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Unique UI study of benefits of fluoride adds new research goals with help from families

IOWA CITY, Iowa -- A unique University of Iowa study of the benefits of fluoride is expanding to address new scientific issues, thanks to hundreds of Iowa families who have offered detailed information about their children's dietary and health habits.

Initiated in 1991 by Dr. Steven Levy, professor of preventive and community dentistry at the UI College of Dentistry, the study began as an effort to link fluoride intake with tooth development, decay prevention and dental fluorosis -- discoloration of the teeth caused by too much fluoride during early tooth development. But the data collected may provide insights into a range of topics.

"This is the only study of its kind to recruit a group of subjects at birth and examine fluoride intake over time," Levy says. "It is very rare that a group like this is put together and kept together. We've worked with colleagues throughout the university to assemble questions that this study might help answer."

Every few months, parents of children enrolled in the study complete questionnaires that detail what foods and beverages the children consume, the sources of the water they drink, their dental health habits and use of fluoride toothpaste or tablets, and other information. About 700 families currently are participating in the study.

When the children reach age 4 1/2 to 5, researchers examine their teeth and link tooth characteristics to questionnaire data. With the youngest participants currently age 3, this component of the study will take two more years to complete. The National Institute of Dental Research recently provided additional funding to carry it through this stage.

Researchers have begun a new project that uses data from the same unique study group. Participants receive specialized, very low radiation x-rays of developing bones when they come to the UI for dental screenings. The goal is to link bone density and mass with dietary factors that include not just fluoride, but also calcium, vitamin D and other nutrients.

"We feel very fortunate that the majority of participants have consistently provided us with useful information. We've asked them to do a lot for only token compensation," Levy says, adding that aside from their expenses and a few small premiums like mugs or t-shirts, participating families get only the satisfaction of contributing to an important research project.

Data gleaned from the questionnaires also have spawned scientific publications on childhood illnesses and antibiotic use, feeding patterns among infants, and the fluoride content of infant formulas, baby foods, bottled waters and juices. Though the study is years from completion, its early findings have already helped establish dietary fluoride supplement guidelines developed by several dental and pediatric health organizations.