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Dental fluorosis and oral health in the African Esophageal Cancer Corridor
Q&A

What is this study about?

Oesophageal cancer, predominantly oesophageal squamous cell carcinoma, is a common cancer in East Africa. This study assessed, for the first time, the associations of multiple measures of poor oral health with the risk of oesophageal cancer in Kenya.

What are the main results?

The study found that poor oral health and poor oral hygiene were risk factors for oesophageal cancer in Kenya. In particular, lack of regular tooth brushing, use of a mswaki (Arak tree stick) to brush, and, independently, the combination of moderate or severe dental fluorosis (mottled enamel) and tooth loss or decay were strong risk factors for oesophageal cancer.

Why is this study important from a public health perspective?

The findings point to the potential for improved oral hygiene and oral health, overall and especially in people affected by dental fluorosis, to prevent oesophageal cancer in Kenya.

What is dental fluorosis?

Dental fluorosis is an irreversible hypomineralization of the tooth enamel caused by ingestion of extremely high levels of fluoride during enamel formation in the first years of life.

Why is dental fluorosis common in Kenya?

In Kenya, dental fluorosis occurs predominantly due to early-life excessive intake of fluoride, which is naturally found in water originating from aquifers in the high-fluorine volcanic rocks of the African Rift Valley. In certain areas of Kenya, levels of fluoride in ground and surface water are excessively high (> 2 mg/L), above the World Health Organization (WHO) guideline value of 1.5 mg/L. Critical exposure ages for the development of dental fluorosis are between the ages of 1 and 7 years, during the development of permanent dentition, when excessive fluoride disrupts enamel mineralization.

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