Journal Articles
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Item Variability of naturally occurring fluoride in diverse community drinking-water sources, Tanna Island, Vanuatu(IWA Publishing, 2021-07) Webb E; Stewart C; Sami E; Kelsey S; Fairbairn Dunlop P; Dennison ELarge variations in fluoride concentrations exist in natural waters, many of which are the source of community drinking-water supplies. Determining fluoride concentrations in community drinking waters can be challenging in developing Pacific countries such as Vanuatu that have limited laboratory capacity. Knowledge of naturally elevated fluoride concentrations that cause irreversible, adverse health outcomes may allow communities the opportunity to treat and manage their drinking-water supplies. Community drinking-water samples (n = 69), sourced from groundwaters, roof catchment rainwaters, surface waters and springs, were sampled on Tanna Island, Vanuatu between 2017 and 2020. In an 18 km2 area of Western Tanna, a set of 30 groundwater-based drinking-water samples had a median fluoride concentration of 3.3 mg/L, with 20 samples >1.5 mg/L and seven samples >4.0 mg/L. These concentrations increase the risk of dental and skeletal fluorosis, respectively. Repeat resampling at five sites showed little variation over the sampling period. Rainwater-fed drinking-water supplies were lower overall and highly variable in fluoride concentrations (<0.05–4.0 mg/L, median of 0.53 mg/L), with variable inputs from volcanic emissions from Yasur volcano. We recommend a comprehensive oral health and bone health study for the whole island to determine adverse health effects of excess fluoride in this vulnerable population.Item Timings of permanent tooth emergence in children of rural Vanuatu, Melanesia(Pasifika Medical Association, 2021-12-30) Webb E; Stewart C; Woods L; Dunlop PF; Tangis J; Stephens J; Dennison EIntroduction: Global patterning and timing of permanent tooth emergence is influenced by ethnicity, with no known timings reported for ethnic Melanesian children living in the tropical archipelago of Vanuatu. Aim: To determine timings of permanent tooth emergence and sequencing for children who reside in rural Vanuatu Methods: Children aged 4-17 years (n=1026), part of a larger oral health cross-sectional study, were examined recording all permanent teeth present, across four spatially separated islands. Binary logistic modelling established children’s median age of emergence of each permanent tooth for each study area. Findings: The median emergence of first permanent molars for girls is 4.9-years and 5.3 -years for boys. In all locations, children had all permanent teeth emerge by age 11 years (excluding 3rd molars). Clinically important differences exist for permanent tooth emergence by study area. Discussion: Permanent teeth emerge earlier for Ni-Vanuatu children compared to both Melanesian children of Papua New Guinea as well as other ethnicities across Oceanic countries. These results can be used as a set standard for Vanuatu. Early tooth emergence suggests oral health education programmes should target pregnant women with clinical preventive strategies commencing for their children before 5-years of age.