Risk of fluorosis associated with infant formulas prepared with bottled water

Author(s): M Buzalaf
Journal: Journal of Dentistry for Children
Volume (number): 71:2
Month, Year: 2004
Major topic: Fluoride
Minor topic(s): Fluorosis
Type of Article: En vitro study
Main Purpose: Evaluate levels of fluoride in formulas prepared with bottled water (fluoridated or unfluoridated)
Overview of method of research: Mix different kinds of formula with different types of bottled water and measure the fluoride content. Each test was done three times to ensure accuracy of the data.
Findings: When mixed with optimally fluoridated water, infant formula contains fluoride levels that are above the recommended limit and may predispose patients to dental fluorosis.
Key points/Summary: Infant formulas may be a major risk factor for fluorosis, especially when prepared with fluoridated water. A total daily intake of fluoride between 0.05 and 0.07 mg/kg is generally regarded as optimum. When mixed with deionized water, all formulas tested provide suboptimal levels of fluoride to the patient. However, when mixed with “optimally fluoridated” water (titrated to optimal value for older patients), levels of fluoride in formula can reach levels that are double the recommended dose, and may cause dental fluorosis. Also of note, older infants (6 months and above) are most likely ingesting fluoride from other sources e.g. foods, water, juices. The author suggests giving specific guidelines to parents for optimization of fluoride levels e.g. how many bottles per day with bottled water formula, and how many from the tap/fluoridated bottled water (are we discussing this in the infant/toddler program?). The author also suggests increasing awareness of this issue in our communities e.g. pediatricians etc…
Assessment of article: Very interesting.