Abstract
The prevalence of enamel fluorosis has increased in optimally fluoridated areas in recent years. This has led to efforts to identify the cause or causes and to make recommendations that seek to maintain the caries-preventive effectiveness offluoride use while minimizing the risk of fluorosis. In this study, the author estimated the potential direct impact that dental practitioners could have on reducing the amount of enamel fluorosis in U.S. children. The findings suggest that dental practitioners could have an important impact on reducing the prevalence of enamel fluorosis by guiding the public toward the most appropriate use of fluoride products.
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Risk of enamel fluorosis associated with fluoride supplementation, infant formula, and fluoride dentifrice use.
Eight hundred fifty 11- to 14-year-old residents of nonfluoridated communities in Massachusetts and Connecticut, who were born between 1972 and 1975, were investigated in a case-control study of the possible association between enamel fluorosis and exposure to fluoride supplements, infant formula, and/or fluoride dentifrice. The effect of median household income,
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Prevalence of dental fluorosis in children from non-water-fluoridated Halmstad, Sweden: fluoride toothpaste use in infancy.
OBJECTIVES: To determine the prevalence and severity of dental fluorosis in children aged 7-9 years from non-water-fluoridated Halmstad, Sweden, and to relate the results to their reported fluoride exposure history during infancy. MATERIAL AND METHODS: In Spring 2002, a questionnaire distributed to a cluster random sample of 1039 parents enquired into
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Risk factors associated with fluorosis in a non-fluoridated population in Norway.
In Norway, there is no water fluoridation and little naturally occurring fluoride in drinking water. Fluoride toothpaste is used by 95% of the population and there is a long tradition of fluoride supplement use. The purpose of this study was to record the prevalence and severity of dental fluorosis in
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Effect of fluoridated water on dental caries and fluorosis in schoolchildren who use fluoridated dentifrice.
This cross-sectional study evaluated the prevalence and severity of dental caries and fluorosis in children and adolescents using fluoridated toothpaste, from areas with and without fluoridated water. Parents of 5-year-old children and 12-year-old adolescents from neighbourhoods that are supplied with and without fluoridated water answered questionnaires for determining socio-economic and
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Factors associated with the use of fluoride supplements and fluoride dentifrice by infants and toddlers.
Dental fluorosis may be associated with the inappropriate use of fluoride dentifrices and/or dietary fluoride supplements by young children, especially for those who consume optimally fluoridated water. Studies to date have used retrospective designs that rely on anamnestic responses of adults to determine fluoride exposures in their children. The 1986
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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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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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Diagnostic Criteria for Dental Fluorosis: The TSIF ("Total Surface Index of Fluorosis")
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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Fluoride & Perioral Dermatitis
Perioral dermatitis (PD) is a common rosacea-like dermatitis that was never reported prior to the mid-fifties. Although it can affect both sexes and all ages, most patients are women ages 20-50 years. Patients with PD frequently report a pre-existing tendency to blush. This disease is most likely multifactorial in origin, and fluoride preparations in dentrifices probably have played a role as precipitator.
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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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