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Table of Contents   
ORIGINAL RESEARCH  
Year : 2010  |  Volume : 21  |  Issue : 4  |  Page : 528-530
Fluoride content in bottled drinking waters, carbonated soft drinks and fruit juices in Davangere city, India


1 Department of Community Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
2 Department of Prosthodontics, JSS Dental College and Hospital, Mysore, Karnataka, India
3 Department of Community Dentistry, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka, India
4 College of Dental Sciences, Davangere, Karnataka, India

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Date of Submission30-Oct-2009
Date of Decision16-Apr-2010
Date of Acceptance16-Aug-2010
Date of Web Publication24-Dec-2010
 

   Abstract 

Background: The regular ingestion of fluoride lowers the prevalence of dental caries. The total daily intake of fluoride for optimal dental health should be 0.05-0.07 mg fluoride/kg body weight and to avoid the risk of dental fluorosis, the daily intake should not exceed a daily level of 0.10 mg fluoride/kg body weight. The main source of fluoride is from drinking water and other beverages. As in other countries, consumption of bottled water, juices and carbonated beverages has increased in our country.
Objective: To analyze the fluoride content in bottled water, juices and carbonated soft drinks that were commonly available in Davangere city.
Materials and Methods: Three samples of 10 commercially available brands of bottled drinking water, 12 fruit juices and 12 carbonated soft drinks were purchased. Bottled water and carbonated soft drinks were stored at a cold place until fluoride analysis was performed and a clear juice was prepared using different fruits without the addition of water. Then, the fluoride analysis was performed.
Results: The mean and standard deviation of fluoride content of bottled water, fruit juices and carbonated soft drinks were measured, which were found to be 0.20 mg (±0.19) F/L, 0.29 mg (±0.06) F/L and 0.22 mg (±0.05) F/L, respectively.
Conclusion: In viewing the results of the present study, it can be concluded that regulation of the optimal range of fluoride in bottled drinking water, carbonated soft drinks and fruit juices should be drawn for the Indian scenario.

Keywords: Bottled drinking water, carbonated soft drinks, clear juice, fluoride concentration

How to cite this article:
Thippeswamy H M, Kumar N, Anand S R, Prashant G M, Chandu G N. Fluoride content in bottled drinking waters, carbonated soft drinks and fruit juices in Davangere city, India. Indian J Dent Res 2010;21:528-30

How to cite this URL:
Thippeswamy H M, Kumar N, Anand S R, Prashant G M, Chandu G N. Fluoride content in bottled drinking waters, carbonated soft drinks and fruit juices in Davangere city, India. Indian J Dent Res [serial online] 2010 [cited 2014 Jul 22];21:528-30. Available from: http://www.ijdr.in/text.asp?2010/21/4/528/74206
Since the last 50 years, a decline in dental caries in the developed countries can be attributed to the widespread use of systemic and topical fluorides. [1] But, the recent changes in the lifestyle promotes the increased use of other refreshments such as fruit juices, cola drinks and bottled water. [2] Fluoride dosage varies according to the age of the child and fluoride concentration of drinking water. [3] In 1986, the American Academy of Pediatrics stated that for optimal dental health benefits, the total daily intake should be 0.05-0.07 mg fluoride/kg body weight and to avoid the risk of dental fluorosis, the fluoride intake should not exceed a daily level of 0.10 mg fluoride/kg body weight. [4]

As far as bottled water is concerned, the fluoride content may be highly variable among different brands, and this may have oral health implications for individuals, especially infants and children, who use bottled water as their primary source of drinking water. [5] A concern expressed in the literature is that children may be drinking less water than before, and studies have shown that they may now be drinking other fluids or beverages as alternatives to water. [6]

In infancy, the main sources of fluoride are thought to be from commercially available beverages and foods used during weaning, as this period coincides with the calcification of different stages of the developing permanent tooth crowns. This is thought to be a critical time for ensuring that the optimum levels of ingested fluoride are not exceeded. [7]

The daily intake of an optimum level of fluoride lowers the prevalence of dental caries; concomitantly, there has been an increase in the prevalence of dental fluorosis. As in other countries, consumption of bottled water, juices and carbonated beverages has increased in India. [8]

According to a commercial report, bottled water consumption in Greece increased during 1996-1999 by 11.05% compared to the 1994-1996 period. Since 1999, the consumption has increased further, with an annual increase of 12%, such that in 2002, the bottled water consumption was 870 million liters. The rate of increase remained the same during the years 2003-2004. [5] The total annual bottled water consumption in India had tripled to 5 billion liters in 2004 from 1.5 billion liters in 1999. The global consumption of bottled water was nearing 200 billion liters in 2006. [9]

Some investigations have suggested that increased consumption of bottled water, soft drinks and juices are a form of systemic fluoridation and have been implicated as risk factors for dental fluorosis in young children. [10]

Therefore, the aim of the present study was to analyze the fluoride content in bottled water, juices and carbonated soft drinks that were commonly available in Davangere city, Karnataka, India.


   Materials and Methods Top


Ten commercially available brands of bottled water and 12 carbonated soft drinks were purchased from different commercial outlets of Davangere city. Three samples of each brand with different batch numbers and date of bottling were purchased. The samples of bottled water were sold in plastic bottles whereas carbonated soft drinks were marketed in glass bottles. All samples were stored in a dark place and in their original closed containers at room temperature until the fluoride analysis was performed.

For fluoride estimation from fruits juices, three samples of different fruits from different shops were purchased and a clear juice was obtained without addition of water from each fruit after peeling out the skin, with the exception for grapes. For the preparation of juice from grapes, the skin portion was also added.

All the samples were analyzed for fluoride using an Orion fluoride ion-specific electrode (Model 96-09 BN) in conjunction with an ion analyzer using an acetate buffer system (TISAB). One batch number (out of three) for each of the bottled water, carbonated soft drinks and juices was randomly selected and the samples were reanalyzed to assess the reliability of the method.


   Results Top


[Table 1] depicts the concentration of fluoride in 10 different types of bottled drinking water. The mean (±SD) fluoride content of the 10 bottled water was 0.20 mg (±0.19) F/L mg, with a range from 0.06 to 1.05 mg F/L. None of the bottled water samples displayed the fluoride concentration and the labels. The highest mean concentration was found in Bisleri bottled water, which had a mean fluoride content of 0.70 mg (±0.56) F/L, followed by Crystal bottled water, which contained a mean fluoride concentration of 0.33 mg (±0.07) F/L. Apart from these products, no substantial difference was found between samples from the bottled water of different companies.
Table 1: Fluoride content (mg F/L) in different bottled waters

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[Table 2] depicts the concentration of fluoride in 12 different carbonated soft drinks. The mean fluoride concentration of all the soft drinks was found to be 0.29 mg (±0.06) F/L, with a range from 0.19 to 0.42 mg F/L. The highest mean concentration was found in Thums Up, which contained 0.4 mg (±0.02) F/L, followed by Citra, which contained 0.37 mg (±0.01) F/L of fluoride. Not much difference was observed in the rest of the sample products.
Table 2: Fluoride content (mg F/L) in different carbonated soft drinks

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[Table 3] shows the fluoride concentration in different fruit juices. There were no significant differences between different fruit juices. The highest fluoride concentration was shown in apple and banana juice, containing 0.27 mg (±0.22) F/L and 0.27 mg (±0.20) F/L, respectively. The lowest concentration was found in watermelon juice, which contained 0.13 mg (±0.08) F/L of fluoride.
Table 3: Fluoride content (mg F/L) in different fruit juices

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   Discussion Top


The present study was designed to determine the fluoride levels in different bottled drinking water, carbonated soft drinks and fruit juices that were available in Davangere city. The dental health of a child who uses these products as the primary source of refreshment may be significantly affected in one of the following three ways: the child may receive an appropriate level of fluoride from the above-mentioned products, allowing for optimal caries prevention, or receive suboptimal levels of fluoride, with a resultant increase in dental caries. Finally, an elevated level of fluoride in a child's consumption could result in fluorosis. Although the testing of bottled waters is carried out under the US Food and Drug Administration's Safe Drinking Water Act, optimal fluoridation of bottled water is not required. The act only sets the upper limit for the amount of fluoride allowed in bottled water. The act also requires that bottled water and other beverages be assayed annually for certain elements, including fluoride, by independent testing agencies. [11] Although in India there is no official regulation defining the limits of fluoride in bottled water or other refreshments, in other countries, the fluoride levels have been set at certain levels according to their fluoride concentration in drinking water. [8]

In this study, the concentration of fluoride in bottled drinking water purchased from local stores was found to vary between 0.06 and 1.05 mg F/L. This variation was generally consistent with previous studies. [2],[4] Bisleri bottled water contains fluoride concentrations up to 1.05 mg F/L. However, none of the bottled waters stated the fluoride concentrations on their labels. Therefore, health professionals should be aware of the contents of bottled water before prescribing any fluoride supplements for the children.

It has been suggested that if the level of fluoride in drinking water is below 0.7 mg F/L, supplements may be required in some cases, whereas if the level is >0.7 mg F/L, supplementation is not necessary. As the baby formulas might themselves contain variable amounts of fluorides, further addition to bottled drinking water with high concentration of fluoride would result in potentially high intake of fluoride in young children.

When considering carbonated soft drinks, the concentration of fluoride was found to be 0.19-0.42 mg F/L. This finding was slightly lower than that in the study conducted by Jimenez et al, [8] and slightly higher than that reported in the study by Martinez-Mier et al. [12] The difference between fluoride values found in the present study and those reported previously in the Mexican literature suggest that the composition of the beverages is not uniform or necessarily consistent. This different fluoride concentration in cola drinks may be due to water from different sources containing different fluoride concentrations that were used in the manufacture of these beverages.

In the present study, the fluoride concentration of fruit juices was between 0.07 and 0.53 mg F/L. The findings of the present study could not be compared with other studies as the juice in the present study was extracted directly from the natural source as, against that from the previous studies, where the fruit juices were taken from the commercially available containers.


   Conclusion Top


The developed countries have drawn an optimal range of fluoride concentration considering various available sources by the greater understanding of its mechanism of action and adverse effects.

In view of the differential level of fluoride, as shown in the present study results, it can be concluded that regulation of optimal range of fluoride in bottled drinking water, carbonated soft drinks and fruit juices should be drawn for the Indian scenario. Dentists should be aware of this variability in fluoride concentrations, which helps while prescribing fluoride as supplements.

 
   References Top

1.Pang DT, Phillips CL, Bawden JW. Fluoride intake from beverage consumption in a sample of North Carolina children. J Dent Res 1992;71:1382-8.  Back to cited text no. 1
[PUBMED]  [FULLTEXT]  
2.Zohouri FV, Maguire A, Moynihan PJ. Fluoride content of still bottled waters available in the North-East of England, UK. Br Dent J 2003;195:515-8.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.Stannard JG, Shim YS, Kristsineli M, Labropoulou P, Tramtsouris A. Fluoride levels and fluoride contamination of fruit juices. J Clin Pediatr Dent 1991;16:38-40.  Back to cited text no. 3
    
4.Toumba KJ, Levy S, Curzon ME. The fluoride content of bottled drinking waters. Br Dent J 1994;176:266-8.  Back to cited text no. 4
[PUBMED]    
5.Ahiropoulos V. Fluoride content of bottled waters available in Northern Greece. Int J Pediatr Dent 2006;16:111-6.  Back to cited text no. 5
    
6.Clovis J, Hargreaves JA. Fluoride intake from beverage consumption. Community Dent Oral Epidemiol 1988;16:11-5.  Back to cited text no. 6
[PUBMED]    
7.Vlachou A, Drummond BK, Curzon ME. Fluoride concentrations of infant foods and drinks in the United Kingdom. Caries Res 1992;26:29-32.  Back to cited text no. 7
[PUBMED]    
8.Gupta H, Gupta P. Fruit drinks: How healthy and safe? Indian Pediatr 2008;45;215-7.  Back to cited text no. 8
    
9.Bottle water industry in India. Site copyright ©2006. Available from: http://www.gits4u.com/water/water16.htm [last cited on 2010 Mar 6].  Back to cited text no. 9
    
10.Jimenez-Farhan MD, Hernandez - Guerrero JC, Loyola - Rodriguez JP, Ledesma - Montes C. Fluoride content in bottled waters, juices and carbonated soft drinks in Mexico City, Mexico. Int J Paediatr Dent 2004;14:260-6.  Back to cited text no. 10
    
11.Flaitz CM, Hill EM. A survey of bottled water usage by pediatric dental patients: implications for dental health. Quintessence int 1989;20;847-52.  Back to cited text no. 11
    
12.Martinez-Mier EA, Soto-Rojas AE, Urena-Cirett JL, Stookey GK, Dunipace AJ. Fluoride intake from foods, beverages and dentifrices by children in Mexico. Community Dent Oral Epidemiol 2003;31:221-30.  Back to cited text no. 12
    

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Correspondence Address:
S R Anand
Department of Community Dentistry, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka
India
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DOI: 10.4103/0970-9290.74206

PMID: 21187619

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    Tables

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