Níveis de fluoretos na água de abastecimento público e em águas engarrafadas, consumo destas águas e impacto na ocorrência de cárie dentária: estudo no sul do Brasil

Abstract

This study aimed to analyze the fluoride content in drinking water and bottled water and investigate whether the consumption of water from different sources could influence the occurrence of dental caries in children in southern Brazil. The samples from the public water supply were collected at 16 locations, including three water treatment plants. Five brands of bottled waters with and without gas available in Pelotas / RS were acquired. The measures were realized for 12 months (July 2013 to June 2014) in duplicate. We used an electrode Orion 96-09 coupled to an analyzer Orion EA 940 ion-(Thermo Scientific, Inc., Waltham, USA) for measurement. Monthly frequencies of fluoride levels were obtained. In 2004, there was a cross sectional study nested in the 2004 Pelotas birth cohort in Pelotas / RS. A sample of 1,123 children was bucally examined and their mothers interviewed at the age 5. Demographic variables, family income, oral health of mothers, oral hygiene habits and the type of water ingested by children, and the outcome (tooth decay) were collected in this study. Descriptive, bivariate and multivariate analyzes were performed using Stata (version 12.0). The results showed uniformity in concentration of fluoride in public collection points, and in 15 of them, the concentration was located within the values indicated as the most effective anti-caries and lower risk of fluorosis. In bottled water, there was inconstant vaues for fluoride concentration. One commercial brand, sparkling or not, presented fluoride levels in the range of indicated as anticaries benefit and without risk of fluorosis, while the others brands the fluoride levels had questionable benefit and high risk of fluorosis. Regarding the OHS-09, most children ingested the public water supply (74.7%), but the richest children drank more frequently bottled water. The prevalence of caries was 48.4% (n=543), with mean dmfs = 4.06. The source of water 12 ingested had no influence on caries prevalence or severity in the primary dentition. The control of fluoride levels in public water supply in Pelotas seems to be well performed and the population has received water in adequate fluoride concentrations. However, the fluoride levels of fluoride in bottled water are inconstant and inadequate and a proper legislation control should be made. The source of water consumed (public supply or bottled water) had not influenced the caries occurrence in children aged five.