Influence of breastfeeding on fluorosis and caries in Namibian schoolchildren

Objectives: To analyse the influence of breastfeeding habits on fluorosis and caries in Namibian schoolchildren due to obviously high prevalence of dental fluorosis. Methods: In 2004, 118 pupils (1st – 8th grade, mean age: 11.9 years) of the Ombili Primary School were examined by one calibrated dentist according to the WHO criteria for caries (dmft/dmfs, ds) and fluorosis (Dean index). The mothers of 72 children could be interviewed about feeding and breastfeeding. In addition, samples of drinking water taken from the 4 wells of the different farmes where the pupils lived and “veldkost” were analysed for fluoride. Results: The prevalence and degree of fluorosis varied greatly for the different farms (maximum: 74.1%, 1.71 Fci; minimum 50%, 0.5 Fci) and correlated with the fluoride concentration in drinking water (0.28 - 1.43mg/l) and the caries prevalence (0.96 - 2.66 DMFT). Veldkost contained considerable amounts of fluoride (up to 5.9 mg/kg). The duration of breastfeeding had been 6 to 48 months with a mean of 22 months (±10.9) and it was negatively associated with fluorosis (r=-0.47, p<0.001, Spearman-Test). The degree 0 of fluorosis was associated with a mean breastfeeding duration of 30 months (±8.5), degree 4 only with 16 months (±7.5). Breastfeeding did not correlate with higher caries prevalence in the permanent dentition (p=0.95), but even a tendency for low caries intensity in deciduous teeth (r=-0.38, p=0.22). Conclusion: The present data indicate that breastfeeding reduces the risk of fluorosis in a highly fluoridated environment without the risk of increased caries.