## 4 Discussion
This measure aims to raise awareness and help parents make informed decisions regarding the water consumed by their children. Thus, based on these recommendations and our findings, we do not recommend the regular use of bottled water brands such as Alcalia and Devin, which have high F content in infants, toddlers and children. Moreover, we advise against consuming brands with F content above 0.7 mg/L during pregnancy and in infants aged 3 or younger. To further reduce the risk of DF in children, we support the Environmental Working Group (EWG), a U.S. non-profit organisation, recommendation to use filtered tap water for preparing infant formula [36]. If tap water is not fluoridated, a carbon filter can be used to remove impurities, and if it is fluoridated, a reverse osmosis filter can be used to remove the F [1; 36]. It is important to note that if bottled water is used for infants, it should be F-free. The Canadian Paediatric Society (CPS) has put forth a different recommendation regarding the F content in drinking water compared to the WHO, ADA and U.S. HHS. According to the CPS, the appropriate amount of F in tap or bottled drinking water is around 0.3 mg/L [25]. They believe this level is sufficient to prevent dental caries while avoiding the risk of DF. The CPS also advises that children under the age of 3 should not consume water with F levels \(\geq\) 0.7 mg/L. These recommendations are based on the understanding that most toothpaste products contain F, and children under 3 years old tend to swallow toothpaste instead of spitting it out, leading to increased daily F intake beyond the recommended dose of 0.7 mg for children aged 1-3 years [6,8,10]. To our knowledge, the last Romanian study focusing on this subject dates back to 2004 when [PERSON] et al. [20] stated that only one of the 19 mineral waters investigated revealed a concentration nearing 1 mg/L of F. The F content of bottled mineral or spring drinking water in our study exhibited a wide range, varying from 0.0338 to 4.6262 mg/L. These findings are consistent with studies conducted in other countries worldwide, including Bangkok, Thailand (0.01-0.89 mg/L); Fortaleza, Brazil (0.07-0.63 mg/L); Thessaloniki, Greece (0.05-4.8 mg/L); Suzhou Urban Area, China (0-0.120 mg/L); Indianapolis, U.S. (0.02-1.22 mg/L); and Victoria, Australia (!0.1-1.6 mg/L) [26,37,38,39,40,41]. According to [PERSON] et al. [42], the estimated individual F exposure from drinking water can be categorised into four groups: very low (!0.3 mg/L); low (0.3-0.69 mg/L); medium (0.7-1.49 mg/L); and high (\(\geq\)1.5 mg/L). Based on this classification, we can categorise the bottled water samples from our study as follows: 85% (n = 34) with a very low concentration of F, 10% (n = 4) with a low concentration, and 5% (n = 2) with a high concentration of F (Table 1). Based on our findings, where 85% of the evaluated waters had a F concentration below 0.3 mg/L, we consider their regular consumption to be safe for children and toddlers over 1 year of age. However, it is crucial to take into account the recommended daily adequate intakes of F for infants and toddlers under 1 year of age. For infants aged 0-6 months, the recommended intake is 0.01 mg/day, and for those aged 7-12 months, it is 0.5 mg/day [6]. Therefore, we recommend selecting water with the lowest possible F concentration for mixing infant formulas or preparing other types of food. This will help ensure that the F intake remains within the appropriate range for optimal dental health in this age group. It has been suggested that F concentrations are lower in water packaged in glass containers compared to water at the source, due to the binding of F to the glass [41]. In our study, three of the brands were packaged in glass bottles, but none of them had recorded F levels on the label. As a result, it was not possible to directly compare the F concentration at the source with those specific brands.