Dental Fluorosis

DONE BY : MARYAM ARBABHOUSE OFFICER

The Contents :What’s dental fluorosisThe causes of fluorosisMagnitude of fluorosisMechanism of dental fluorosis Mottled enamelClassification of dental fluorosisFluorosis Treatment Fluorosis Prevention References

What’s Dental Fluorosis?

Fluorosis : Is a cosmetic condition that affects the teeth. It’s caused by overexposure to fluoride during the first eight years of life. This is the time when most permanent teeth are being formed .

• Or fluorosis is a disease caused by deposition of fluorides in the hard and soft tissues of the body.

• It’s not merely caused by the excess intake of fluoride but there are many other attributes and variables which determine the onset of fluorosis in human population.

• It is usually characterised by discoloration of teeth and crippling disorders.

Magnitude Of Fluorosis :• Worldwide in distribution

• Endemic in 22 countries

• Asia (India and China are the worst affected)

• Mexico in North, Argentina in Latin America, East and North Africa are also endemic

The Causes Of Fluorosis:

Main sources of fluoride are:

• Water

• Food

• Medicament

• Cosmetics

Common causes of fluoros is inc lude:

1. Excess fluor idat ion of dr ink ing water .

2. Ingest ion of fluor ide toothpaste .

3. Overuse of fluor ide tab lets .

4. Consumpt ion of processed food made with fluor idated water.

Mechanism Of Dental Fluorosis :

• Structurally, an increase in fluoride intake results in an increase in degree and extent of porosity of the enamel.

• the enamel changes described may be a result of a fluoride damage of secretory ameloblasts

• This can either be due to a fluoride-induced change in composition of enamel matrix, or be a result of a disturbance of the cellular processes during enamel maturation.

Mottled Enamel :• Mottled enamel is a condition indicates the

fluorosis characterized by minute white flecks, or yellow or brown spots or areas, scattered irregularly or streaked over the surface of a tooth

• It is scored according to a method described by Al alousi’ et al as follow:

• Type A: White areas less than 2mm

• Type B: White areas more than 2mm

• Type C: Brown areas less than 2mm

• Type D: Brown areas less than 2mm

• Type E: Horizontal white lines

• Type F: Horizontal brown lines

Classification Of Dental Fluorosis :

Smooth, glossy, pale creamy-white, translucent surface.

Normal

Questionable

Ranging from a few white flecks to occasional white spots.

Very mildSmall opaque, paper white areas scattered irregularly over the tooth but not involving as much as 25% of the tooth surface.

MildThe white opaque areas in the enamel of the teeth are more extensive but do not involve as much as 50% of the tooth.

ModerateAll enamel surfaces of the teeth are affected, and the surfaces subject to attrition show wear. Brown stain is frequently a disfiguring feature.

SevereAll enamel surfaces are affected , discrete or confluent pitting. Brown stains are widespread and teeth often present a corroded-like appearance.

Fluorosis Treatment:

Although the enamel defect caused by dental fluorosis is permanent, the tooth discoloration that fluorosis causes can be reduced, and sometimes eliminated, through cosmetic treatment

1. Microabrasion (conservative removal of the outer most layer of enamel) followed by teeth whitening can make the brown discoloration less apparent.

2. Bonding, which coats the tooth with a hard resin that bonds to the enamel

3. Crowns

4. Veneers, which are custom-made shells that cover the front of the teeth to improve their appearance

Fluorosis Prevention :• To prevents the fluorosis the fluoridation

of drinking water shouldn’t exceed the normal range (0.7- 1.2) ppm

• When Fluoride in water is more than 1.5 mg/litre, it is toxic to health

• Fluoride supplements should only prescribed for children living in non fluoridated areas.

• Use only acceptable amount of toothpaste for children under 6 years

Fluorosis Prevention :It’s also important to monitor the child’s use of fluoridated toothpaste. It’s important to teach the child to spit out the toothpaste after brushing instead of swallowing it. To encourage spitting, avoid toothpastes containing flavors that children may be likely to swallow.

References :

1)http://www.webmd.com/children/fluorosis-symptoms-causes-treatments

2) Fluoride action network/ http://fluoridealert.org/issues/fluorosis

3)American dental association

4)http://www.webmd.com/children/fluorosis-symptoms-causes-treatments

5)American dental association/fluoridation facts 2005/dr.herschel horowitz

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