Fluoride Action Network


An investigation of the occurrence of fluorosis and caries was carried out in districts in Sweden with extremely high fluoride (F) concentrations in the drinking water. In areas with ? 10 ppm F* severe fluorosis, DEAN’S Index Grade 3 and 4, occurred on all permanent teeth and most of the primary teeth. The fluorosis was related to the F supply during the period of mineralization of the teeth. One case of “delayed” fluorosis was, however, demonstrated. In the area ? 5 ppm, 50 % of individuals had fluorosis Grade 2 and 28 % Grade 3 or 4 in the permanent teeth. Fluorosis in the primary dentition was milder, but only 20 % of the individuals were completely free from fluorosis and several cases of Grade 3 and 4 occurred in this area also. Caries frequency in the permanent teeth was higher in the ? 10 ppm area in comparison with the ? 1 ppm area. The highest DMFS values could be related to fluorosis Grade 3 and 4 in both the ? 10 ppm and ? 5 ppm areas. For the primary teeth the deft value decreased with increasing water F content and the caries frequency was not related to the degree of fluorosis. Duration of breastfeeding influenced the degree of fluorosis in areas up to ? 5 ppm in both the primary and secondary dentitions; in areas with ? 10 ppm F only the primary dentition was influenced, while the permanent teeth in these areas showed severe fluorosis even with long duration of breastfeeding. F content of saliva was, like the F content of bone and blood plasma, increased in the ? 10 ppm area. F deposition in primary teeth from the ? 10 ppm area was of the order four times that in the 1 ppm area. Pre? and post?natal F deposition is discussed with reference to analyses of F content of blood and bone, and the significance of these factors during pregnancy