Fluorosis, caries experience and nutritional status in 5- and 12-yr. olds from 4-Huila municipalities

Objectives: Colombia (fluoridated-salt-PAHO, 1989), showed in ENSAB-IV (2015) a high-caries experience (dmf/DMF-T) prevalence and mean (5-yrs.: 62.24%; 2.84; 12-yrs.: 58.75%; 1.75, respectively) and fluorosis (F_ci) prevalence and degree (5-yrs.: 8.43%; 0.13; 12-yrs.: 65.15%; 0.90). The Central Region, including Huila, was catalogued as a public-health problem region (F_ci: 0.89 in 12- and 15-yr. olds). Drinking-water-source-fluoride concentrations reports in Pitalito, Rivera, El-Agrado and Altamira, are 0.5-12.8 ppm F (Gobernación-Huila, 2009; SDS-H, 2009).

Objective: To establish the fluorosis and caries epidemiologic profile and the nutritional status in 5- and 12-year olds, and to determine the fluoride content in water sources, in Pitalito, Rivera, El Agrado and Altamira (Huila).
Methods: A representative 5 and 12 year-old sample (n=800) in 4-Colombian Huila municipalities was clinically assessed (5-trained examiners) for caries experience: conventional and ICCMS^TM-Epi (derived from ICDAS, including initial caries lesions under field-examination conditions:"A", plus moderate: B, and extensive: C caries lesions), and fluorosis (TFI). Children height (m) and weight (Kg) were measured. Water samples were collected from each municipality water sources and the fluoride concentration was measured by ion-specific electrode.
Results: A total of 838 children were examined. Prevalence and mean conventional-caries experience was in 5-yr. olds of 70.65%, 5.14±6.56, and in 12-yr. olds of 53.40%, 1.81±3.02, respectively. Prevalence of fluorosis (TFI≥1) was: 5-years: 97.28%, 12-years: 99.36%. Nutritional status disclosed that 47.53% of 5-yr. olds and 38.18% of 12-yr. olds were not considered within the normality range. The table shows details for each clinical assessment in both age groups. Water-source-fluoride concentration ranged from 0.10 to 0.93 ppm F^-.
Conclusions: A very high prevalence of fluorosis was found in both age groups, representing a public-health warning. Conventional-caries experience was higher than national figures for 5-yr. olds and similar for 12-yr. olds. While water-source-fluoride concentration was not as high as expected, the association between fluorosis severity and nutritional status should be further explored.