Fluoride Concentration in Baby Milk Formulas Available in Riyadh Pharmacies, Saudi Arabia

Sultana A. Al-Sadoon^1, , Lojaen S. Sendy², Mohammed Al-Dhubaiban³ and Saad M. Al-Manea⁴

¹Paediatric Dentistry Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia

²Paediatric Dentistry Department, King Saud Medical City, Riyadh, Saudi Arabia

³Department of Paediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia

⁴Paediatric Dentistry Department, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia

Cite this paper:
Sultana A. Al-Sadoon, Lojaen S. Sendy, Mohammed Al-Dhubaiban and Saad M. Al-Manea. Fluoride Concentration in Baby Milk Formulas Available in Riyadh Pharmacies, Saudi Arabia. American Journal of Public Health Research. 2023; 11(2):51-55. doi: 10.12691/ajphr-11-2-2

Abstract

Purpose: This study aimed to ascertain the fluoride concentrations in infant formula (baby milk) sold in pharmacies situated in Riyadh, Saudi Arabia, and to confirm the accuracy of the fluoride quantities declared on the package. Methods: 26 different infant formulae product samples from 13 manufacturers were obtained from pharmacies in Riyadh, Saudi Arabia. Two different products from the same manufacturer measured fluoride concentrations (one product for the 0-6 months age group and one for the 1-3 years age group) using a combination fluoride-ion-selective electrode. Results: The average concentration of fluoride for all the samples measured was 0.987 µg/g. In all but one sample, there was a wide difference between the declared Fluoride concentrations and what was measured. The difference was smallest in Humana Bebemil 1 which had 0.84 µg/g (measured) and 0.75 µg/g (declared). The average intake of fluoride is way below the recommended daily allowance. The quantities of fluoride that can potentially be consumed, depending on the brand, ranged from 0.115 mg/day to 0.206 mg/day. Conclusion: All the analyzed infant formulae did not reveal fluoride concentrations above the recommended daily allowance. One can cautiously assume that there is no risk for children to suffer from over-exposure to fluoride.

Keywords:
fluoride baby milk formula concentration over-exposure risk

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References:

[1]	Dalal, M., Clark, M. & Quiñonez, R. B. 2019. Pediatric oral health: Fluoride use recommendations. Pediatrics, 36.
[2]	Pitts, N. B., Zero, D. T., Marsh, P. D., Ekstrand, K., Weintraub, J. A., Ramos-Gomez, F., Tagami, J., Twetman, S., Tsakos, G. & Ismail, A. 2017. Dental caries. Nature reviews Disease primers, 3, 1-16.
[3]	Bhagavatula, P., Curtis, A., Broffitt, B., Weber-Gasparoni, K., Warren, J. & Levy, S. M. 2018. The relationships between fluoride intake levels and fluorosis of late-erupting permanent teeth. Journal of public health dentistry, 78, 165-174.
[4]	Kadam, P., Jabade, M. V. & Chavan, R. 2019. Assess the Knowledge Regarding Prevention of Dental Carries Among Schoolchildern. Indian Journal of Public Health Research & Development, 10, 1662-1664.
[5]	Mathur, V. P. & Dhillon, J. K. 2018. Dental Caries: A Disease Which Needs Attention. The Indian Journal of Pediatrics, 85, 202-206.
[6]	Meyer, J., Margaritis, V. & Mendelsohn, A. 2018. Consequences of community water fluoridation cessation for Medicaid-eligible children and adolescents in Juneau, Alaska. BMC Oral Health, 18, 1-10.
[7]	O Mullane, D., Baez, R., Jones, S., Lennon, M., Petersen, P. E., Rugg-Gunn, A., Whelton, H. & Whitford, G. M. 2016. Fluoride and oral health. Community dental health, 33, 69-99.
[8]	Curtis, A., Levy, S., Cavanaugh, J., Warren, J., Kolker, J. & Weber-Gasparoni, K. 2020. Decline in Dental Fluorosis Severity during Adolescence: A Cohort Study. Journal of Dental Research, 99, 388-394.
[9]	Akuno, M. H., Nocella, G., Milia, E. P. & Gutierrez, L. 2019. Factors influencing the relationship between fluoride in drinking water and dental fluorosis: a ten-year systematic review and meta-analysis. Journal of Water and Health, 17, 845-862.
[10]	Reddy, D. R. 2017. The element fluorine and its effects on human health including its neurological manifestations. Neurology India, 65, 238-239.
[11]	Avocefohoun, A. S., Gbaguidi, B. A., Sina, H., Biaou, O., Houssou, C. S. & Baba-Moussa, L. 2017. Fluoride in water intake and prevalence of dental fluorosis stains among children in Central Benin. International Journal of Medical Research & Health Sciences, 6, 71-77.
[12]	Dec, K., Łukomska, A., Maciejewska, D., Jakubczyk, K., Baranowska-Bosiacka, I., Chlubek, D., Wąsik, A. & Gutowska, I. 2017. The Influence of Fluorine on the Disturbances of Homeostasis in the Central Nervous System. Biological Trace Element Research, 177, 224-234.
[13]	Lu, Y., Sun, Z., Wu, L., Wang, X., Lu, W. & Liu, S. 2000. Effect of high-fluoride water on intelligence in children. Fluoride, 33, 74-78.
[14]	World Health Organisation 2011. Guidelines for Drinking-water Quality, Switzerland, WHO Press.
[15]	Berg J, Gerweck C, Hujoel PP, et al. Evidence-based clinical recom- mendations regarding fluoride intake from reconstituted infant formula and enamel fluorosis. J Am Dent Assoc. 2011; 142(1):79-87.
[16]	Aldrees, A. M. & Al-Manea, S. M. 2010. Fluoride content of bottled drinking waters available in Riyadh, Saudi Arabia. The Saudi Dental Journal, 22, 189-193.
[17]	Walia, T., Abu Fanas, S., Akbar, M., Eddin, J. & Adnan, M. 2017. Estimation of fluoride concentration in drinking water and common beverages in United Arab Emirates (UAE). The Saudi Dental Journal, 29, 117-122.
[18]	Y. Agha, M. Kowash, I. Hussein, A. AlSalami, M. Al‐Halabi. 2019. Fluoride Concentration of Commercially available infant formulae in the United Arab Emirates. European Archives of Paediatric Dentistry, 21, 657-666.
[19]	Nagata ME, Delbem AC, Kondo KY, de Castro LP, Hall KB, Percinoto C, Aguiar SM, Pessan JP. Fluoride concentrations of milk, infant formulae, and soy-based products commercially available in Brazil. J Public Health Dent. 2015; 76(2): 32-39.