Biomedical subjects

John J Warren

Publications and source records attributed to John J Warren.

At least 19 recordsLinked to original sources

PubMed2007

Comparison of the intakes of sugars by young children with and without dental caries experience.

BACKGROUND: Relationships among sugars and dental caries in contemporary societies are unclear. The authors describe young children's intakes of nonmilk extrinsic (NME) and intrinsic/milk sugars and relate those intakes to dental caries. METHODS: The authors conducted cross-sectional analyses of dietary data collected from the Iowa Fluoride Study using three-day diaries for subjects at ages 1, 2, 3, 4 and 5 years and for subjects aged 1 through 5 years according to dental caries experience at 4.5 to 6.9 years of age. They categorized foods and beverages as containing NME or intrinsic/milk sugars. RESULTS: Subjects' total, NME, food NME and intrinsic/milk sugars intakes at ages studied did not differ between subjects with and without caries experience. Beverage NME sugars intakes at age 3 years predicted caries (P < .05) in logistic regression models adjusted for age at dental examination and for fluoride intake. CONCLUSIONS: Dental caries is a complex, multifactorial disease process dependent on the presence of oral bacteria, a fermentable carbohydrate substrate and host enamel. A simple NME-intrinsic/milk sugars categorization appears insufficient to capture the complex dietary component of the caries process. CLINICAL IMPLICATIONS: Cariogenicity is more likely a function of the food and/or beverage vehicle delivering the sugar and the nature of exposure-that is, frequency and length of eating events-than of the sugar's categorization.

Adolescent↗

PubMed2006

Changes in the prevalence of nonnutritive sucking patterns in the first 8 years of life.

INTRODUCTION: The purposes of the study were to determine prospectively the duration of nonnutritive sucking behaviors of children between 1 and 8 years of age and the effect of persistent habits on selected occlusal characteristics in the late deciduous dentition. METHODS: Sucking behavior data were initially collected from 797 children who were followed longitudinally from birth; the data came from periodic questionnaires completed by the parents. In addition, study models were obtained for 372 children at 4 to 5 years of age and assessed for posterior crossbite, anterior open bite, and overjet. The subjects were grouped according to the duration and type of habit (pacifier or digit, for less than 12 months or more than 48 months). Children with nonnutritive sucking of less than 12 months were further grouped according to the duration of breast-feeding. The McNemar nonparametric test was used to compare the changes in the incidence and effect of the habits with time. RESULTS: There was a significant (P = .001) decrease in the incidence of pacifier habits between 1 and 5 years of age, from 40% to 1%. There was a significant (P = .01) decrease in the incidence of digit habits between 1 and 4 years of age, from 31% to 12%. Between 4 and 7 years of age, the decrease in the incidence reached a plateau--ie, the decrease continued but at a slower rate. Between 7 and 8 years of age, there was an additional significant (P = .008) decrease in the incidence of digit habits, but 4% of the children were, to various extents, still sucking fingers. Children who had pacifier or digit habits lasting less than 12 months did not have significantly different occlusal characteristics than children who were breast-fed for 6 to 12 months. Prolonged pacifier and digit habits caused significant changes in the occlusal characteristics in the late deciduous dentition, and the effects of pacifier habits were different from those of digit sucking. CONCLUSIONS: To intercept the development of crossbites and functional shifts, the developing occlusion should be observed in the deciduous dentition in children with prolonged digit or pacifier habits. The transverse occlusal relationship, particularly in pacifier-sucking children, should be evaluated between 2 and 3 years of age. If there are interfering contacts of the deciduous canines, the parents should be instructed to reduce pacifier-sucking time, and appropriate treatment should be rendered, if required.

Chi-Square Distribution↗

PubMed2006

Comparison of shear bond strength of two self-etch primer/adhesive systems.

Orthodontic brackets adhesive systems use three different agents, an enamel conditioner, a primer solution, and an adhesive resin. A unique characteristic of some new bonding systems is that they combine the conditioning, priming, and adhesive agents into a single application. The purpose of this study was to assess and compare the effects of using one-step and two-step self-etch primer/adhesive systems on the shear bond strength of orthodontic brackets. The brackets were bonded to extracted human molars according to one of two protocols. Group I (control): a two-step self-etch acidic primer/adhesive system was used, Transbond Plus was applied to the enamel surface as suggested by the manufacturer. The brackets were bonded with Transbond XT and light cured for 20 seconds. Group II: a one-step self-etch, self-adhesive resin cement system, Maxcem, was applied directly to the bracket. The self-etch primer/adhesive is made of two components that mix automatically during application. The brackets were then light cured for 20 seconds. The mean shear bond strength of the two-step acid-etch primer/adhesive was 5.9 +/- 2.7 Mpa and the mean for the one-step system was 3.1 +/- 1.7 MPa. The in vitro findings of this study indicated that the shear bond strengths (t = 3.79) of the two adhesive systems were significantly different (P = .001). One-step adhesive systems could potentially be advantageous for orthodontic purposes if their bond strength can be improved.

Acid Etching, Dental↗

PubMed2006

Fluoride release rate from an orthodontic sealant and its clinical implications.

The objectives were to measure the rate and amount of fluoride ions released from the sealant over a period of 17 weeks and to determine whether the fluoride-releasing sealant has a recharging ability when fluoride ions are reintroduced into the environment. Disc-shaped specimens were prepared from two types of sealants: (1) 10 discs were made using a fluoride-releasing sealant and (2) 10 discs were made of a nonfluoride adhesive primer (control). An ion analyzer was used to measure the fluoride release using a fluoride ion-specific combination electrode. The results of the repeated measure analysis (F = 7.76) indicated that the fluoride-containing sealant released fluoride ions into the solution in sustained but significantly (P = .014) decreasing rates from a high of 0.074 +/- 0.04 ppm/week/mm2 in the first week to a low of 0.015 +/- 0.017 ppm/week/mm2 at the end of the 17th week. Furthermore, the Pro Seal discs had the ability to be recharged with fluoride ions introduced from a foaming solution of acidulated phosphate fluoride. The mean fluoride release rate one week after recharging was 0.354 +/- 0.095 ppm/week/mm2 and decreased to 0.014 +/- 0.009 ppm/week/mm2 after eight weeks. The control sealant showed no significant fluoride release and was unable to absorb the fluoride ions available in the solution. The fluoride-containing sealant Pro Seal released fluoride ions in sustained but significantly decreasing amounts. The Pro Seal discs had the ability to be recharged with fluoride ions.

Cariostatic Agents↗

PubMed2006

Early shear bond strength of a one-step self-adhesive on orthodontic brackets.

OBJECTIVE: The purpose of this study was to determine whether a self-adhesive universal cement, RelyX Unicem (3M ESPE, Seefeld, Germany), can be used successfully to bond orthodontic brackets to enamel. MATERIALS AND METHODS: Forty human molars were cleaned, mounted, and randomly divided into two groups: 20 orthodontic brackets were bonded to teeth using RelyX Unicem, and 20 brackets were bonded using the Transbond XT (3M Unitex, Monrovia, Calif) adhesive system. The teeth were debonded within 30 minutes after initial bonding using a universal testing machine. After debonding, the enamel surface was examined under 10x magnification to determine the amount of residual adhesive remaining on the tooth. Student's t-test was used to compare the shear bond strength (SBS) of the two groups, and the chi-square test was used to compare the Adhesive Remnant Index (ARI) scores for the two adhesive systems. RESULTS: The mean SBS of the brackets bonded using the RelyX Unicem was 3.7 +/- 2.1 MPa and was significantly lower (t = 2.07, P = .048) than the SBS of the brackets bonded with the Transbond system (x = 5.97 +/- 4.2 MPa). The comparisons of the ARI scores between the two groups (chi(2) = 17.4) indicated that bracket failure mode was significantly different (P = .002) with more adhesive remaining on the teeth bonded with Transbond XT. CONCLUSIONS: The SBS of the self-adhesive universal cement needs to be increased for it to be successfully used for bonding orthodontic brackets.

Adhesiveness↗

PubMed2006

Timing of fluoride intake in relation to development of fluorosis on maxillary central incisors.

OBJECTIVES: Several studies have focused on the timing of fluoride intake relative to the development of dental fluorosis. This study reports the relationships of fluoride intake during the first 48 months of life with fluorosis on early-erupting permanent teeth. METHODS: Subjects were followed from birth to 48 months with questionnaires every 3-4 months. Questionnaires gathered data on intakes from water, diet, supplements, and dentifrice to estimate total fluoride intake. Early-erupting permanent teeth of 579 subjects were assessed for fluorosis using the Fluorosis Risk Index (FRI) at approximately age 9. Fluorosis cases were defined as having FRI definitive or severe fluorosis on both maxillary central incisors. Individuals with FRI questionable fluorosis were excluded. The importance of fluoride intake during different time periods was assessed using t-tests and logistic regression. RESULTS: One hundred and thirty-nine (24%) subjects had fluorosis on both maxillary central incisors. Mean fluoride intake per unit body weight (bw) ranged from 0.040 to 0.057 mg/kg bw, with higher intake during earlier time periods and relative stability after 16 months. In bivariate analyses, fluoride intakes during each of the first 4 years were individually significantly related to fluorosis on maxillary central incisors, with the first year most important (P < 0.01), followed by the second (P < 0.01), third (P < 0.01), and fourth year (P = 0.03). Multivariable logistic regression analyses showed that, after controlling only for the first year, the later years individually were still statistically significant. When all four time periods were in the model, the first (P < 0.01) and second years (P = 0.04) were still significant, but the third (P = 0.32) and fourth (P = 0.82) were not. CONCLUSIONS: The first two years of life were most important to fluorosis development in permanent maxillary central incisors; however, this study also suggests the importance of other individual years.

Age Factors↗

PubMed2006

The cost-effectiveness of large amalgam and crown restorations over a 10-year period.

OBJECTIVE: To assist clinical decision making for an individual patient or on a community level, this study was done to determine the differences in costs and effectiveness of large amalgams and crowns over 5 and 10 years when catastrophic subsequent treatment (root canal therapy or extraction) was the outcome. METHODS: Administrative data for patients seen at the University of Iowa, College of Dentistry for 1735 large amalgam and crown restorations in 1987 or 1988 were used. Annual costs and effectiveness values were calculated. Costs of initial treatment (large amalgam or crown), and future treatments were determined, averaged and discounted. The effectiveness measure was defined as the number of years a tooth remained in a state free of catastrophic subsequent treatment. Years free of catastrophic treatment were averaged, and discounted. The years free of catastrophic treatment accounted for individuals who dropped out or withdrew from the study. RESULTS: Teeth with crowns had higher effectiveness values at a much higher cost than teeth restored with large amalgams. The cost of an addition year free of catastrophic treatment for crowns was 1088.41 dollars at 5 years and 500.10 dollars at 10 years. Teeth in women had more favorable cost-effectiveness ratios than those in men, and teeth in the maxillary arch had more favorable cost-effectiveness ratios than teeth in the mandibular arch. CONCLUSIONS: Neither the large amalgam or crown restoration had both the lowest cost and the highest effectiveness. The higher incremental cost-effectiveness ratio for crowns should be considered when making treatment decisions between large amalgam and crown restorations.

Adult↗

PubMed2006

Longitudinal study of non-cavitated carious lesion progression in the primary dentition.

OBJECTIVES: This study reports changes in non-cavitated tooth surface diagnoses after a 4-year period. METHODS: Dental examinations were conducted for Iowa Fluoride Study cohort children who had non-cavitated lesions in the primary dentition and were also examined an average of 4 years later in the mixed dentition. Comparison of fluoride exposures, socioeconomic factors, and beverage consumption patterns were made between children who had lesions progress and those who did not. RESULTS: Of 129 non-cavitated pit and fissure lesions in the first exams, 40 (31%) progressed to either frank decay or filled status, while among 132 noncavitated smooth surface lesions, 7 (5%) were filled and none had frank decay in the second exam. No fluoride, socioeconomic status or beverage variables were significantly associated with lesion progression. CONCLUSIONS: Non-cavitated smooth surface lesions rarely progressed in this age group, but nearly one-third of pit and fissure lesions progressed.

Cariostatic Agents↗

PubMed2006

Use of the fluorosis risk index in a cohort study: the Iowa fluoride study.

OBJECTIVES: Several studies have used the Fluorosis Risk Index (FRI) to assess risk factors for dental fluorosis. This study reports fluorosis prevalence estimates in a birth cohort using the FRI in different ways. METHODS: Subjects (n=443) were participants in the Iowa Fluoride Study, a birth cohort study of fluoride exposures and intake, fluorosis, and caries. Early-erupting permanent teeth were assessed for fluorosis using the FRI at approximately age 9. Fluorosis prevalence rates were calculated separately for specific teeth and different combinations of teeth, with varied FRI zones included and using different thresholds. Mean numbers of teeth with fluorosis were calculated. RESULTS: Tooth-specific fluorosis prevalence varied, with maxillary central incisor fluorosis most prevalent and mandibular incisors least affected. Considering three zones of each tooth (cervical zones excluded), 40.6% overall had at least one tooth with mild or more involved fluorosis, 30.2% were questionable fluorosis, and 29.1% had no fluorosis. When only FRI zone I areas were considered, the corresponding percentages were 33.2%, 29.3%, and 37.5%, respectively. When different combinations of teeth were used to define fluorosis cases, the prevalences estimated using three zones were generally 1 to 9 percentage points higher than those estimated from FRI zone 1 only. Most fluorosis was mild, with only 7 individuals (1.6%) having FRI severe fluorosis. CONCLUSIONS: The FRI has advantages for use in analytical epidemiologic studies of dental fluorosis. However, the population prevalence estimates vary, depending on the index and case definition used. Therefore, it is recommended that consideration be given to concurrent use of another index (i.e., TSIF, TF, Dean's) if prevalence estimates are an important study outcome.

Cariostatic Agents↗

PubMed2006

Associations between dental fluorosis of the permanent and primary dentitions.

OBJECTIVES: Relatively little is known about associations between primary and permanent tooth fluorosis. In this study, associations between dental fluorosis of the permanent and primary dentitions were assessed. METHODS: Subjects (n = 601) are in the Iowa Fluoride Study, which included fluorosis examinations of the primary and early-erupting permanent dentitions by trained dentist examiners. Relative risks, correlations, and logistic regression assessed associations between permanent tooth fluorosis and primary molar fluorosis. RESULTS: Ten percent had primary molar fluorosis at age 5; 36% had definitive (mostly mild), 28% questionable, and 36% no permanent incisor fluorosis at age 9. Those with primary molar fluorosis were significantly more likely to have definitive permanent incisor fluorosis (76% vs. 32%), and permanent molar fluorosis (59% vs. 16%). The strong association between primary and permanent tooth fluorosis is independent of level of fluoride intake. CONCLUSIONS: Detection of primary tooth fluorosis in pre-school children should alert clinicians and parents to the high likelihood of subsequent fluorosis in the permanent dentition.

Child↗

PubMed2006

Fluoride intake levels in relation to fluorosis development in permanent maxillary central incisors and first molars.

Gaps remain in our knowledge about the levels of fluoride intake that cause dental fluorosis. The purpose of this study was to report the fluorosis prevalence by levels of estimated fluoride intake in an effort to understand the importance of different levels of daily fluoride intake. As part of the longitudinal Iowa Fluoride Study, subjects were followed from birth to 36 months with questionnaires every 3-4 months to gather information on fluoride intake from various sources. Daily fluoride intake in mg per kg body weight (BW) was estimated from water, beverages and selected foods, fluoride supplements and dentifrice. Six hundred and twenty-eight subjects were examined for fluorosis on permanent incisors and first molars at about age 9 by two calibrated examiners using the Fluorosis Risk Index categories. Fluorosis prevalence rates were determined separately for maxillary central incisors and first molars by levels of estimated fluoride intake. There were significant positive associations between fluorosis prevalence and levels of fluoride intake. Cumulatively from birth to 36 months, average daily intake of 0.04 mg F/kg BW or less carried relatively low risk for fluorosis (12.9% for maxillary central incisors, 6.8% for first molars). Average daily intake of 0.04-0.06 mg F/kg BW showed a significantly elevated risk for fluorosis (23.0% for maxillary central incisors, 14.5% for first molars), while fluorosis risk was even higher for average intake above 0.06 mg F/kg BW (38.0% for maxillary central incisors, 32.4% for first molars). The study suggests that fluorosis prevalence is related to elevated fluoride intake when averaged over the first 3 years of life, but is even more strongly related to fluoride intake that is elevated for all of the first 3 years of life.

Adult↗

PubMed2006

Fluoride dentifrice ingestion and fluorosis of the permanent incisors.

BACKGROUND: Fluoride dentifrice is a primary means of preventing childhood caries, but it is also an important risk factor for fluorosis. The authors examine the influence of fluoride dentifrice ingestion on fluorosis of the permanent incisors. METHODS: Participants in the Iowa Fluoride Study received questionnaires at regular intervals concerning fluoride sources. The authors assessed fluorosis using the fluorosis risk index. They estimated daily fluoride ingestion from dentifrice, diet and fluoride supplements and divided the amount by kilograms of body weight. The statistical analysis related fluoride ingestion to fluorosis in the permanent incisors. RESULTS: In bivariate analyses, mild fluorosis was significantly related to ingestion of fluoride dentifrice at ages 24 and 36 months (P = .02 for both). After the authors adjusted for fluoride ingested from dietary sources, logistic regression showed a significant association between fluorosis and dentifrice ingestion at age 24 months (P = .04). CONCLUSIONS: The study results suggest that fluorosis of the permanent incisors is influenced by ingestion of fluoride dentifrice during the first three years of life. Further research is needed to assess total intake of fluoride as a risk factor for fluorosis. CLINICAL IMPLICATIONS: These results support recommendations that young children use only a pea-sized amount of dentifrice. Parents should supervise young children as they brush their teeth with fluoride dentifrice.

Age Factors↗

PubMed2005

Association of amoxicillin use during early childhood with developmental tooth enamel defects.

BACKGROUND: It has been speculated that amoxicillin use could be associated with dental enamel defects. OBJECTIVE: To assess the association between dental fluorosis, one of the most common developmental tooth enamel defects, and amoxicillin use during early childhood. DESIGN, SETTING, AND PARTICIPANTS: As participants in the Iowa Fluoride Study, subjects were followed up from birth to 32 months using questionnaires every 3 to 4 months to gather information on fluoride intake and amoxicillin use. METHODS: Early-erupting permanent teeth of 579 subjects were assessed for fluorosis using the Fluorosis Risk Index at approximately the age of 9 years. Relationships between fluorosis and amoxicillin use were assessed using relative risk (RR), Mantel-Haenszel stratified analyses, and multivariable logistic regression. RESULTS: Amoxicillin use was reported by 75% of subjects by 12 months and 91% by 32 months. Overall, 24% had fluorosis on both maxillary central incisors. Amoxicillin use from 3 to 6 months significantly increased the risk of fluorosis on the maxillary central incisors (RR = 2.04; 95% confidence interval [CI], 1.49-2.78). After adjusting for fluoride intake and otitis media, the risk of fluorosis on the maxillary central incisors from amoxicillin use during 3 to 6 months (Mantel-Haenszel RR = 1.85; 95% CI, 1.20-2.78) was still statistically significant. Multivariable logistic regression analyses confirmed the increased risk of fluorosis from amoxicillin use during 3 to 6 months (odds ratio = 2.50; 95% CI, 1.21-5.15); fluoride intake was also statistically significant. CONCLUSION: The findings from this study suggest a link between amoxicillin use during infancy and developmental enamel defects of permanent teeth; however, further research is needed.

Amoxicillin↗

PubMed2005

Comparison of bonding time and shear bond strength between a conventional and a new integrated bonding system.

Conventional adhesive systems use 3 different agents, an enamel conditioner, a primer solution, and an adhesive resin during the bonding of orthodontic brackets to enamel. A characteristic of some new bonding systems is that they combine the conditioning and priming agents into a single application as well as precoat the bracket with the adhesive in an attempt to save time during the bonding procedure. This study compared the total bonding time and shear bond strength (SBS) of 2 bracket-bonding systems: (1) an integrated system that incorporates a self-etching primer and precoated brackets and (2) a conventional system in which the etchant and primer are applied separately and the adhesive applied to the bracket by the clinician. The results of the SBS and the total bonding time comparisons (t = 3.451) of the 2 adhesive systems showed a significant difference (P = .0001). The mean SBS was 9.4+/-3.7 MPa for the new bonding system and 6.2+/-4.4 MPa for the conventional system. The mean total bonding time was 36.5 s/tooth for the new system and 46.7 s/tooth for the conventional system. The clinician has to decide whether the increase in bond strength, the decrease in the total bonding time, and the steps saved during the bonding procedure with the new bonding system balance the increased cost incurred.

Analysis of Variance↗

PubMed2005

Waterline disinfectant effect on the shear bond strength of orthodontic brackets.

The purpose of this study was to determine whether the use of an iodine compound for disinfecting the waterlines in dental units has an effect on the shear bond strength of orthodontic brackets bonded to enamel. Forty molar teeth were divided randomly into two groups- group 1 control: twenty teeth were etched for 15 seconds with 35% phosphoric acid, washed with a distilled water spray for 10 seconds, stored in distilled water for 5 minutes, dried to a chalky white appearance, and the sealant applied to the etched surface; group 2 experimental: twenty teeth were etched for 15 seconds with 35% phosphoric acid and washed for 10 seconds with water containing iodine. The teeth were stored for five minutes in the iodinated water, dried to a chalky white appearance, and the sealant applied to the etched surface as in the control group. Precoated brackets were placed on all the teeth and light cured for 20 seconds. All teeth were debonded within 30 minutes from the initial time of bonding. The t-test results (t = 1.74) indicated that there were no significant (P = .09) differences in the shear bond strengths of the teeth that were washed and immersed in the iodine solution and the control group in which distilled water was used. The mean shear bond strengths for the two groups were 6.5 +/- 3.5 MPa and 4.7 +/- 3.1 MPa, respectively.

Acid Etching, Dental↗

PubMed2005

Effect of antimicrobial monomer-containing adhesive on shear bond strength of orthodontic brackets.

A new antibacterial and fluoride-releasing bonding system consists of a self-etching primer that contains an antibacterial monomer and a bonding agent that contains sodium fluoride. This study was to determine the effect of using this new adhesive on the shear bond strength of orthodontic brackets. Forty molar teeth were randomly divided into two groups. Group 1 consisted of 20 teeth that were etched for 15 seconds with 35% phosphoric acid, washed with a water spray for 10 seconds, and dried to a chalky white appearance, and the sealant was applied to the etched surface. The precoated brackets were placed on the teeth and light cured. Group 2 consisted of 20 teeth that were etched with 35% phosphoric acid for 15 seconds as suggested by the manufacturer when bonding to intact enamel. The teeth were washed with a water spray for 10 seconds and dried to a chalky white appearance, and the primer containing antibacterial monomer was applied to the etched surface, left for 20 seconds, and sprayed with a mild airstream. The adhesive was applied to each tooth, and the precoated bracket was placed and light cured. There were no significant differences (P = .220) in the shear bond strengths of the two groups. The mean shear bond strength for the antibacterial fluoride-releasing adhesive was 11.7 +/- 5.6 MPa and for the control was 9.6 +/- 5.0 MPa. The use of an antibacterial fluoride-releasing adhesive system did not affect the shear bond strength of the orthodontic brackets within the first half hour after initial bonding.

Adhesives↗

PubMed2005

Effect of changing a test parameter on the shear bond strength of orthodontic brackets.

The purpose of this study was to determine the effect of changing the crosshead speed of the testing machine on the shear bond strength of orthodontic brackets to enamel while standardizing all the other variables. Forty freshly extracted human molars were bonded using the Transbond XT adhesive system (3M Unitek, Monrovia, Calif). The teeth were randomly divided into two groups. In group I, the shear bond strength was measured at a crosshead speed of 5.0 mm/min, and in group II the shear bond strength was measured at a crosshead speed of 0.5 mm/ min. Within half an hour from the initial bonding of each tooth, an occlusogingival load was applied to the bracket, producing a shear force at the bracket-tooth interface. This was accomplished by using the flattened end of a steel rod attached to the crosshead of a Universal Test Machine (Zwick GmbH & Co, Ulm, Germany). The t-test results (t = 2.71) indicated that there was a significant difference (P = .014) in the shear bond strengths between the group tested at a crosshead speed of 5.0 mm/min and the group tested at a crosshead speed of 0.5 mm/min. The mean shear bond strengths for the two groups were 7.0 +/- 4.6 MPa and 12.2 +/- 4.0 MPa, respectively. These findings indicated that it is important to identify the parameters included in shear bond testing in order to enable meaningful comparisons of the performance of different materials.

Dental Bonding↗

PubMed2005

Patterns of dietary fluoride supplement use in children from birth to 96 months of age.

OBJECTIVE: This paper reports on fluoride supplement use from birth to age 96 months. METHODS: As part of the Iowa Fluoride Study, questionnaires were mailed at 3 to 6- month intervals assessing use of supplements. Estimated fluoride intake from supplements was calculated as a daily fluoride intake in mg. Analyses include descriptive statistics of supplements use for individual periods, area-under-the-curve (AUC) for combined periods, and associations between fluoride supplement use and demographic covariates. RESULTS: Participants (n=1,388) were mostly white, with about two-thirds of parents having some college education. Percentages using fluoride supplements were 11.2% (12 months), 6.3% to 6.8% (24, 36, 48 and 60 months) and 3.6% to 4.7% (72, 84 and 96 months). Physicians prescribed most supplements until age three. The mean supplement dosage when used gradually increased from 0.25 mg (12 months) to 0.82 mg (84 months) and 0.75 mg (96 months). The effective mean daily fluoride supplement quantities ingested among users for the successive age groups from 12 to 96 months old were 0.14, 0.14, 0.25, 0.34, 0.37, 0.43, 0.48, and 0.37 mg, respectively. Estimated daily average fluoride ingested from supplements increased from 0.06 mg (birth-12 months) to 0.07 mg (12-60 months) to 0.18 mg (60-96 months). CONCLUSION: Fluoride supplement use patterns varied substantially among individuals; however, average use within the intervals birth-12 months, 12-60 months, and 60-96 months was fairly consistent.

Adolescent↗