Exposure, prevention and management introduction dental fluorosis is a developmental disturbance of dental enamel, caused by successive exposures to high concentrations of fluoride during tooth development, leading to enamel with lower mineral content and increased porosity. Dental fluorosis refers to changes in the appearance of tooth enamel that are caused by longterm ingestion of fluoride during the time teeth are forming 1. An index for measuring any condition should be sensitive, easy to understand and reliable. Nonspecific descriptive indices such as the developmental defects of enamel index have also been used to record fluorosis. The greatest risk is from birth to 8, particularly between 15 and 30 months. Epidemiologic indices for measuring the clinical manifestations of. Subjects n443 were participants in the iowa fluoride study, a birth cohort study of fluoride exposures and intake, fluorosis, and caries. Fluorosis has most commonly been recorded using clinical examinations and photographs. The fluorosis risk index appears to be particularly useful for. Fluorosis, chronic intoxication with fluorine usually combined with some other element to form a fluoride that results in changes in the skeleton and ossification of tendons and ligaments. Deans fluorosis index article about deans fluorosis index. Prevalence and severity of dental fluorosis in hail.
Dental fluorosis prevalence and severity using deans index based on six teeth and on 28 teeth article pdf available in clinical oral investigations 123. The purpose of this paper is to describe and compare the three principal ones in use today. Aug 15, 2017 fluorosis is a crippling disease resulted from deposition of fluorides in the hard and soft tissues of body. Oct 07, 2019 a major cause of fluorosis is the wrong use of fluoridecontaining dental products such as toothpaste and mouth rinses. Dental caries was low with a predominance of tooth decay. Fluoride intake after the age of 8 cannot cause fluorosis. Fluorosis, caused by ingestion of excessive amount of fluoride through food or water, is a major public health problem in india. Fluoride action network community fluorosis index cfi. Deans index of fluorosis 1947 is the oldest index of fluorosis. We have used this index many times in surveys of oral health in ireland, we have trained examiners in many different. While the dean index is still widely used in surveys of fluorosis including the cdcs national surveys of fluorosis in the united states dental researchers have developed more finely tuned diagnostic scales.
Endemic fluorosis in developing countries to discuss with a larger group the results of studies and research carried out by individual members of the committee. The continued use of deans classification system and derived index. If you need to print pages from this book, we recommend downloading it as a pdf. It normally does not affect the function of the teeth or cause pain. Note the distribution pattern of any defects and decide if they are typical of fluorosis i. Article information, pdf download for epidemiologic indices for measuring the. Front matter health effects of ingested fluoride the. Are there good reasons for fluoride labelling of food and. As a result the literature over the last two decades has also reported numerous studies with differing and confusing results. This paper describes for the clinician the condition and summarizes.
The objective of this symposium is to draw attention to the fluorosis problem in relation to water. The traditional criteria the dean index for diagnosing dental fluorosis was developed in the first half of the 20th century by h. Considering the narrow dosegap between caries reduction benefit and dental fluorosis risk, the issue of monitoring fluoride intake in young children was raised by the world health organisation. It is a public health problem caused by excess intake of fluoride through drinking waterfood productsindustrial pollutants over a long period.
If the two teeth are not equally affected score on the least affected. The subject should be examined in the upright position, with the examiner facing the subject with his or her back to the light window. Search engines use a very sophisticated indexing system to keep track of billions of pages on the web. In the 20th century, the various indices used for measurement of dental fluorosis are. Unfortunately, this book cant be printed from the openbook. It is widely used and provides a basis for current and historical comparisons of fluorosis. Oct 09, 2016 fluorosis index department of public health dentistry 9 9. Deans index is scored on the condition of these two teeth. Pdf fluorosis is important to measure because it is a condition that can. Risk factor exposure was assessed via a mailed questionnaire with a response rate of 80%.
The community fluorosis index cfi is a way of measuring the burden of dental fluorosis in a population. Prevalence and severity of dental fluorosis in the united. The fluorosis risk index frl, a new index developed for use in analytical epidemiologic studies, is designed to permit a more accurate identification of associations between age. Exposure to different sources of fluoride, was a risk factor for the development of fluorosis and a benefit with regard to dental caries.
Birzeit water dropsofficial bulletin of institute of environmental and water studies 9. The fluorosis status of the subjects was determined on the basis of a clinical dental examination using the fluorosis risk index fri. When scoring, start at the higher end of the index i. The fri has advantages for use in analytical epidemiologic studies of dental fluorosis.
Once teeth break through the gums, you cannot develop fluorosis fluorosis isnt a disease and doesnt affect the health of your teeth. Pdf dental fluorosis prevalence and severity using deans. Although no numbers were used it was considered to be on an ordinal scale. This paper describes for the clinician the condition and summarizes the recent literature on the risk factors for fluorosis. Other indices such as tooth surface fluorosis index, thylstrup and fejerskov index and fluorosis risk index can also be used. It is uncomplicated and provides a whole mouth score in one code. Skeletal fluorosis, a bone disease caused by excessive accumulation of fluoride in the bones. Two examiners whose techniques were calibrated examined randomly selected middleschoolaged children living in bergen, norwaywhere the water supply contains less than 0. Only children aged 8 years and younger are at risk because this is when permanent teeth are developing. If fluorosis is present then decide on the two most severely affected teeth. Exposure to fluoride in optimum amounts about one part per million of fluoride to water is claimed to be beneficial to the teeth in the prevention of caries and probably to bone development. Most fluorosis is the result of consuming too much fluoride before the age of. Dental fluorosis in permanent incisor teeth in relation to.
Exposure to fluoride in optimum amounts about one part per million of fluoride to water is claimed to be. Pdf dental fluorosis prevalence and severity using dean. Micro and macro abrasion were employed for this patient. An integrated approach to address endemic fluorosis in. To help prevent both tooth decay and dental fluorosis, the centers for disease control and prevention cdc recommends the following. Fluorosis varied treatment options pubmed central pmc. A total of 1026 high school adolescents 1217 years were enrolled from. Fluorosis risk in grade 2 students residing in a rural area with widely. Fluorosis index department of public health dentistry 9 9.
This study reports fluorosis prevalence estimates in a birth cohort using the fri in different ways. Lalumandier and richard gary rozier, journalpediatric dentistry, year1995, volume17 1, pages 1925. Dental fluorosis occurs while the permanent teeth are developing, before they have erupted. Toothpaste that is swallowed but not toothpaste that is spit out contributes to a childs total fluoride intake. Studies conducted in the 1930s showed that the severity of tooth decay was lower and dental fluorosis was higher in areas with more fluoride in the drinking water 2. Pdf the prevalence and risk factors of fluorosis among. Fluoride toxicity, elevated levels of the fluoride ion in the body. Risk factors for enamel fluorosis in a nonfluoridated population. The two main classification systems are described below. Mar 08, 2019 dental fluorosis is caused by taking in too much fluoride over a long period when the teeth are forming under the gums. The prevalence and risk factors of fluorosis among patients in a pediatric dental practice.
These include fluorosis specific indices such as deans index. High prevalence of dental fluorosis among adolescents is a. However, the population prevalence estimates vay, depending on the index and case definition used. This study was undertaken to quantify the dental fluorosis burden among school going adolescents and to find factors associated with dental fluorosis in kolar taluka, karnataka, india. Instead of just measuring the overall prevalence of fluorosis i. Fluorosis community water fluoridation faqs community. Dental fluorosis is caused by taking in too much fluoride over a long period when the teeth are forming under the gums. Dental fluorosis causes, prevention, treatment, pictures.
Dental fluorosis is the appearance of faint white lines or streaks on the teeth that only occurs when younger children consume too much fluoride, from any source, over long periods when teeth are developing under the gums. Fluorosis index department of public health dentistry 10 the fluorosis index set criteria for categorization of dental fluorosis on a 7 point scale. This article comes from madurai in india where its surrounding towns are fluorosis prone zones. Most fluorosis was mild, with only 7 individuals 1. Ingestion of excess fluoride, most commonly in drinkingwater affects the teeth and bones. According to the cfi in the studied example, dental fluorosis represents a public health problem in the studied sample. The severity of the condition is dependent on the dose, duration, and age of the. Risk factors for enamel fluorosis in a fluoridated population. Studies have identified four fluoride sources that are commonly associated with a childs risk for developing fluorosis. Once teeth break through the gums, you cannot develop fluorosis. The treatment options for fluorosis are varied depending upon individual cases. The results of this study, focusing on kinetics and sorption isotherms, demonstrate that an inexpensive, locally. This paper presents the grounds for an integrated approach to address endemic fluorosis in jharkhand, india, an approach that encompasses health monitoring, communitybased water systems management, and locally synthesized hydroxyapatite, a sustainable water treatment technology. Children younger than 6 years have a poor swallowing reflex and tend to swallow much of the toothpaste on their brush.
This disambiguation page lists articles associated with the title fluorosis. A database index has an entry for each key field account number, name, etc. Deans fluorosis index article about deans fluorosis. Objectives to determine the prevalence and severity of fluorosis in permanent incisor teeth in young children in a fluoridated and a fluoridedeficient community and to. This technique has been employed successfully for mild to moderate grade fluorosis.
Prevalence and severity of dental fluorosis in hail, saudi arabia, authorhazza abdullah alhobeira and ammar ahmed siddiqui and rashid iqbal mian and siddiqui aa, journaljournal of international oral health, year. Dental fluorosis is a common disorder, characterized by hypomineralization of tooth enamel caused by ingestion of excessive fluoride during enamel formation it appears as a range of visual changes in enamel causing degrees of intrinsic tooth discoloration, and, in some cases, physical damage to the teeth. Clinical examination, using the fluorosis risk index, a fluorosis index developed for this project, allowed cases and controls to be identified based upon the specific time period of exposure to the various sources of ingested fluoride. As soon as the first tooth appears, begin cleaning by brushing without toothpaste with a small, softbristled toothbrush and plain water after each. Risk index fri classification i enamel surfaces was strongly associated.
The risk of enamel fluorosis and caries among norwegian. Fluoride poisoning can be prevented or minimized by using alternative water sources, by removing excessive fluoride from drinking water, and by improving the nutritional status of populations at risk. Risk factor exposure was ascertained via a mailed questionnaire with a response rate of 90% and a questionnaire reliability of 87%. Aug 26, 2000 objectives to determine the prevalence and severity of fluorosis in permanent incisor teeth in young children in a fluoridated and a fluoridedeficient community and to establish what relationship.
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