died within 60 minutes. Using a Cox Proportional Hazard model, each 1.8 mM/kg dose of calcium chloride administered reduced the risk of death by 33%. Magnesium sulfate treatment was not associated with a hazard reduction. CONCLUSION: Calcium chloride administered simultaneously with sodium fluoride reduces the bioavailability of fluoride poisoning in a mouse model. The equivalent dose of magnesium sulfate does not significantly decrease fluoride bioavailability.

Animals↗
PubMed2004

Seasonal variation in fluoride intake: the Iowa fluoride study.

OBJECTIVES: Although patterns of fluid intake change seasonally, little is known about how fluoride intake varies by season. Since even short-term increases in fluoride intake could potentially lead to more dental fluorosis, it is valuable to assess the degree of seasonal variation to determine if it increases fluoride intake to levels that could be considered a concern in young children. METHODS: Questionnaires were mailed periodically to participants in the Iowa Fluoride Study beginning at 6 weeks of age and continuing for a number of years. Parents recorded the date; child's weight; estimates of the amounts of water and other beverages that their child consumed per week; the type and amount of any fluoride supplements used; and the type, amount, and frequency of dentifrice used, with an estimate of the proportion of dentifrice that was swallowed. Documented water fluoride levels from municipal sources and assay of individual sources were linked to water intake amounts. Total fluoride intake per kg body weight was estimated from water, other beverages, fluoride supplements, and ingested dentifrice. Generalized linear models compared temperature-related and seasonal effects after adjusting for the child's age. RESULTS: Separate analyses for ages 0-12 months and 12-72 months showed different results. Children younger than 12 months of age did not exhibit significant seasonal or temperature-related variation in any of the components of fluoride intake. Children aged 12-72 months had higher fluoride intake (mg F/kg bw) from beverages in summer (P<.05), and fluoride intake from beverages increased with monthly temperature (P<.001). CONCLUSIONS: Fluoride intake from beverages for children aged 12-72 months is slightly higher in the summer and increases with mean monthly temperature. Fluoride intake from supplements and dentifrice did not change significantly with either season or temperature.

Age Factors↗
PubMed2005

Fluoride concentration of bottled water, tap water, and fluoridated salt from two communities in Mexico.

AIM: To determine fluoride levels in bottled water, tap water, and fluoridated salt from two communities in Mexico. DESIGN: Stratified random collection of water and salt samples from Mexico City and Veracruz, Mexico for fluoride analysis. METHODS: Samples were analysed using a combination fluoride ion-specific electrode. Results were compared using Student's t-test and mixed-model ANOVA. Water fluoride values were compared by type, community and collection area; salt fluoride values were compared by community and collection area. RESULTS: 197 tap water samples, 133 bottled water samples and 20 fluoridated salt samples were collected. The mean (+/- SD) fluoride content for all tap water was 0.20 +/- 0.17 microg F/g (ranging from 0.01 to 0.88 microg F/g) and 0.24 +/- 0.24 microg F/g for all bottled water (ranging from 0.01 to 2.80 microg F/g). This difference was not statistically significant. When results were analysed by city, the difference between tap water samples was statistically significant. Ten bottled water samples contained more than negligible fluoride (ranging from 0.7-2.8 microg F/g). Mean salt fluoride content was 230.0 +/- 49.8 microg F/g, which was within governmental regulation levels. CONCLUSION: Some water samples had amounts of fluoride exceeding the maximum recommended levels. Salt fluoride levels were within regulation limits. Monitoring of fluoride content of both bottled and tap water is strongly advised.

Analysis of Variance↗