Abstract
OBJECTIVES: The purpose of this study was to investigate the relationships between caries experience and dental fluorosis at different fluoride concentrations in drinking water. The impact of other fluoride products also was assessed.
METHODS: This study used data from the 1986-87 National Survey of US School-children. Fluoride levels of school water were used as an indicator of the children’s water fluoride exposure. The use of fluoride drops, tablets, professional fluoride treatments, and school fluoride rinses were ascertained from caregiver questionnaires. Only children with a single continuous residence (n = 18,755) were included in this analysis.
RESULTS: The sharpest declines in dfs and DMFS were associated with increases in water fluoride levels between 0 and 0.7 ppm F, with little additional decline between 0.7 and 1.2 ppm F. Fluorosis prevalence was 13.5 percent, 21.7 percent, 29.9 percent, and 41.4 percent for children who consumed < 0.3, 0.3 to < 0.7, 0.7 to 1.2, and > 1.2 ppm F water. In addition to fluoridated water, the use of fluoride supplements was associated with both lower caries and increased fluorosis.
CONCLUSIONS: A suitable trade-off between caries and fluorosis appears to occur around 0.7 ppm F. Data from this study suggest that a reconsideration of the policies concerning the most appropriate concentrations for water fluoridation might be appropriate for the United States.
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Dental fluorosis in permanent incisor teeth in relation to water fluoridation, social deprivation and toothpaste use in infancy.
OBJECTIVES: To determine the prevalence and severity of fluorosis in permanent incisor teeth in young children in a fluoridated and a fluoride-deficient community and to establish what relationship, if any, there was between the occurrence of dental fluorosis and the reported use of fluoride toothpaste in childhood. DESIGN: A prevalence study
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[Fluorosis due to fluoride in drinking water. A health risk even in Norway?].
About 99% of the Norwegian population are supplied with surface water with very low fluoride levels. Accordingly, they need to use fluoride preparations to prevent dental caries. Groundwater with excess fluoride is a problem mainly in a few areas of South-Eastern Norway, where in some samples of borehole water the
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Characteristics of epidemiology of dental caries in children from regions with high and optimum fluorine content in drinking water.
Objective: Introduction: Prevention of dental diseases in children is the priority item on the modern dentistry agenda. Among the undeniable factors known as contributing into caries incidence, there is fluoride content in the external environment, especially in drinking water, which is the main source of fluoride intake. The aim: This
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Dental fluorosis in children in areas with fluoride-polluted air, high-fluoride water, and low-fluoride water as well as low-fluoride air: a study of deciduous and permanent teeth in the Shaanxi province, China.
OBJECTIVE: The aim of the study was to assess dental fluorosis (DF) in the deciduous and permanent teeth of children in areas with high-F coal (area A) and high-F water (area C) compared to children from area B, with low-F water and coal. MATERIAL AND METHODS: 596 children were examined. DF
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Prevalence of dental fluorosis in fluoridated and nonfluoridated communities--a preliminary investigation
As a result of undocumented observations that the prevalence of dental fluorosis in both fluoridated and nonfluoridated communities may be higher than would be predicted on the basis of Dean's data from the 1940s, dental fluorosis assessments using a modification of Dean's Index were made in 1981 as part of
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Dental Fluorosis in the U.S. 1950-2004
Before the widespread use of fluoride in dentistry, dental fluorosis was rarely found in western countries. Today, with virtually every toothpaste now containing fluoride, and most U.S. water supplies containing fluoride chemicals, dental fluorosis rates have reached unprecedented levels. In the 1950s, it was estimated that only 10% of children in
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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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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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Dental Fluorosis Impacts Dentin in Addition to Enamel
Dental fluorosis is a mineralization defect of tooth enamel marked by increased subsurface porosity. The enamel, however, is not the only component of teeth that is effected. As several studies have demonstrated, dental fluorosis can also impair the mineralization of dentin as well. As noted in one review: "The fact that
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