Epidemiological investigations in human populations in several parts of the world, including England, together with animal experiments have revealed associations between caries prevalence and trace elements in the environment or diet. These reports led to collaborative studies on caries prevalence in school children in England and Wales in areas where past base metal mining has left a legacy of extensive heavy metal contamination of garden and agricultural soils. In the Tamar Valley of Cornwall and Devon and in Ceredigion (Dyfed, Wales) a raised caries prevalence has been associated with high levels of plant-available Pb in soils, whereas in Somerset Cd pollution was not associated with any change in caries prevalence. If Pb is causal in these relationships then dietary Pb is probably more significant than Pb in air or water.

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