Dental fluorosis in 12-15-year-old rural children exposed to fluorides from well drinking water in the Hail region of Saudi Arabia.

To investigate the relationship between fluoride levels in well drinking water, severity of dental fluorosis and dental caries in the Hail region of Saudi Arabia, 2355 rural children aged 12-15 years were examined. Over 90% of the children had fluorosed teeth and chi-square tests showed a strong association (P < 0.001) between fluoride level (0.5-2.8 ppm) in well drinking water and severity of dental fluorosis. Although regression analysis showed a statistically significant relationship (P < 0.001) between fluoride concentration and caries experience, the amount of variation explained was very low (R2 = 0.9%). Since fluoride in well water had little influence on caries experience and is causing dental fluorosis, it should be removed by defluoridation or the rural population should be provided with an alternative source of drinking water with lower fluoride concentration.