Fluorosis and Oral Health Status in Adolescents Living in a High-Fluoride Groundwater Area: A Case Study of Nairobi Suburbs (Kenya)

Abstract

Dental fluorosis is an irreversible defect in dental enamel caused by long-term undesired fluoride intake during tooth formation. The clinical manifestations may range from white spots to dark brown areas, which can initially represent only an aesthetic problem, but they can also lead to functional problems—in severe cases, pitting and fractures can occur. The aim of this cross-sectional study in a cluster of 215 Kenyan adolescents was to evaluate oral health status—especially with respect to fluorosis and dental caries risk factors—in the Nairobi suburbs. Clinical data were recorded using DMFT and TF indices in accordance with the WHO standards. A multivariate model with logistic regression was carried out. In total, 36.7% of individuals presented carious lesions. The DMFT index was 0.87 in the total sample. Around 78.6% were affected by mild-to-severe forms of fluorosis. Statistically significant associations were found between the presence of caries and consuming sweets during (OR = 3.9) and between meals (OR = 3.6), consuming soft drinks during (OR = 2.8) and between meals (OR = 4.3), tooth-brushing frequency (OR = 2.8), use of toothbrush and toothpaste (OR = 3.8), presence of bleeding (OR = 10.2), and calculus (OR = 12.1). It is critical to give people sufficient knowledge and to educate the communities to mobilize the implementation of preventive measures, such as reducing fluoride ingestion and paying attention to the dangers of drinking untreated water, in order to develop strategies to ensure equitable access to medical services and promote oral prevention programs to significantly reduce the impact of oral diseases.