Determinação da exposição apropriada a fluoreto no futuro para países de economia de mercado não estabilizada

An appropriate exposure to fluoride must be able to interfere with the development of dental caries (benefit) without great concern for dental fluorosis (risks). This condition in relation to individual seems feasible leading to a rational use of fluoride. Nevertheless, dealing with population and particularly non-EME countries (non-Established Market Economies or developing), the most suitable method of fluoride use will depend on each nation. On the other hand, each country should have a public health program to control dental caries as part of its health system. The choice between fluoridated dentifrice or fluoridated drinking water and the option for salt will depend on its applicability in each country. At the same time, it is important that either the appropriate exposure to a community method of fluoride use as well as the association with other methods and preventive measures in relation to risks-benefits are evaluated for each country. The determination of an appropriate exposure to fluoride in non-EME countries in the future will depend on critical analysis of how it has been used at present. Available data have shown that some non-EME countries have even been able to revert the dramatic situation of dental caries in their population, but in others caries experience continues a public health problem. Nevertheless, in other countries the increase in caries prevalence, which was expected, has not occurred but endemic fluorosis has been a concern. The challenges for non-EME countries are huge and identical solutions cannot be used for distinct problems.An appropriate exposure to fluoride must be able to interfere with the development of dental caries (benefit) without great concern for dental fluorosis (risks). This condition in relation to individual seems feasible leading to a rational use of fluoride. Nevertheless, dealing with population and particularly non-EME countries (non-Established Market Economies or developing), the most suitable method of fluoride use will depend on each nation. On the other hand, each country should have a public health program to control dental caries as part of its health system. The choice between fluoridated dentifrice or fluoridated drinking water and the option for salt will depend on its applicability in each country. At the same time, it is important that either the appropriate exposure to a community method of fluoride use as well as the association with other methods and preventive measures in relation to risks-benefits are evaluated for each country. The determination of an appropriate exposure to fluoride in non-EME countries in the future will depend on critical analysis of how it has been used at present. Available data have shown that some non-EME countries have even been able to revert the dramatic situation of dental caries in their population, but in others caries experience continues a public health problem. Nevertheless, in other countries the increase in caries prevalence, which was expected, has not occurred but endemic fluorosis has been a concern. The challenges for non-EME countries are huge and identical solutions cannot be used for distinct problems1128395Uma exposição apropriada ao fluoreto é aquela capaz de interferir com o desenvolvimento de cárie dental (benefício) sem grandes preocupações com fluorose dental (riscos). Esta condição em termos de indivíduo parece factível levando ao uso racional do fluoreto. Entrentanto, em se tratando de população e particularmente países non-EME, o método mais adequado de usar fluoreto vai depender de cada nação. Por outro lado, é imprescindível que haja uma política nacional de um método coletivo para controlar cárie como integrante do sistema de saúde de cada país. A escolha entre dentifrício fluoretado ou água fluoretada e a opção por sal vai depender da sua aplicabilidade a cada país. Ao mesmo tempo, é importante que para cada país seja avaliada não só a exposição apropriada do método coletivo de usar fluoreto, assim como a associação com outros métodos e meios em termos de riscos-benefícios. A determinação da exposição apropriada a fluoreto nos países non-EME no futuro dependerá da análise crítica de como ele tem sido usado no presente. Dados disponíveis têm mostrado que alguns países non-EME têm inclusive conseguido reverter a situação dramática de cárie de sua população, mas em outros a experiência de cárie continua dramática. Entretanto, em outros países não tem ocorrido um aumento da prevalência de cárie que se esperaria, mas fluorose endêmica é uma preocupação. Os desafios para países non-EME são imensos e para problemas distintos não existem as mesmas soluçõe

In situ study of sucrose exposure, mutans streptococci in dental plaque and dental caries

The purpose of this study was to investigate the relationship among frequency of sucrose exposure, mutans streptococci levels and dental caries. Adult volunteers took part in this crossover study performed in 4 phases of 28 days each. The volunteers wore intra-oral palatal appliances containing blocks of human dental enamel and dripped 20% sucrose solution onto the dental blocks from 0 to 8 times/day. After each phase, the colony forming units (CFU) were determined in dental plaque and enamel dental caries was evaluated using cross-sectional hardness. Sucrose frequency had no statistically significant effect on mutans streptococci levels. In the enamel cross-sectional hardness tests, significant differences (p < 0.05) in relation to area of mineral loss were observed only when sucrose exposure was 8 times/day. Similar results were obtained when cross-sectional hardness was assessed at each distance from enamel surface.The purpose of this study was to investigate the relationship among frequency of sucrose exposure, mutans streptococci levels and dental caries. Adult volunteers took part in this crossover study performed in 4 phases of 28 days each. The volunteers wore intra-oral palatal appliances containing blocks of human dental enamel and dripped 20% sucrose solution onto the dental blocks from 0 to 8 times/day. After each phase, the colony forming units (CFU) were determined in dental plaque and enamel dental caries was evaluated using cross-sectional hardness. Sucrose frequency had no statistically significant effect on mutans streptococci levels. In the enamel cross-sectional hardness tests, significant differences (p < 0.05) in relation to area of mineral loss were observed only when sucrose exposure was 8 times/day. Similar results were obtained when cross-sectional hardness was assessed at each distance from enamel surface12210110

Anticaries potential of low fluoride dentifrices found in the brazilian market

CNPQ – CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOLow-fluoride (F) dentifrices (<600 µg F/g) are widely available worldwide, but evidence to recommend the use of such dentifrices, with either regular or improved formulations, is still lacking. Therefore, the aim of this study was to evaluate the anticaries potential of low-F dentifrices found in the Brazilian market, using a validated and tested pH-cycling model. Enamel blocks were selected by surface hardness (SH) and randomized into four treatment groups (n=12): non-F dentifrice (negative control), low-F dentifrice (500 μg F/g), low-F acidulated dentifrice (550 μg F/g) and 1,100 μg F/g dentifrice (positive control). The blocks were subjected to pH-cycling regimen for 8 days and were treated 2x/day with dentifrice slurries prepared in water (1:3, w/v). The pH of the slurries was checked, and only the acidulated one had low pH. After the pH cycling, SH was again determined and the percentage of surface hardness loss was calculated as indicator of demineralization. Loosely- and firmly-bound F concentrations in enamel were also determined. The 1,100 μg F/g dentifrice was more effective than the low-F ones to reduce enamel demineralization and was the only one that differed from the non-F (p<0.05). All F dentifrices formed higher concentration of loosely-bound F on enamel than the non-F (p<0.05), but the 1,100 μg F/g was the only one that differed from the non-F in the ability to form firmly-bound F. The findings suggest that the low-F dentifrices available in the Brazilian market, irrespective of their formulation, do not have anticaries potential27315CNPQ – CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOCNPQ – CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOsem informaçã

Quality Of Drinking Water Fluoridation Of Capão Bonito, S P, Brazil, Evaluated By Operational And External Controls

Purpose: To evaluate the quality of drinking water fluoridation of Capão Bonito, S P, Brazil, whose optimal fluoride concentration should be between 0.6 to 0.8 ppm F, considering the balance benefits/risks. Methods: Historical records (n=1,964) from 2005 to 2009 of the water treatment plant (operational control) were evaluated. Also, from July 2009 to June 2010, 120 samples of the network water were collected for analysis and the fluoride concentrations found (external control) were compared with records of operational control of the same period. Results: According to the historical records, 76.3% of the samples had acceptable fluoride concentration and this value was confirmed by the external control done during one year, which found that 80.8% of samples were within the optimal range. However, considering the samples out the optimal range, while the records of the operational control showed values below the minimum, the results of the external control found higher percentage of samples above the maximum. Conclusion: The data show the relevance to have a quality control of drinking water fluoridation because at same time the operational control analysis suggests that certain percentage of the population would not be receiving anticaries benefits, the external control indicates that it would be in increased risk of fluorosis. Copyright: © 2011 Olivati et al.;.264285290McDonagh, M.S., Whiting, P.F., Wilson, P.M., Sutton, A.J., Chestnutt, I., Cooper, J.X., Systematic review of water fluoridation (2000) BMJ, 321, pp. 855-859Galagan, D.J., Vermillion, J.R., Determining optimum fluoride concentrations (1957) Public Health Rep, 72, pp. 491-493Frazão, P., Peres, M.A., Cury, J.A., Drinking water quality and fluoride concentration (2011) Rev Saude Publica, 45, pp. 964-973Brasil. Lei Federal n°6.050, de 24/05/1974 (1974) Coleção Das Leis de 1974: Atos do Poder Legislativo: Leis de Abril a Junho, 3, p. 107. , Brasília, DF: Departamento de Imprensa NacionalCatani, D.B., Amaral, R.C., Oliveira, C., Souza, M.L.R., Cury, J.A., Ten years of external control of the fluoride level in public drinking water by Brazilian cities, Brazil, 1996-2006 (in Portuguese) (2008) RGO x, 56, pp. 145-149Panizzi, M., Peres, M.A., Ten years of external control over water fluoridation in Chapecó, Santa Catarina State, Brazil (in Portuguese) (2008) Cad Saúde Pública, 24, pp. 2021-2031Portaria 635 de 26 de Dezembro de 1975. Aprova Normas e Padrões Sobre a Fluoretação da Água de Sistemas Públicos de Abastecimento. Diario Oficial União, , http://189.28.128.100/dab/docs/legislacao/portaria635_26_12_75.pdf, 30 jan. 1976 cited 2006 Jan. 18(2006) National Guideline on Sampling Plan of the Environment Health Vigilance for Assessment of Quality of Water for Human use, , Brazil. Ministry of Health, Brasília, in PortugueseMartínez-Mier, E.A., Cury, J.A., Heilman, J.R., Katz, B.P., Levy, S.M., Li, Y., Maguire, A., Development of gold standard ion-selective electrode-based methods for fluoride analysis (2011) Caries Res, 45, pp. 3-12Moura, M.S., Silva, J.S., Simplício, A.H.M., Cury, J.A., Long-Term Assessment of Fuoride Level of Public Water Supply in Teresina-Piauí (in Portuguese) (2005) Rev Odonto Ciênc, 20, pp. 132-136Ramires, I., Maia, L.P., Rigolizzo, D.S., Lauris, J.L.P., Buzalaf, M.A.R., External control of water supply in Bauru, S P, Brazil (2006) Rev Saúde Pública, 40, pp. 883-889Amaral, R.C., Sousa, M.L.R., Eight months of external control of fluoride levels in the public water supply in Piracicaba, São Paulo, Brazil (2007) Revista de Odontologia da Universidade Cidade de São Paulo (in Portuguese), 19, pp. 131-136Cury, J.A., Tenuta, L.M., Enamel remineralization: Controlling the caries disease or treating early caries lesions? (2009) Braz Oral Res, 23 (1 SUPPL.), pp. 23-30Bardsen, A., "Risk periods" associated with the development of dental fluorosis in maxillary permanent central incisors: A meta-analysis (1999) Acta Odontol Scand, 57, pp. 247-256Catani, D.B., Hugo, F.N., Cypriano, S., Sousa Mda, L., Cury, J.A., Relationship between fluoride levels in the public water supply and dental fluorosis (2007) Rev Saude Publica, 41, pp. 732-739Catani, D.B., Tenuta, L.M., Andaló, F.A., Cury, J.A., Fluorosis in rats exposed to oscillating chronic fluoride doses (2010) Braz Dent J, 21, pp. 32-37Documento de Consenso Técnico, , http://www.cecol.fsp.usp.br/dcms/fck/file/SeminarioVigifluor2011/ CECOL-USP-ClassificacaoAguasSegundoTeorFluor-DocumentoConsensoTecnico-2011(2). pdf, Classificação de águas de abastecimento público, Acesso em Nov. 1

Fluoride Intake By Children From Water And Dentifrice

Objective. To determine the total fluoride dose to which children were exposed during the critical age of developing dental fluorosis, in an optimally fluoridated region, having diet (liquids and solids) and dentifrice as fluoride sources. Methods. For the pilot study, 39 children (aged 20 to 30 months) were selected from a day care center in Piracicaba, Brazil. They drank and ate food prepared with fluoridated water. To determine the total dose of fluoride exposure, duplicate-plate samples and products from tooth brushing were collected for two consecutive days, in four periods of the year. Fluoride was determined using an ion specific electrode. A 5% level of significance variance analysis (Anova) was carried out. Results. Children were exposed to a total fluoride dose of 0.090 mg/day/kg of body weight, of which 45% came from the diet and 55% from dentifrice. Conclusions. Assuming 0.07 mg/kg as a threshold value of fluoride systemic exposure, children were exposed to a risk dose for dental fluorosis. Thus, measures to reduce fluoride intake at the studied age range would be recommended. Reducing the amount of dentifrice used for tooth brushing seems to be the best measure, given the risk/benefits of fluoride use from the public health perspective.356576581Burt, B.A., The changing patterns of systemic fluoride intake (1992) J. Dent. Res., 71 (SPEC. ISSUE), pp. 1228-1237Cury, J.A., Representatividade dos dentifrícios fluoretados no mercado brasileiro e sua confiabilidade como método preventivo (1989), São Paulo: Associação Brasileira de Odontologia PreventivaCury, J.A., Cárie e creme dental (1998) J. ABOPREV, 9, p. 2. , (espec)Cury, J.A., Determination of appropriate exposure of fluoride in non-EME countries in the future (2000) J. Dent. Res., 79 (4), p. 901Cury, J.A., Uso do flúor e o controle da cárie como doença (2001), pp. 34-68. , Baratieri LNMonteiro S, Andrada MAC, Vieira LCC, Ritter AV, Cardoso AC. Odontologia Restauradora - Fundamentos e Possibilidades. São Paulo: SantosDuarte, F.F., Pisaneschi, E., Cury, J.A., Avaliação do flúor dos dentifrícios mais consumidos no Brasil e comercializados nas cinco regiões do país (1999) Rev. ABOPREV, 2 (2), pp. 3-10Fejerskov, O., Baelum, V., Richards, A., Dose-response and dental fluorosis (chapter 9) (1996) Fluoride in Dentistry, , Fejerskov O, Ekstrand J, Burt BA. 2nd ed. Copenhagen: Munksgaard Chapter 9Ferreira, H.C.G., Gomes, A.M.M., Silva, K.R.C.S., Rodrigues, C.R.M.D., Gomes, A.A., Avaliação do teor de flúor na água de abastecimento público do município de Vitória, ES (1999) Rev. APCD, 53 (6), pp. 455-459Guha-Chowdhury, N., Drummond, B.K., Smillie, A.C., Total fluoride intake in children aged 3 to 4 years: A longitudinal study (1996) J. Dent. Res., 75, pp. 1451-1457Holloway, P.J., Ellwood, R.P., The prevalence, causes and cosmetic importance of dental fluorosis in the United Kingdom: A review (1997) Community Dent. Health, 14, pp. 148-155Tratamento e fluoretação da água dos municípios brasileiros (2000), http://www.saude.gov.br/programas/bucal/fluoreta%.htm, Ministério da Saúde. [on line]. Disponível em URL: [dez 18]Narvai, P.C., Frazão, P., Castellanos, R.A., Declínio na experiência de cárie em dentes permanentes de escolares brasileiros no final do século XX (1999) Odontol. Socied., 1, pp. 25-29Paiva, S.M., Cury, J.A., Contribution of diet and fluoridated dentifrice to the risk of dental fluorosis (1999) J. Dent. Res., 78, p. 367. , [IADR abstract n. 2089]Pendrys, D.G., Katz, R.V., Morse, D.E., Risk factors for enamel fluorosis in a fluoridated population (1996) Am. J. Epidemiol., 143, pp. 808-815Reis, S.R.A., Mendonça, L.L., Cabral, M.B.B.S., Marchionni, A.M.T., Andrade, M.G.S., Souza, F.M., Fluorose dental, estado nutricional e cárie dental em escolares de diferentes estratos socioeconômicos de Salvador, Bahia - Parte I (1999) RPG Rev. Pós. Grad., 6, pp. 387-394Rojas-Sanchez, F., Kelly, S.A., Drake, K.M., Eckert, G.J., Stookey, G.K., Dunipace, A.J., Fluoride intake from foods, beverages and dentifrice by young children in communities with negligible and optimally fluoridated water: A pilot study (1999) Community Dent. Oral. Epidemiol., 27, pp. 288-297(2001), http://www.saude.sp.gov.br/html/fr_sbucal.htm, Secretaria de Estado da Saúde. Resolução SS-95, de 27/06/200. Recomendações sobre o uso de produtos fluorados no âmbito do SUS/SP em função do risco de cárie dentária. [on line] [ ago21]Taves, D.R., Separation of fluoride by rapid diffusion using hexamethyldisiloxane (1968) Talanta, 15, pp. 969-974Villena, R.S., Cury, J.A., Flúor: Uso racional na 1a infância (1998) Odontologia na 1a Infância, pp. 291-314. , Nahas S. São Paulo: Santo

Influence Of A Cobalt-chromium Metal Framework On Surface Roughness And Knoop Hardness Of Visible Light-polymerized Acrylic Resins

Although visible light-polymerized acrylic resins have been used in removable partial dentures, it is not clear whether the presence of a metal framework could interfere with their polymerization, by possibly reflecting the light and affecting important properties, such as roughness and hardness, which would consequently increase biofilm accumulation. The aim of this study was to compare the roughness and Knoop hardness of a visible light-polymerized acrylic resin and to compare these values to those of water-bath- and microwave-polymerized resins, in the presence of a metal framework. Thirty-six specimens measuring 30.0 x 4.0 ± 0.5 mm of a microwave- (Onda Cryl), a visible light- (Triad) and a water-bath-polymerized (Clássico) (control) acrylic resins containing a cobalt-chromium metal bar were prepared. After processing, specimens were ground with 360 to 1000-grit abrasive papers in a polishing machine, followed by polishing with cloths and 1-μm diamond particle suspension. Roughness was evaluated using a profilometer (Surfcorder SE 1700) and Knoop hardness (Kg/mm 2) was assayed using a microhardness tester (Shimadzu HMV 2000) at distances of 50, 100, 200, 400 and 800 μm from the metal bar. Roughness and Knoop hardness means were submitted to two-way ANOVA and compared by Tukey and Kruskal Wallis tests at a 5% significance level Statistically significant differences were found (p&lt;0.05) for roughness and Knoop hardness, with light-polymerized resin presenting the highest values (Ra = 0.11 μm and hardness between 20.2 and 21.4 Kg/mm 2). Knoop values at different distances from the metal bar did not differ statistically (p&gt;0.05). Within the limitations of this in vitro study, it was concluded that the presence of metal did not influence roughness and hardness values of any of the tested acrylic resins.143208212Anusavice, K.J., (2003) Philip's Science of Dental Materials. 11 th Ed., p. 96. , 11 St. Louis: Elsevier ScienceBollen, C.M.L., Lambrechts, P., Quirynen, M., Comparison of surface roughness of oral hard materials to the threshold surface roughness for bacterial plaque retention: A review of the literature (1997) Dent Mater, 13 (4), pp. 258-269Borchers, L., Tavassol, F., Tschernitschek, H., Surface quality achieved by polishing and by varnishing of temporary crown and fixed partial denture resins (1999) J Prosthet Dent, 82 (5), pp. 550-556Braun, K.O., Del Bel Cury, A.A., Cury, J.A., Use of microwave energy for processing acrylic resin near metal (1998) Braz Oral Res, 12 (2), pp. 173-180Curtis, D.A., Eggleston, T.L., Marshall, S.J., Watanabe, L.G., Shear bond strength of visible-light-cured resin relative to heat-cured resin (1989) Dental Mater, 5 (7), pp. 314-318De Clerck, J.P., Microwave polymerization of acrylic resins used in dental prosthesis (1987) J Prosthet Dent, 57 (5), pp. 650-658Khan, Z., Von Fraunhofer, J.A., Razavi, R., The staining characteristics, transverse strength, and microhardness of a visible light-cured denture base material (1987) J Prosthet Dent, 57 (3), pp. 384-386Levin, B., Sanders, J.L., Reitz, P.V., The use of microwave energy for processing acrylic resins (1989) J Prosthet Dent, 61 (3), pp. 381-383Ogle, R.E., Sorensen, S.E., Lewis, E.A., A new visible light-cured resin system applied to removable prosthodontics (1986) J Prosthet Dent, 56 (4), pp. 497-506Quirynen, M., Cml, B., Willems, G., Van Steenberghe, D., Comparison of surface characteristics of six commercially pure titanium abutments (1994) JOMI, 9 (1), pp. 71-76Reitz, P.V., Sanders, J.L., Levin, B., The curing of denture acrylic resins by microwave energy. Physical properties (1985) Quintessence Int, 6 (8), pp. 547-551Rodrigues Garcia, R.C.M., Souza Jr., J.A., Rached, R.N., Del Bel Cury, A.A., Effect of denture cleansers on the surface roughness and hardness of a microwave-cured acrylic resin and dental alloys (2004) J Prosthodont, 13 (3), pp. 1-6Rueggeberg, F.A., Goughman, W.F., Curtis Jr., J.W., Effect of light intensity and exposure duration on cure of resin composite (1994) Oper Dent, 19 (1), pp. 26-32Truong, V.T., Thomasz, F.G., Comparison of denture acrylic resins cured by boiling water and microwave energy (1988) Aust Dent J, 33 (3), pp. 201-204Ulusoy, M., Ulusoy, N., Aydin, A.K., An evaluation of polishing technique on surface roughness of acrylic rsins (1986) J Prosthetic Dent, 56 (1), pp. 107-11

Fluoride content in children's dentifrices marketed in Lima, Peru

The aim of the present study was to determine the concentration of total fluoride (TF) and total soluble fluoride (TSF) in children's dentifrices marketed in the city of Lima, Peru. Three samples of 23 dentifrices (4 without fluoride and 19 with fluoride) were purchased in different pharmacies in Lima, Peru. The TF and TSF concentrations found in the dentifrices were determined by ion-selective electrode, expressed in ppm F (μg F/g of dentifrice). The TF concentration in the majority of the fluoride toothpastes matched that shown on the label, except for one declared as 1450 ppm F by the manufacturer, whereas only 515.1 ppm F was found. The concentration of TSF found in the fluoride toothpastes ranged from 457.5 to 1134.8 ppm F. All the dentifrices were formulated with silica, but one also presented calcium carbonate. In conclusion, 83% of the children's dentifrices marketed in Lima, Peru, were fluoridated, but only 53% contained a TSF concentration greater than 1000 ppm F, the minimum concentration required to provide an anticaries effect33COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESnão te

Does traumatic occlusal forces lead to peri-implant bone loss? a systematic review

Observational studies have indicated that crestal bone level changes at implants are typically associated with clinical signs of inflammation, but still mechanical overload has been described as possible factor leading to hard-tissue deficiencies at implant sites without mucosal inflammation. The aim of this paper was systematically review the literature regarding the possible effect of traumatic occlusal forces on the peri-implant bone levels. Literature search was conducted using PubMed, Scielo and Lilacs, including the following terms: oral OR dental AND implant$AND (load OR overload OR excessive load OR force$ OR bruxism) AND (bone loss OR bone resorption OR implant failure$). Databases were searched for the past 10 years of publications, including: clinical human studies, either randomized or not, cohort studies, case control studies, case series and animal research. Exclusion criteria were review articles, guidelines and in vitro and in silico (finite element analysis) research, as well as retrospective studies. The PICO questions formulated was: "does traumatic occlusal forces lead to peri-implant bone loss?" The database searches as well as additional hand searching, resulted in 807 potentially relevant titles. After inclusion/exclusion criteria assessment 2 clinical and 4 animal studies were considered relevant to the topic. The included animal studies did not reveal an association between overload and peri-implant bone loss when lower overloads were applied, whereas in the presence of excessive overload it seemed to generate peri-implant bone loss, even in the absence of inflammation. The effect of traumatic occlusal forces in peri-implant bone loss is poorly reported and provides little evidence to support a cause-and-effect relationship in humans, considering the strength of a clinically relevant traumatic occlusal force33

Relationship Between Fluoride Levels In The Public Water Supply And Dental Fluorosis

Objective: To assess the prevalence of dental flourosis among schoolchildren subjected to different fluoride concentrations in the public water supply of their cities. Methods: The sample comprised 386 seven-year-old schoolchildren living in two municipalities in the State of São Paulo that practiced external control over the fluoridation of the water from 1998 to 2002: one with homogenous fluoride concentration and the other with oscillating concentration. Dental fluorosis was determined by dry examination of the upper permanent incisors using Dean's index. Scores classified as questionable were considered to represent fluorosis. Sociodemographic variables and questions regarding oral health were assessed using a structured questionnaire sent to the children's parents or the adults responsible for these children. Correlates of fluorosis were assessed using multivariate logistic regression (p<0.05). Results: Both municipalities presented a mild degree of fluorosis. The prevalence of fluorosis in the municipality with oscillating fluoride content in the water was 31.4%, and it was 79.9% in the municipality with homogenous fluoride content. The prevalence of fluorosis was associated with the municipality with homogeneous fluoride levels in the water (OR=8.33, 95% CI: 5.15; 13.45) and with not owning a car (OR=2.10, 95% CI: 1.27;3.49). Conclusions: The prevalence of dental fluorosis was higher in the city with better control of fluoride levels in the water supply, however, this higher prevalence was not related with children's satisfaction with the appearance of their teeth.415732739Aoba, T., Fejerskov, O., Dental fluorosis: Chemistry and biology (2002) Crit Rev Oral Biol Med, 13 (2), pp. 155-170Bårdsen, A., Risk periods associated with the development of dental fluorosis in maxillary permanent central incisors: A meta-analysis (1999) Acta Odontol Scand, 57 (5), pp. 247-256Clark, D.C., Berkowitz, J., The influence of various fluoride exposures on the prevalence of esthetic problems resulting from dental fluorosis (1997) J Public Health Dent, 57 (3), pp. 144-149Clark, D.C., Hann, H.J., Williamson, M.F., Berkowitz, J., Influence of exposure to various fluoride technologies on the prevalence of dental (1994) Community Dent Oral Epidemiol, 22 (6), pp. 461-464Cypriano S, Sousa MLR, Rihs LB, Wada RS. Prevalência e severidade da fluorose dentária em Piracicaba, SP, Brasil. RPG Rev Pos Grad. 2004;11(1):67-73Evans, R.W., Stamm, J.W., An epidemiological estimate of the critical period during which human maxillary central incisors are most susceptible to fluorosis (1991) J Publ Health Dent, 51 (4), pp. 251-259Fejerskov, O., Manji, F., Baelum, V., The nature and mechanisms of dental fluorosis in man (1990) J Dent Res, p. 69. , Spec No:692-700Frazão, P., Peverari, A.C., Forni, T.I., Mota, A.G., Costa, L.R., Fluorose dentária: Comparação de dois estudos de prevalência (2004) Cad Saude Publica, 20 (4), pp. 1050-1058Horowitz, H.S., Grand Rapids: The public health story (1989) J Public Health Dent, 49 (1), pp. 62-63Hosmer, D.W., Lemeshow, S., (1989) Applied logistic regression, , New York: John Wiley & Sons;Mackay, T.D., Thomsom, W.M., Enamel defects and dental caries among Southland children (2005) N Z Dent J, 101 (2), pp. 35-43Maltz, M., Silva, B.B., Relação entre cárie, gengivite e fluorose e nível sócio-econômico em escolares (2001) Rev Saude Publica, 35 (2), pp. 170-176Narvai, P.C., Fluoretação da água: Heterocontrole no município de São Paulo no período de 1990-1999 (2000) Rev Bras Ondontol Saude Coletiva, 1 (2), pp. 50-56Nunn, J.H., Ekanayake, L., Rugg-Gunn, A.J., Saparamadu, K.D., Assessment of enamel opacities in children in Sri Lanka and England using a photographic method (1993) Community Dent Health, 10 (2), pp. 175-188Levantamento Epidemiológico básico de saúde bucal: Manual de instruções (1991) São Paulo: Editora, , Organização Mundial da Saúde, 3 ed, Santos;Tabari, E.D., Ellwood, R., Rugg-Gunn, A.J., Evans, D.J., Davies, R.M., Dental fluorosis in permanent incisor teeth in relation to water fluoridation, social deprivation and toothpaste use in infancy (2000) Br Dent J, 189 (4), pp. 216-220(1962) Public Health Service: Drinking water standards 1962, p. 956. , United States Public Health Service, Washington: Government Printing Office;, Public Health Service PublicationVan Nieuwenhuysen, J.P., Carvalho, J.C., D'Hoore, W., Caries reduction in Belgian 12-year-old children related to socioeconomic status (2002) Acta Odontol Scand, 60 (2), pp. 123-128(1997) Bucal health surveys: Basic methods, , World Health Organization, 4. ed. Geneva;World Health Organization. Fluorides and Oral Health. Geneva1994. (Who Technical Report Series, 846