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Associations between Urinary, Dietary, and Water Fluoride Concentrations among Children in Mexico and Canada
Abstract
Fluoride, which may be toxic to the developing brain, is added to salt in Mexico and drinking water in Canada to prevent dental caries. We compared childhood urinary fluoride (CUF) concentrations in Mexico City and Canada to characterize patterns of fluoride exposure in these two populations. We also examined associations of CUF with dietary and water fluoride levels in Mexico City and Canada respectively. We included 561 children (ages 4–6; mean age 4.8 years) from the Programming Research in Obesity, Growth, Environment, and Social Stress (PROGRESS) cohort in Mexico City, and 645 children (ages 2–6; mean age 3.7 years) from the Maternal–Infant Research on Environmental Chemicals (MIREC) cohort in Canada. We applied Spearman correlations, T-tests, ANOVA or covariate-adjusted linear regression to examine associations of CUF (mg/L; adjusted for specific gravity) with demographics and dietary or water fluoride concentrations. We used Welch equivalence testing to compare means across cohorts. Mean (SD) CUF was equivalent (t = 4.26, p < 0.001) in PROGRESS: 0.74 (0.42) and fluoridated Canadian communities: 0.66 (0.47), but lower in non-fluoridated Canadian communities: 0.42 (0.31) (t = −6.37, p < 0.001). Water fluoride concentrations were significantly associated with CUF after covariate adjustment for age and sex in MIREC (B = 0.44, 95% CI: 0.30, 0.59, p < 0.001). In contrast, daily food and beverage fluoride intake was not associated with CUF in PROGRESS (p = 0.82). We found that CUF levels are comparable among children in Mexico City and fluoridated Canadian communities, despite distinct sources of exposure. Community water fluoridation is a major source of fluoride exposure for Canadian children.
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“However, excessive fluoride intake through food, beverages, dental materials or supplements [3], particularly during the critical period of dental development [4,5], can lead to the formation of dental fluorosis, which poses a significant threat to oral health [6].”
From Severity-dependent alterations in oral microbiota and antibiotic resistance in children with dental fluorosis (2026) · cites this paper as [6]
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Lakens, D. (2017) · Social Psychological and Personality Science · doi:10.1177/1948550617697177 · Cited by 2,161 · cited 1×
“We applied two one-sided tests (TOST) Welch equivalence testing [41] to compare CUFSG means between PROGRESS and MIREC, which allows for skewed outcome data and does not assume equal variances between groups [42].”
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Cited by
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Xia, Y., Peng, S., Yu, J., Wang, Y., Ye, Y., Liu, M., Shang, L., Cui, X., Wang, P., & Ding, Z. (2026) · Journal of Oral Microbiology · doi:10.1080/20002297.2026.2714622
Metadata
- Authors
- Green, R., Till, C., Cantoral, A., Lanphear, B., Martinez-Mier, E., Ayotte, P., Wright, R., Tellez-Rojo, M., & Malin, A.
- Affiliations
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada
- Departamento de Salud, Universidad Iberoamericana, Ciudad de México 01219, Mexico
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V5A 1S6, Canada
- School of Dentistry, Indiana University, Indianapolis, IN 46202, USA
- Department of Social and Preventive Medicine, Laval University, Quebec City, QC G1V 0A6, Canada
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- School of Public Health, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico
- Venue
- Toxics
- Publisher
- MDPI AG
- Published
- 2020-11-20
- Volume
- 8
- Issue
- 4
- Pages
- 110
- ISSN
- 2305-6304
- PMC
- PMC7711675
- Cited by
- 27
- References
- 1
- Language
- en
- Funders
- Canadian Institutes of Health Research (MOP-81285)
- National Institute of Environmental Health Sciences (P30ES023515, R01ES013744, R01ES014930, R01ES021357, R01ES020268, R01ES026333, R01ES028927, R21ES027044)
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