Read more about this disease, some with Classification – Types – Signs and symptoms – Genetics – Pathophysiology – Diagnosis – Screening – Prevention – Treatment and management – Cures and much more, some including pictures and video when available.
Dental fluorosis is a health condition caused by a child receiving too much fluoride during tooth development. The critical period of exposure is between 1 and 4 years old; children over age 8 are not at risk.[1] In its mild form, which is the most common, fluorosis appears as tiny white streaks or specks that are often unnoticeable. In its severe form it is characterized by black and brown stains, as well as cracking and pitting of the teeth.[2]
The severity of dental fluorosis depends on the amount of fluoride exposure, the age of the child, individual response, and nutritional and other factors.[1] Although water fluoridation can cause fluorosis, most of this is mild and not usually of aesthetic concern.[3] Severe cases can be caused by exposure to water that is naturally fluoridated to levels well above the recommended levels, or by exposure to other fluoride sources such as brick tea or pollution from high fluoride coal.[4]
Dental fluorosis occurs because of the excessive intake of fluoride either through fluoride in the water supply, naturally occurring or added to it; or through other sources. The damage in tooth development occurs between the ages of 3 months to 8 years, from the overexposure to fluoride. Teeth are generally composed of hydroxyapatite and carbonated hydroxyapatite; when fluoride is present, fluorapatite is created. Excessive fluoride can cause white spots, and in severe cases, brown stains or pitting or mottling of enamel. Fluorosis cannot occur once the tooth has erupted into the oral cavity. At this point, fluorapatite is beneficial because it is more resistant to dissolution by acids (demineralization). Although it is usually the permanent teeth which are affected, occasionally the primary teeth may be involved.
The differential diagnosis for this condition may include Turner’s hypoplasia (although this is usually more localized), some mild forms of amelogenesis imperfecta, and other environmental enamel defects of diffuse and demarcated opacities.
H.T. Dean’s fluorosis index was developed in 1942 and is currently the most universally accepted classification system. An individual’s fluorosis score is based on the most severe form of fluorosis found on two or more teeth.[5]
As of 2005[update] surveys conducted by the National Institute of Dental Research in the USA between 1986 and 1987[6] and by the Center of Disease Control between 1999 and 2002[7] are the only national sources of data concerning the prevalence of dental fluorosis.
The Center of Disease Control found a 9% higher prevalence of dental fluorosis in American children than was found in a similar survey 20 years ago. In addition, the survey provides further evidence that African Americans suffer from higher rates of fluorosis than Caucasian Americans.
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