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Dental Fluorosis

  1. S.S Hotchandani
  2. • • • • White Spots? White Streaks? Cloudy Splotches? Brown Stains?
  3. • Fluorosis is a defect of tooth enamel caused by too much fluoride intake during the first 8 years of life. • Although fluorosis can be cosmetically treated, the damage to the enamel is permanent. • Common causes of fluorosis include: – fluoridated drinking water (particularly during infancy), – ingestion of fluoride toothpaste, – use of fluoride tablets, – consumption of processed foods made with fluoridated water.
  4. • Worldwide in distribution • Endemic in 22 countries • Asia and in Asia,India and China are worst affected • Mexico in North and Argentina in Latin America • East and North Africa are also endemic
  5. • Developmental Disturbance. • NOT a disease but rather affects the way that teeth look. • Dental fluorosis is a defect of the teeth marked by increased porosity of the enamel (a condition known as “Hypomineralization“).
  6. • The safe level for daily fluoride intake is 0.05 to 0.07 mg F/Kg/day. Above this level, the risk of developing fluorosis due to chronic fluoride consumption will be evident
  7. • Teeth are generally composed of hydrooxyapatite and Carbonated Hydro oxyapatite; – as the intake of fluoride increases, so does the teeth's composition of fluroapatite.
  8. • Inappropriate use of fluoridecontaining dental products such as Toothpastes and mouth rinses. • taking a higher-than-prescribed amount of a fluoride supplement during early childhood. • taking a fluoride supplement when fluoridated drinking water or fluoridefortified fruit juices and soft drink already provide the right amount.
  9. • Tiny white specks or streaks • Dark brown stains and rough, pitted enamel . • Teeth that are unaffected by fluorosis are smooth and glossy. • They should also be a pale creamy white.
  10. • 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.
  11. • 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 Fluoridation” (H. Trendley Dean), • Dean Index classifies fluorosis into five types: – – – – – “questionable,” “very mild,” “mild,” “moderate,” “severe.”
  12. • The enamel discloses slight aberrations from the translucency of normal enamel, ranging from a few white flecks to occasional white spots. • This classification is utilized in those instances where a definite diagnosis of the mildest form of fluorosis is not warranted and a classification of ‘normal’ is not justified.”
  13. Small opaque paper-white areas are scattered over less than 25% of the tooth surface.
  14. White opaque areas on the surface are more extensive but still affect less than 50% of the surface.
  15. All enamel surfaces of the teeth are affected, and the surfaces subject to attrition show wear. Brown stain is frequently a disfiguring feature.”
  16. All enamel surfaces are affected and hypoplasia is so marked that the general form of the tooth may be affected. The major diagnostic sign of this classification is discrete or confluent pitting. Brown stains are widespread and teeth often present a corrodedlike appearance.
  17. • Mild, no treatment is needed. • The appearance of teeth affected by moderate-to-severe fluorosis can be significantly improved by a variety of techniques. • Such techniques may include: – Tooth whitening and other procedures to remove surface stains – Bonding, which coats the tooth with a hard resin that bonds to the enamel – Crowns – Veneers, which are custom-made shells that cover the front of the teeth to improve their appearance
  18. • Parental vigilance is the key to preventing fluorosis. – At home, keep all fluoride-containing products such as toothpaste, mouth rinses, and supplements out of the reach of young children. • Since the major source of fluoride is drinking water, de-fluoridation is the best preventive measure which can be carried out at domestic as well as community level. • Nutritional interventions like high intake of vitamin C and Calcium also helps reduce the problem.