Tag: diagnosis
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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 researchers have developed more finely […]
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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 researchers have developed more finely […]
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Diagnosis
Dental fluorosis comes in various stages of severity. The severity of fluorosis increases with the dose of fluoride the child consumes, and can be exacerbated by nutritional deficiencies and kidney impairment. Dentists generally use the “Dean Index” to diagnose the severity of a child’s fluorosis. Developed in the 1930s and 1940s by the “Father of […]
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Fluoride, Arthritis, and the Specter of Misdiagnosed Skeletal Fluorosis in the US
It has been known since the 1930s that ingesting too much fluoride can cause stiff and painful joints. According to scientists who have studied this condition (commonly referred to as skeletal fluorosis), the joint damage caused by fluoride may mimic other, more common, forms of “arthritis,” making it easy to misdiagnose — especially by doctors […]
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Variability in Radiographic Appearance of Skeletal Fluorosis
Osteosclerosis (dense bone) is the bone change typically associated with skeletal fluorosis, particularly in the axial skeleton (spine, pelvis, and ribs). Research shows, however, that skeletal fluorosis produces a spectrum of bone changes, including osteomalacia, osteoporosis, exostoses, changes resulting from secondary hyperparathyroidism, and combinations thereof. Although the reason for this radiographic variability is not yet fully understood, it is believed to relate to the dose of fluoride consumed, the individual’s nutritional status, exposure to aluminum, genetic susceptibility, presence of kidney disease, and area of the skeleton examined.
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X-Ray Diagnosis of Skeletal Fluorosis
In 1937, Kaj Roholm published his seminal study Fluorine Intoxication in which he described three phases of bone changes that occur in skeletal fluorosis. (See below). These three phases, which are detectable by x-ray, have been widely used as a diagnostic guide for detecting the disease. They describe an osteosclerotic bone disease that develops first in the axial skeleton (the spine, pelvis, and ribs), and ultimately results in extensive calcification of ligaments and cartilage, as well as bony outgrowths such as osteophytes and exostoses. Subsequent research has found, however, that x-rays provide a very crude measure for diagnosing fluorosis since the disease can cause symptoms and effects (e.g., osteoarthritis) before, and in the absence of, radiologicaly detectable osteosclerosis in the spine.