Intelligence Quotient in Children with Dental Fluorosis in Rural Areas of Paraíba.

IF 2.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Caries Research Pub Date : 2026-08-05 DOI:10.1159/cre/abuag002

Marcos Alexandre Casimiro de Oliveira, Clarissa Lopes Drumond, Alexandre Almeida Júnior, Cláudia Batista Vieira de Lima, Raulison Vieira de Sousa, Jessica Klöckner Knorst, Hemílio Fernandes Campos Coêlho, Fábio Correia Sampaio

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引用次数: 0

Abstract

Introduction: Concerns about possible neurotoxicity related to fluoride exposure remain controversial, and evidence is heterogeneous across exposure ranges and study settings. This study evaluated the association between dental fluorosis and intelligence quotient (IQ) among children living in rural areas of Paraíba, Brazil.

Methods: A nested case-control study was conducted within a cross-sectional survey. Participants were matched 1:1 by age and sex. IQ was assessed using Raven's Colored Progressive Matrices and dichotomized as lower IQ (levels IV-V) versus higher IQ (levels I-III). Dental caries (DMFT/dmft) and fluorosis (TF index) were assessed after cleaning and drying. Fluoride concentration in drinking water was determined using a fluoride ion-specific electrode. Associations with lower IQ were tested using conditional logistic regression in the matched sample (n = 136) and a sensitivity analysis using logistic regression with cluster-robust standard errors.

Results: In crude-matched analyses (68 pairs; n = 136), low family income was associated with lower IQ (odds ratio [OR] = 3.50, 95% confidence interval [95% CI]: 1.15-10.63; p = 0.027), while dental caries showed a borderline association (OR = 1.85, 95% CI: 0.94-3.63; p = 0.075). In the adjusted conditional logistic regression model, associations were not statistically significant (income: adjusted OR = 2.93, 95% CI: 0.89-9.58; p = 0.076; caries: adjusted OR = 1.32, 95% CI: 0.57-3.05; p = 0.514), and dental fluorosis (TF >0) was not associated with lower IQ (adjusted OR = 1.02, 95% CI: 0.45-2.33; p = 0.965). In the sensitivity analysis using the full analytic sample (n = 175) with cluster-robust standard errors clustered at the school level, low income (adjusted OR = 2.64, 95% CI: 1.04-6.71; p = 0.0416) and dental caries (adjusted OR = 2.13, 95% CI: 1.20-3.78; p = 0.0096) were associated with lower IQ, whereas dental fluorosis was not (adjusted OR = 0.89, 95% CI: 0.55-1.45; p = 0.6471).

Conclusion: Socioeconomic disadvantage and dental caries showed the most consistent associations with lower IQ, whereas dental fluorosis, used as an indirect marker of earlier fluoride exposure during tooth development, was not independently associated with IQ status after adjustment when comparing lower IQ versus higher IQ.

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农村氟牙症儿童智商调查Paraíba。

关于氟化物暴露可能引起的神经毒性的担忧仍然存在争议，并且在暴露范围和研究环境中证据是不一致的。本研究评估了生活在巴西Paraíba农村地区儿童氟牙症与智商（IQ）之间的关系。方法：在横断面调查中进行巢式病例对照研究。参与者按年龄和性别按1:1配对。智商使用瑞文彩色递进矩阵进行评估，并分为低智商（IV-V级）和高智商（I-III级）。清洁干燥后评估龋病（DMFT/ DMFT）和氟中毒（TF指数）。使用氟离子特异性电极测定饮用水中的氟浓度。在匹配样本（n=136）中使用条件逻辑回归测试与低智商的关联，并使用具有聚类鲁棒标准误差的逻辑回归进行敏感性分析。结果：在粗略匹配分析中（68对，n = 136），低家庭收入与低智商相关（OR = 3.50, 95% CI: 1.15-10.63; p = 0.027），而龋齿与低智商相关（OR = 1.85, 95% CI: 0.94-3.63; p = 0.075）。在调整后的条件logistic回归模型中，相关性无统计学意义（收入：调整后的OR = 2.93, 95% CI: 0.89-9.58; p = 0.076；龋齿：调整后的OR = 1.32, 95% CI: 0.57-3.05; p = 0.514），氟斑牙（TF>）与低智商无相关性（调整后的OR = 1.02, 95% CI: 0.45-2.33; p = 0.965）。在使用整个分析样本（n = 175）的灵敏度分析中，聚类稳健标准误差聚集在学校水平，低收入（调整后的OR = 2.64, 95% CI: 1.04-6.71; p = 0.0416）和龋齿（调整后的OR = 2.13, 95% CI: 1.20-3.78; p = 0.0096）与较低的智商相关，而氟斑牙则无关（调整后的OR = 0.89, 95% CI: 0.55-1.45; p = 0.6471）。结论：社会经济劣势和龋齿与低智商的相关性最为一致，而氟牙症作为牙齿发育早期氟暴露的间接标志，在调整后与低智商和高智商的比较中，与智商状况没有独立的相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Caries Research 医学-牙科与口腔外科

CiteScore

6.30

自引率

7.10%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Caries Research'' publishes epidemiological, clinical and laboratory studies in dental caries, erosion and related dental diseases. Some studies build on the considerable advances already made in caries prevention, e.g. through fluoride application. Some aim to improve understanding of the increasingly important problem of dental erosion and the associated tooth wear process. Others monitor the changing pattern of caries in different populations, explore improved methods of diagnosis or evaluate methods of prevention or treatment. The broad coverage of current research has given the journal an international reputation as an indispensable source for both basic scientists and clinicians engaged in understanding, investigating and preventing dental disease.