Skip to main content
Article thumbnail
Location of Repository

Exposure to High Fluoride Drinking Water and Risk of Dental Fluorosis in Estonia

By Ene Indermitte, Astrid Saava and Enn Karro


The purpose of this study was to assess exposure to drinking water fluoride and evaluate the risk of dental fluorosis among the Estonian population. The study covered all 15 counties in Estonia and 93.7% of population that has access to public water supplies. In Estonia groundwater is the main source for public water supply systems in most towns and rural settlements. The content of natural fluoride in water ranges from 0.01 to 7.20 mg/L. The exposure to different fluoride levels was assessed by linking data from previous studies on drinking water quality with databases of the Health Protection Inspectorate on water suppliers and the number of water consumers in water supply systems. Exposure assessment showed that 4% of the study population had excessive exposure to fluoride, mainly in small public water supplies in western and central Estonia, where the Silurian-Ordovician aquifer system is the only source of drinking water. There is a strong correlation between natural fluoride levels and the prevalence of dental fluorosis. Risk of dental fluorosis was calculated to different fluoride exposure levels over 1.5 mg/L

Topics: Article
Publisher: Molecular Diversity Preservation International (MDPI)
OAI identifier:
Provided by: PubMed Central

Suggested articles


  1. (2005). A quantitative look at fluorosis, fluoride exposure, and intake in children using a health risk assessment approach. Environ. Health Persp.
  2. (1934). Classification of mottled enamel diagnosis.
  3. (2004). Eesti põ hjavee kasutamine ja kaitse. [Use and protection of groundwater in Estonia]. Eesti Põ hjaveekomisjon:
  4. (1999). Exposure to natural fluoride in well water and hip fracture: A cohort analysis in
  5. (2005). Fluoride levels in the Silurian-Ordovician aquifer system of western Estonia. Fluoride
  6. (2006). Fluoride occurrence in publicly supplied drinking water
  7. (2004). Fluorides in groundwater, soil and infused black tea and the occurrence of dental fluorosis among school children of the Gaza Strip.
  8. (2004). Guidelines for drinking-water quality. 3 nd Ed.; World Health Organization:
  9. (1997). Handbook of pediatric dentistry;
  10. (2006). High fluoride content of K-bentonite beds in Estonian Paleozoic carbonate rocks. Fluoride
  11. (1970). Joogivee erineva fluorisisalduse mõ just laste hammaskonna seisundile Eesti NSV tingimustes. [The influence of different fluoride content in drinking water to dental status of children
  12. (1963). Joogivee fluori- ja joodisisaldus Eesti NSV-s [Fluoride and iodine content of drinking water in Estonian SSR]. Kurortoloogilised Uurimised
  13. (1973). Mikroelementide sisaldus Eesti vetes ja nende osa kohalikus patoloogias [Content of microelements in water in Estonia and their role in local pathology]. Eesti Loodus
  14. (1997). Oral Health Surveys. Basic Methods, 4 th Ed.; World Health Organisation:
  15. (2009). Social Affairs. Joogivee kvaliteedi- ja kontrollinõ uded ning analü ü simeetodid. [The quality and monitoring requirements for drinking water and methods of analysis]. Riigi teataja 2001, 100, 1369 (in Estonian).
  16. (2000). Sources of dietary fluoride intake in 4-year-old children residing in low, medium and high fluoride areas in Iran.
  17. (2007). Tap water fluoride levels in Estonia. Fluoride
  18. (2005). The contribution of drinking water towards dental fluorosis: A case study in Tartu. Paper Anthropol.
  19. (2001). Well water fluoride, dental fluorosis, bone fractures in the Guadiana Valley of Mexico. Fluoride

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.