July 27, 2010
School of Dentistry, Kochi
Dental fluorosis is a major public health problem in nearly twenty states in India. Now an epidemiological study has confirmed the causal role of jowar consumption in cases of severe dental fluorosis among children in North Karnataka.
“This is the first community-based study of its kind reported in scientific literature,” informed Dr. Chandrashekar, who published his work as a paper titled Severe Dental Fluorosis and Jowar Consumption in Karnataka, India.
The paper was published in the Journal of Community Dentistry and Oral Epidemiology.
Jowar, a type of millent, exacerbates fluorosis when consumed by a child who is under eight, when he or she is at greatest risk for this health condition caused by receiving too much fluoride during the period of tooth development.
Dr. Chandrashekar, who serves currently as HoD and Professor in the Department of Public Health Dentistry at the Amrita School of Dentistry, led a community-based case control study.
The study was carried out in villages having different levels of fluoride (high, medium and low) in drinking water in the Davangere District of Karnataka, India.
“352 school children aged 12-15 years with severe grades of dental fluorosis classified by Thylstrup and Fejerskov indices (scores 4 to 9) were selected,” informed Dr. Chandrashekar.
“428 school children aged 12-15 years with no dental fluorosis, were also selected randomly from the same areas as controls.”
“Exposure ascertainment of jowar consumption was done by the 24-hour diet recall method and food frequency questionnaire. Ion selective electrode method was used to estimate the fluoride level in spot urine samples of subjects and in drinking water.”
A logistic regression analysis was performed on the obtained data using SPSS v17. It was found that children who consumed jowar were 2.67 times more likely to suffer from severe dental fluorosis as compared to those who did not.
Children from villages that had high levels of fluoride in drinking water had higher odds of suffering from severe dental fluorosis as compared to children from villages with low or medium levels of fluoride in drinking water.
“Daily and weekly jowar consumers stood a higher risk for dental fluorosis as compared to non-consumers of jowar,” summarized Dr. Chandrashekar.
“Jowar consumption was found to be positively associated with the severity of dental fluorosis in this population,” he noted. “Delayed introduction of jowar to a child’s diet, until the child is over eight years old, would greatly help reduce the incidence of severe dental fluorosis.”