Fluorosis

Abstract

Dental fluorosis (DF) is a developmental disturbance of the dental enamel, caused by successive exposures to high concentrations of fluoride during tooth development, leading to enamel with lower mineral content and increased porosity. The use of fluoride is considered an important factor in the prevention and management of dental caries through optimally fluoridated community water supplies and fluoridated oral care products. With the substantial decline in the prevalence and severity of dental caries, there has been an increase in the prevalence of fluorosis. Fluorosis varies in appearance from white striations to stained pitting of the enamel. The severity of DF depends on when and for how long the overexposure to fluoride occurs. Because of its simplicity, Dean's index has been used to compare the prevalence and severity of fluorosis for many decades. The DF classification index criteria developed from the Thylstrup and Fejerskov index are the most appropriate to determine the kind of treatment required to deal with this issue. However, controlling the fluoride intake remains the best preventive measure for DF. The effects of fluoride on enamel development have been studied in a wide range of animal species and tooth type with rat having been proved to be the best model for the study of human DF. Many mechanisms have been proposed to explain the pathological effects of excess fluoride in animal models, which we briefly review.