Abstract
It is observational, analytical and cross-sectional aimed to evaluate the association between severity and prevalence of fluorosis and dental caries in rural communities with endemic dental fluorosis in the north state of Minas Gerais, Brazil, with fluoride concentrations in water up to 4.8 mg/L. Data were collected by one examiner (intra-examiner kappa, 0.96 to 0,95 for caries and fluorosis) after toothbrushing. The study included 511 individuals aged 7 – 22 years, categorized according to age: 7 – 9 years (n = 227), 10 to 12 years (n = 153), 13 to 15 years (n = 92), 16 to 22 years (n = 39). For the diagnosis of dental caries used the criteria of the World Health Organization to measure indices DMFT. For fluorosis used the index Thylstrup and Fejerskov (TF), dichotomized according to prevalence (TF = 0 and TF > 0) and severity (TF < 4 and TF > 5). In the two younger groups, the DMFT and its decay component were higher in the group with more severe fluorosis (p < 0.001). This association was not found among adolescents and adults (p > 0.05). The association was found between the conditions more severe fluorosis and caries in individuals under 12 years.
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Dental Fluorosis and Dental Caries.
FOR some 8 or 9 years past the presence of fluorine in water supplies has been attracting much attention, chiefly as a danger and as the cause of endemic dental fluorosis, or mottled enamel, which has been reported in some 300 communities in 23 states of the Union. According to Dean,1
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Fluorosis and dental caries in Mexican schoolchildren residing in areas with different water fluoride concentrations and receiving fluoridated salt
OBJECTIVE: To explore the association between fluoride in drinking water and the prevalence and severity of fluorosis and dental caries in children living in communities receiving fluoridated salt. MATERIAL AND METHODS: Participants were schoolchildren (n = 457) living in two rural areas of the State of Morelos, Mexico, where the water
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Drinking water fluoride levels, dental fluorosis, and caries experience in Brazil
OBJECTIVES: The main aim of this study was to consider the association between water fluoride levels and caries prevalence in three Brazilian populations. METHODS: A total of 457 6-12-year-old lifetime residents from three economically deprived groups with 2-3, 0.7, and less than 0.01 ppm F in their water supplies were examined.
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Higher fluorosis severity makes enamel less resistant to demineralization
Fluorotic teeth could either be more resistant or more susceptible to the caries process than sound ones due to their higher enamel fluoride concentration and higher porosity (subsurface hypomineralization), respectively; however, there is no consensus on this subject. In this study, a total of 49 human unerupted third molars presenting
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Caries and dental fluorosis in a 0.25 and a 2.5 ppm fluoride area in the Sudan
The purpose of this study was to assess the caries prevalence of children living in areas with either 0.25 or 2.5 ppm fluoride in the drinking water, and to relate caries experience to the severity of dental fluorosis. The children, aged 6-16 years (mean 11.3 years), were lifelong residents of their rural
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Moderate/Severe Dental Fluorosis
In its "moderate" and severe forms, fluoride causes a marked increase in the porosity of the enamel. After eruption into mouth, the porous enamel of moderate to severe fluorosis readily takes up stain, creating permanent brown and black discolorations of the teeth. In addition to extensive staining, teeth with moderate to severe fluorosis are more prone to attrition and wear - leading to pitting, chipping, and decay.
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Community Fluorosis Index (CFI)
The current Community Fluorosis Index for U.S. adolescents as a whole (from both fluoridated and non-fluoridated areas) is roughly 5 times higher than the CFI health authorities predicted for fluoridated areas when fluoridation first began. It is also higher than the CFI that the NIDR found in fluoridated areas back in the 1980s. It is readily apparent, therefore, that children are ingesting far more fluoride than was the case in the 1950s, and even as recently as the 1980s.
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Diagnostic Criteria for Dental Fluorosis: The Thylstrup-Fejerskov (TF) Index
The traditional criteria (the "Dean Index") for diagnosing dental fluorosis was developed in the first half of the 20th century by H. Trendley Dean. While the Dean Index is still widely used in surveys of fluorosis -- including the CDC's national surveys of fluorosis in the United States -- dental
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Dental Fluorosis Is a "Hypo-mineralization" of Enamel
Teeth with fluorosis have an increase in porosity in the subsurface enamel ("hypomineralization"). The increased porosity of enamel found in fluorosis is a result of a fluoride-induced impairment in the clearance of proteins (amelogenins) from the developing teeth. Despite over 50 years of research, the exact mechanism by which fluoride impairs amelogin
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Racial Disparities in Dental Fluorosis
In 2005, the Centers for Disease Control published the results of a national survey of dental fluorosis conducted between 1999 and 2002. According to the CDC, black children in the United States have significantly higher rates of dental fluorosis than either white or Hispanic children. This was not the first time that black children were found to suffer higher rates of dental fluorosis. At least five other studies -- dating as far back as the 1960s -- have found black children in the United States are disproportionately impacted by dental fluorosis.
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