Enamel opacities: prevalence, classifications and aetiological considerations

Abstract

Prevalence studies of enamel opacities in high, optimum and low fluoride areas have been reviewed. In low fluoride areas the number of children with at least one affected tooth varied from 14·6 to 83·5 per cent, while at optimum fluoride levels the findings ranged from 8 to 36·4 per cent. In areas with 5 parts F/10 6 or more in the drinking water, almost all children had ‘mottled enamel’. Although a high concentration of fluoride in drinking water causes enamel opacities, 97 other aetiological factors have been implicated. They can be divided into two main groups: those which cause localized defects limited to one or a few teeth and those which cause generalized defects, affecting most or all teeth. A clinical approach to ascertaining the aetiology of enamel opacities is proposed.