Safe use of fluoride-containing toothpastes for caries prevention in children

Relevance. Following environmental rehabilitation efforts in Chapayevsk, Samara Region, an increase in the prevalence and severity of dental caries has been observed, particularly among preschool-aged children.

Objective. To evaluate the safety of fluoride use for preventing dental caries in children.

Material and methods. A survey was conducted among 124 parents of children aged 5–6 years attending preschools and 361 adolescents aged 12 and 15 years, using the WHO questionnaire (2013). Responses regarding oral hygiene habits were analyzed. Fluoride ion concentrations were measured in drinking water using the potentiometric method (GOST 4386-89 S.6), in urine according to GOST 8.563-96, and in toothpastes following GOST 7983-2016. The availability and popularity of fluoride-containing toothpastes in pharmacies and supermarkets were also assessed. Statistical analysis was performed using IBM SPSS Statistics v.26 (IBM Corporation).

Results. Over the past 15 years, the fluoride content in drinking water decreased from 0.78–0.91 mg/L to 0.49– 0.71 mg/L following the city’s environmental rehabilitation efforts, remaining suboptimal for caries prevention. Analysis of fluoride excretion via the kidneys indicated low overall fluoride intake from water, toothpaste, and food. A weak correlation was found between the DMFT (decayed, missing, and filled teeth) index and urinary fluoride levels (ρ = 0.35), as well as estimated systemic fluoride levels (ρ = 0.36). These results indicate low fluoride intake, eliminating concerns about toxic effects on health. An analysis of toothpaste preferences showed that the population primarily chooses fluoride-free toothpastes or those with fluoride levels below 1000 ppm. This trend is influenced by the product range available, low adherence to preventive dental care, and misinformation from online sources that often attribute negative effects to fluoridation or raise safety concerns. The actual fluoride content in toothpastes was found to be within acceptable technological limits.

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