Geo-Environmental Factors' Influence on the Prevalence and Distribution of Dental Fluorosis: Evidence from Dali County, Northwest China

Residents living in areas with high fluorine environmental background will ingest excessive fluorine from the atmosphere, drinking water, food and other ways. Long-term effects of fluorine on the human body could cause people suffering from dental fluorosis and influence the sustainable development of the severe fluorosis areas. Previous studies have independently discussed the high fluoride environment in Dali County from the aspects of natural environment, drinking water quality and endemic fluorosis. This study carried out a detail investigation on dental fluorosis population in seven selected villages of Dali County, Shaanxi province, northwest China. The highest dental fluorosis index of 1.9 was found in Lianjia village located near the Anren depression, while the lowest dental fluorosis index of 0.0 was found in Jiaxi village near the Yellow River alluvium. Groundwater fluorine contents the range was 0.01 mg/L to 11.80 mg/L, with the highest value (2.6 mg/L) being observed in the 2nd terrace of Weihe River. The lowest groundwater fluorine content (0.8 mg/L) was observed in the Yellow River alluvium. Soil fluorine contents ranged from 1.18 mg/kg to 13.70 mg/kg, with its highest value (13.70 mg/kg) observed in Xinfeng village near the Anren depression. The lowest value of fluorine (1.18 mg/kg) was found in soil from the 1st terrace of Weihe River. As for the fluorine contents of corn, they ranged from 4.04 mg/kg to 7.72 mg/kg. The highest value (7.72 mg/kg) appeared in the 3rd terrace of Weihe River and the lowest value (4.04 mg/kg) in the 2nd terrace of Weihe River. The soil leaching was the dominant fluorine source of groundwater environment. Areas with severe dental fluorosis are located at the edge of the depression and the conjunction between steep slope and gentle slope. A poor correlation was found between the dental fluorosis index from the seven investigated villages and the corn fluorine content contrarily to the groundwater fluorine content, which positively correlated to the dental fluorosis index. Based on the obtained results, two recommendations were done to prevent and control dental fluorosis and accelerate the sustainable development in Dali County: to strengthen the use of low fluorine groundwater for drinking water supply, and to widely install the public water purifiers in the rural communities for purifying high-fluorine water to reduce the incidence of dental fluorosis in the population.