Severity Of Dental Fluorosis Research Articles

Association between dental fluorosis prevalence and inflammation levels in school-aged children with low-to-moderate fluoride exposure

Inflammation mediates the neurological deficits caused by fluoride. Thus, whether inflammation is the underlying mechanism of dental fluorosis (DF) in school-aged children is worth exploring. A cross-sectional study was conducted to investigate the association between inflammation and the prevalence and severity of DF with low-to-moderate fluoride exposure. Fasting morning urine and venous blood samples were collected from 593 children aged 7–14 years. The fluoride content in the water and urine samples was measured using a fluoride ion-selective electrode assay. The levels of interleukin-1β (IL-1β) and C-reactive protein (CRP) were detected using an enzyme-linked immunosorbent assay. The Dean's index was used when performing dental examinations. Regression, stratified, and mediation analyses were performed to analyze the association between fluoride exposure, inflammation, and DF prevalence. In the adjusted regression models, the prevalence of mild DF was 1.723-fold (95% confidence interval [CI]:1.612, 1.841) and 1.594-fold (1.479, 1.717) greater than that of normal DF for each 1 mg/L increase in water and urinary fluoride content, respectively. The prevalence of mild DF increased by 3.3% for each 1 pg/mL increase in the IL-1β level and by 26.0% for each 1 mg/L increase in the CRP level. Stratified analysis indicated a weaker association between fluoride concentration and DF prevalence in boys than in girls, and susceptibility in the boys was reflected by the association of IL-1β with very mild and moderate DF prevalence. For every 1 mg/L increase in water and urinary fluoride levels, the proportion of IL-1β-mediated effects on the prevalence of mild DF was 10.0% (6.1%, 15.8%) and 8.7% (4.8%, 15.2%), respectively, and the proportion of CRP-mediated effects was 9.2% (5.5%, 14.9%) and 6.1% (3.3%, 11.0%), respectively. This study indicates that the DF prevalence may be sex-specific. Inflammatory factors may partially mediate the increased prevalence of mild DF in school-aged children with low-to-moderate fluoride exposure.

Efficiency of 5% Sodium Hypochlorite in The Removal of Dental Fluorosis Stains

Dental fluorosis is a specific disturbance in tooth formation, and is defined as a chronic, fluoride-induced condition in which enamel development is disrupted. Objective: To test the efficiency of 5% sodium hypochlorite in removing dental fluorosis stains. Methods: A 5 percent solution of NaOCl was used in each case. It was administered with a cotton applicator to the whole surface of the teeth, and it was repeated until the NaOCl solution had evaporated. After treatment, a follow-up assessment was conducted by a vita shade guide. Results: Patients with dental fluorosis aged 12 to 20 were enrolled in the study. 32 men (59.3%) and 22 women were studied (40.7%). One patient (1.9%) had completed college. There were 23 (42.6%), 23 (42.6%) and 05 (09.3%) cases with inadequate socioeconomic status. One in ten people (or 18.5%) had a family history of fluorosis. 26 (48.1%) brushed once, 23 (42.6%) brushed twice, and just 05 (09.3%) brushed three times. There were 25 mild instances, 15 moderate cases, 10 severe cases, and 4 severe dental cases (DF). 5% sodium hypochlorite was efficacious in 40 (74.1%) and 14 (24.9%) cases of mild to severe dental fluorosis. Conclusion: The 5% sodium hypochlorite was found to be an efficient method for eliminating dental fluorosis lesions in this investigation. Non-invasive and safe procedure for these lesions. No additional supplies are needed, and it may be used on children's permanent teeth with ease. To support the efficacy of a bigger sample size, further studies are recommended.

Moderate and Severe Dental Fluorosis in the Rural Population of Anantapur, India: Change in Their Biological Susceptibility?

Dental fluorosis affects the quality of life. A cross-sectional, observational study was conducted in a community affected by endemic fluorosis for several generations with a conserved biological and social environment. The study included patients from the rural population of Anantapur, India. The Dean index (DI) and the Thylstrup and Fejerskov Index (TFI) were used for fluorosis classification. Additionally, water samples were collected for fluoride analysis, taken from the patients’ living areas. The statistical association between the variables was analyzed. In total, 785 patients between 10 and 60 years old were included in the study (58.7% women and 41.3% men). Fluorosis signs were found in 94.6% of patients examined using the DI and 94.4% using the TFI. Moderate–severe dental fluorosis was observed in 62.8% by DI and 73.1% by TFI consuming untreated water with up to 2.9 ppm of fluoride. Furthermore, moderate–severe dental fluorosis was observed in 33.2% by DI and 39.9% by TFI consuming water with ≤1.5 ppm of fluoride. The high prevalence of moderate–severe dental fluorosis in patients consuming water with a low fluoride concentration suggests that other factors are involved. Biological susceptibility change could play an essential role in the severity of dental fluorosis in populations exposed for several generations, affecting its actual and future quality of life.

Dental Fluorosis and Its Associated Factors Amongst Libyan Schoolchildren

BackgroundLittle is known about dental fluorosis (DF) in Benghazi, Libya, where the public water supply is naturally fluoridated. ObjectiveThe study aims to investigate the distribution of DF and its related risk factors and impact on oral health–related quality of life (OHRQoL) and the association between DF and caries amongst Libyan school children. MethodsA cross-sectional survey was carried out amongst 12-year-old schoolchildren in the city of Benghazi. Dean's and decayed, missing, and filled surfaces (DMF) indices were used to assess the severity of DF and dental caries. In addition, a self-administered questionnaire was used to collect sociodemographic and behavioural information and OHRQoL using the Child Oral Health Impact Profile–Short Version 19 (COHIP-SF19). ResultsOut of 1125 children who participated in the study, 15%, 7.8%, 2.2%, and 0.4% of participants were coded as having questionable, mild, moderate, and severe DF, respectively. Children enrolled in private schools were less likely to have DF (odds ratio, 0.55; 95% confidence interval, 0.35–0.83; P = .007). Moderate-severe DF was associated with more decayed surfaces and DMF scores and low scores for COHIP-SF19 and its socioemotional well-being subscale. ConclusionsThe data demonstrate that rates of DF are relatively low in naturally fluoridated areas in Libya. DF amongst Libyan schoolchildren was associated with social disparities, higher caries rates, and negative impacts on OHRQoL.

Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations.

There is currently no consensus among researchers on the optimal level of fluoride for human growth and health. As drinking water is not the sole source of fluoride for humans, and fluoride can be found in many food sources, this work aimed to determine the incidence and severity of dental fluorosis in Poland, in areas where a low fluoride content characterizes the drinking water, and to assess the impact of fluoride on the enamel composition and microstructure. The dental examination involved 696 patients (aged 15–25 years) who had since birth lived in areas where the fluoride concentration in drinking water did not exceed 0.25 mg/L. The severity of the condition was evaluated using the Dean’s Index. Both healthy teeth and teeth with varying degrees of fluorosis underwent laboratory tests designed to assess the total protein and fluoride content of the enamel. Protein amount was assessed spectrophotometrically while the level of fluoride ions was measured by DX-120 ion chromatography. The clinical study revealed 89 cases (12.8%) of dental fluorosis of varying severity. The enamel of teeth with mild and moderate fluorosis contained a significantly higher protein (p-value < 0.001 and 0.002, respectively) and fluoride level (p < 0.001) than those with no clinical signs of fluorosis. SEM images showed irregularities in the structure of the fluorotic enamel. An excessive fluoride level during amelogenesis leads to adverse changes in the chemical composition of tooth enamel and its structure. Moreover, dental fluorosis present in areas where drinking water is low in fluorides indicates a need to monitor the supply of fluoride from other possible sources, regardless of its content in the water.

A Systematic Review and Meta-Analysis of the Relationship Between the Severity of Dental Fluorosis and Fluoride Biomarkers in Endemic Areas.

The intake of high concentrations of fluoride, mainly through drinking water, diet and fluoridated dentifrices, produces fluorosis, which in its early stages is manifested as dental fluorosis (DF). To recognize exposure to fluoride in endemic areas and to evaluate the risk of developing health impairment, the WHO has established several biomarkers that are used to determine systemic fluorine (F-) exposure. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the relationship between the severity of DF and fluoride biomarkers in endemic areas. The protocol of this study was previously registered as CRD42021244974. A digital search was carried out in PubMed/Medline, SpringerLink, Scopus, Cochrane and Google Scholar by employing the keywords "urine", "nails", "hair", "plasma", "saliva" and "dental fluorosis" for the original studies with content associated with F- for the biomarkers and DF. The mean difference was established as the effect measure for the meta-analysis. Seven studies fulfilled the eligibility criteria, among which five assessed urine and two employed nails as fluoride biomarkers. A positive significant difference was found between the biomarkers and the severity of DF (0.27, p < 0.001) and individually for each biomarker (urine: 0.14, p = 0.001; nails: 0.88, p < 0.05). The F- concentration in urine and nails is correlated with the severity of DF, with the most evident differences between healthy individuals and those with mild severity. Both biomarkers are adequate to assess this relationship in endemic areas of fluoride and DF.

Perceptions of dental fluorosis among community members in the Sudano-Sahelian Cameroon

Introduction: Dental fluorosis is a hypomineralisation of the enamel resulting from chronic ingestion of high levels of fluoride (above 1 mg/l) during amelogenesis. The disease affects the social relations, psychosocial wellbeing and quality of life of affected persons. Endemic areas of dental fluorosis have been reported in Cameroon and several people would be affected. Objective: To determine the perceptions of dental fluorosis in the Sudano-Sahelian part of Cameroon. Materials and Method: Cross-sectional study was conducted in 25 communities in the Sudano-Sahelian Region of Cameroon, from 30 December 2019 to 31 march 2020. Community members aged 12 years and above, who consented to participate were examined for the assessment of dental fluorosis. Participants were submitted to a questionnaire adapted from the Internalized Stigma for Mental Illness (ISMI) scale, adjusted for dental fluorosis. Results: Out of the 1665 participants examined, 1215 presented signs of dental fluorosis, for a prevalence of 73%. Persons with dental fluorosis demonstrated an overall mild level of internalized stigma (ISS) (2,04±0,47). The highest score was noted for the stigma resistance (2,24±0,58), social withdrawal (2,12±0,48) and alienation (2,11±0,49). The highest score (2.94±0.69) was recorded amid persons with severe dental fluorosis. Persons aged 26-30 years experienced the highest score (2,22±0,92). Females (2.16±0.79) exhibited higher internalized stigma levels than males (1,98±0,65) (p< 0,001). Conclusion: The level of internalized stigma increase with the degree of dental fluorosis.

FULL MOUTH REHABILITATION OF SEVERE FLUOROSIS CASE WITH WORN-OUT DENTITION WITH ALL- CERAMIC RESTORATION- A CASE REPORT

Dental uorosis is the hypomineralization of the enamel due to overexposure to excessive uoride concentration during the time of tooth development. Severe discoloration and tooth wear are the main adverse effects of this condition. This case report describes 28 year old patient with generalized attrition of full complement of teeth with brownish discoloration , pitting and reduction in the vertical dimension due to severe dental Fluorosis. Complete rehabilitation of entire dentition was the proposed treatment and occlusal splint was used to increase the vertical dimension. Once the new vertical dimension was established provisional xed restoration followed by permanent rehabilitation.The following case report proposes that a promising clinical outcome was obtained by re-establishment of the vertical dimension with improvisation in esthetics and function.

Dental fluorosis and associated risk factors among secondary school students in Zing community, North-Eastern Nigeria

Fluorosis affects both children’s oral health and quality of life because even the mildest form of tooth discoloration is considered cosmetically unacceptable and is a cause of psychological concern for those affected. This study aims to assess the prevalence of dental fluorosis and determine its associated risk factors among adolescents in the Zing community. This study is a quantitative crosssectional survey. The study participants were 300 children residing in Zing community and studying in one of the secondary schools selected for this study using a systematic random sampling technique. A questionnaire was designed and pretested to record information about demographic characteristics and risk factors for dental fluorosis. The children were also asked about their source of water consumption and their main source of drinking water recorded. The Dean Fluorosis Index (1934) was used to determine the grade of the severity of dental fluorosis. A Chi-square analysis test was used to test for possible associations. The prevalence of dental fluorosis was calculated as 52.0% and it varied significantly with age. A severe form of dental fluorosis (21.7%) was the most common grade of severity of dental fluorosis. Mild dental fluorosis had the lowest prevalence of 6.0%. The correlation between the occurrence of dental fluorosis and the duration of residence was found to be highly statistically significant (p≤0.001). The prevalence of dental caries in this study was 12.7%. No correlation was found between dental fluorosis and caries status. The prevalence of dental fluorosis was significantly high among the secondary school students of the Zing community in Taraba State. There is thus a need for health education and community awareness for preventing fluorosis and for early intervention to reduce the consequences on dental and periodontal health status.

Index assessment of malocclusion in schoolchildren in the endemic fluorosis area (pilot study). Part 2

Relevance . The formation of malocclusion is due to some general and local risk factors, well described in the specialized literature. At the same time, information on the possible effect of an increased concentration of fluorides in drinking water on the prevalence and structure of malocclusion in children and adolescents is scarce and contradictory. The study aimed to investigate the prevalence of malocclusion in schoolchildren aged 12 and 15 years old, living in the area of endemic fluorosis, using DAI. Materials and methods . A cross-sectional dental examination was performed in 361 (12- and 15-year-old) schoolchildren permanently residing in a settlement with high fluoride levels in drinking water (up to 4.5 ppm). The examined children were divided into several groups based on the presence and severity of dental fluorosis (DF). The study assessed DF according to the WHO classification and malocclusion according to the DAI. The obtained results were statistically processed using the SPSS ® Statistics 23.0 program. Results . The study revealed a high prevalence of FD (65.4%) and malocclusion (66.2%) among the examined students. 49% of schoolchildren had mild fluorosis. Incisal segment crowding was the most common malocclusion (DAI, component 2). Pronounced (more than 1 mm) irregularity (DAI, component 5) of the upper incisors was more common than the lower ones. Deviation in anterior-posterior molar relation was the second most common malocclusion (DAI - component 10). Half-a-cusp deviations were twice as frequent as full-cusp deviations. The prevalence of most DAI components was comparable in groups of schoolchildren without fluorosis and with dental fluorosis of different severity. The study noticed an increase in the frequency of deviations in the anterior-posterior first molar relation in patient groups with severe dental fluorosis. Conclusions . The prevalence of most DAI components in schoolchildren without and with dental fluorosis of different severity was comparable. Further research is necessary to verify the obtained results.

Association Between Frequency and Severity of Dental Fluorosis and Molar Incisor Hypomineralization.

To assess the association between the frequency and severity of dental fluorosis (DF) and molar incisor hypomineralization (MIH) in a fluoridated salt region. In this retrospective cross-sectional study, we evaluated the buccal, occlusal/incisal, and palatal/lingual surfaces of first permanent molars and permanent incisors of 453 patients aged 13-16 years through intraoral standardized photographs. Two standardized examiners evaluated DF and MIH independently, utilizing the Thylstrup-Fejerskov (TF) index and the MIH index. The statistical analysis was performed using a generalized linear model and logistic regression adjusted for age, sex, and dental caries experience. The MIH frequency at the surface level was lower in the presence of DF (PR= 0.03; P= 0.00, 95% CI: 0.01-0.08). At the surface level, MIH severity was lower among those presenting mild DF (aOR= 0.02; 95% IC: 0.01-0.07). Regarding severe DF, we found no significant difference in MIH severity (P= 0.174). MIH frequency and severity tend to be lower in the presence of DF.

Are there associations between the occurrence of dental fluorosis and the experience of dentine hypersensitivity? A cross-sectional study

Associations between the occurrence of dentine hypersensitivity (DH) and dental fluorosis (DF) have been suggested. Testing this association requires studies among populations with both conditions. This study aimed to determine the association between DF and the experience of DH among a population endemic for DF. This was a cross-sectional study conducted in 2021 over 6 months among 428 adult patients. Participants' demographics were collected, followed by verbal screening for DH and oral examinations. Clinical assessment for DH was carried out by tactile and evaporative methods. The presence and severity of DF were also assessed using the Thylstrup and Fejerskov Index. Data analysis included Chi-square and correlation statistics to assess the presence and strength of associations. The overall prevalence of DH was 31.1%. A higher proportion (41.1%, P < 0.001) of participants with DF had DH than those without DF. The association between DH and DF was minimal but statistically significant (r = 0.174, P < 0.001). Among those with DF, the prevalence of DH was highest in participants with severe fluorosis (50%, P = 0.740). The proportion of sensitive teeth to the teeth examined was significantly higher (P < 0.0001) for participants with DF (289/4167, 6.9%) than participants without DF (267/6758, 4%). This proportion was also highest for severe DF (20/254, 7.9%, P = 0.572) than the mild and moderate forms. DH was more prevalent among individuals with DF. The prevalence of DH was not dependent on the severity of DF.

Conservative esthetic management with in-office bleaching of dental fluorosis

Tooth discoloration varies in etiology, appearance, localization, severity, and adherence to the tooth structure. It can be intrinsic, extrinsic, or a combination of both. Extrinsic stains are typically caused by tobacco use or by drinking coffee and tea, wine, and pigmented residue from food. This can be removed by regular dental cleaning and brushing the teeth with whitening toothpaste. Intrinsic teeth stains occur most commonly due to exposure of high levels of fluoride, tetracycline antibiotic administration and pulpitis, inherited developmental disorders, and trauma. This can be treated with professional bleaching or at-home chemical teeth-whitening products, porcelain, and composite veneering. Among these procedures, bleaching procedures are more conservative, simple to perform, and less expensive. This case report suggests that in-office bleaching is an effective and conservative method for esthetic correction of tooth discoloration in severe and mild dental fluorosis.

Distribution pattern of enamel fluorosis severity: What is it telling us about local fluoride exposure?

Introduction and objective: dental fluorosis severity reflects fluoride exposure during dental enamel development. Recently, prenatal and postnatal exposure to fluoride has been associated with negative neurodevelopmental outcomes. The aim of this study was to describe and compare the severity and distribution pattern of dental fluorosis in the primary and permanent dentition, as a basis to discuss the timing and extent of fluoride exposure of children living in endemic areas of fluorosis in the department of Huila. Materials and methods: 840 children (preschoolers and schoolchildren) from four municipalities of the Huila Department were examined by trained dentists for dental fluorosis using the Thylstrup &amp; Fejerskov Index. To estimate the prevalence of severities of fluorosis, each child was classified according to the most severe score. The distribution of the prevalence of enamel fluorosis severity by age-group and type of dentition were reported as prevalence rates (%). Results: Prevalence of dental fluorosis in preschoolers was of 97.2% and in schoolers of 99.9%. For both preschoolers and schoolers moderate fluorosis was the most prevalent (75.6% and 63.5%, respectively). For both primary and permanent teeth, mild fluorosis was more prevalent in anterior teeth than in posterior teeth. Moderate and severe fluorosis were more prevalent in posterior teeth than in anterior teeth. Conclusions: the distribution pattern of the severity of dental fluorosis suggests both prenatal and postnatal exposure to fluoride above recommended levels. This study raises the importance of the validation of dental fluorosis as a potential historical biomarker of fluoride exposure at moments that are critical for neurodevelopment.

Esthetic and Functional Rehabilitation of an Adolescent Patient with Severe Dental Fluorosis: A Clinical Report.

Dental fluorosis is a developmental defect affecting amelogenesis. It presents clinically in different forms depending on the concentration, duration, and time of exposure to fluoride. Several therapeutic modalities have been described to manage mild and moderate forms of dental fluorosis; however, limited literature is available on the restorative management of severe forms of dental fluorosis, specifically in young individuals. This clinical report describes a complete prosthodontic rehabilitation of an adolescent patient with severe dental fluorosis affecting his permanent dentition. The patient was treated with a combination of monolithic, minimally-veneered zirconia crowns and direct composite resins. At the 1-year follow-up appointment, there were no complications, and both the patient's oral health and the integrity of the restorations remained stable.

Microscopic observation of the enamel microstructures of SD rats with different degrees of fluorosis

Objective: To establish a dental fluorosis model of SD rats with various degrees, to observe the microstructures of enamel samples under scanning electron microscope and to clarify the changes of enamel microstructures with various degrees of dental fluorosis, so as to provide clinical reference for the treatment of patients with moderate and severe dental fluorosis. Methods: Thirty male SD rats (6 weeks of age) were randomly divided into 3 groups with 10 rats in each group. The control group was fed with deionized water without fluoride, the low fluoride group was fed with 50 mg/L NaF deionized water and the high fluoride group was fed with 100 mg/L NaF deionized water in order to establish the dental fluorosis model of rats. After feeding for 6 weeks, the rats were sacrificed and the mandibular incisor teeth were collected and recorded. The surface and sagittal plane of each tooth were observed by scanning electron microscopy and the enamel thickness was measured. Results: In the control group, the enamel color was brown yellow. Enamel color discoloration occurred both in low-fluoride group and high-fluoride group. The enamel color in low-fluoride group was mostly yellow and white striped while in high-fluoride group was mostly chalky white. Under electronic microscope, the enamel rods were alternately arranged and their structure was clear and plump in the control group. The enamel rods of moderate fluorosis were arranged in a straight orientation like tips of bamboo shoots. The enamel rods of severe fluorosis, however, became thinner and the tips of rods were broken. In the control group, sagittal images of enamel turned out to be a dense outer structure with clear boundaries among the inner. The structure of the middle layer was reticulated showing a clear boundary with middle and outer layers. The structure of enamel rods in the inner layers was arranged vertically and horizontally. In the moderate fluorosis group, the outer layer of the enamel became thinner and the middle layer disappeared although the boundary between the outer and middle layers was still clear. In the inner layer, the vertically arranged enamel rods seemed still clear, however the horizontal enamel rods disappeared. In the severe fluorosis group, the outer layer could not be traced. The middle layer was exposed to the air and the inner enamel rods contracted. The inner layers of the enamel had gradually become thinner with the development of the dental fluorosis. The thicknesses of inner layers in control, moderate and the severe groups were (180.71±7.01), (157.10±11.04) and (121.10±12.56) μm respectively. As for the thicknesses of the full layers in the above mentioned three groups, the same trend was observed. The thicknesses, in order of the severity of dental fluorosis, were (241.54±7.76), (207.42±14.36) and (143.79±14.60) μm. Conclusions: With the development of dental fluorosis, the outer enamel layers became thinner or disappeared and the inner enamel layers became thinner or lost its normal structure as well. It is highly recommended that the resin penetration could be used for the proper treatment of moderate and severe dental fluorosis and the strong bleaching and the micro-grinding should be used cautiously.

Dental fluorosis among people and livestock living on Gihaya Island in Lake Kivu, Rwanda

BackgroundDental fluorosis is caused by prolonged exposure to excessive fluoride during the period of permanent tooth formation and is characterized by tooth discoloration, pitting, and loss of shape. Communities living near Lake Kivu in Western Rwanda exhibit a high prevalence of dental fluorosis; however, data on prevalence and risk factors are scarce.MethodsThis cross sectional, quantitative study used a One Health approach to investigate dental fluorosis prevalence among people and livestock and to measure fluoride content in the environment. In 2018, oral health examinations were conducted to assess the prevalence of fluorosis in children (aged 9 to 15 years), cattle and goats residing on Gihaya Island (Rwanda, East Africa). All children and cattle/goats meeting basic eligibility criteria (e.g., island residence) were invited to participate. Presence and severity of dental fluorosis was categorized according to the Dean’s Fluorosis Index. Samples of local foods, water, soil and grass were collected from communal sources and individual households and analyzed for fluoride content using standard laboratory techniques. Descriptive and binomial analyses (Fisher Exact Test) were used to assess this dataset.ResultsOverall, 186 children and 85 livestock owners (providing data of 125 livestock -23 cattle and 102 goats) participated. Dental fluorosis was recorded in 90.7% of children and 76% of livestock. Moderate to severe fluorosis was observed in 77% children while goats and cattle most often exhibited mild or absent/questionable severity, respectively. Water from Lake Kivu (used primarily for human cooking water and livestock drinking water) contained fluoride levels that were consistently higher than the maximum threshold (1.5 mg/L) recommended by the World Health Organization. Other sources (borehole and rainwater) were within safe limits. All food, soil and grass samples contained fluoride. The highest levels were observed in porridge (0.5 mg/g) and small fishes (1.05 mg/g).ConclusionsAltogether, dental fluorosis was highly prevalent among children and goats on Gihaya Island with various food and water sources contributing a cumulative exposure to fluoride. An immediate and coordinated response across human, animal and water professionals is needed to reduce fluoride exposure within safe limits for island residents.

Severity of dental fluorosis among 12-15 years old school children in Zeway, Oromia Region, Ethiopia

Severity of dental fluorosis among 12-15 years old school children in Zeway, Oromia Region, Ethiopia

Hydrogeogenic fluoride in groundwater and dental fluorosis in Thai agrarian communities: a prevalence survey and case\u2013control study

BackgroundDental fluorosis can be a disease of social inequity in access to safe drinking water. This dental public health issue becomes prominent in socially disadvantaged agrarian communities in fluoride endemic areas where the standard irrigation system is unavailable and groundwater containing natural fluoride is the major drinking water source. This study aimed to determine the prevalence and severity of dental fluorosis in children and to evaluate its association with fluoride in groundwater in the aforementioned setting in Thailand.MethodsA cross-sectional survey of 289 children in Nakhon Pathom Province was conducted in 2015. Children with very mild to severe fluorosis were regarded as ‘cases’ while their counterparts were ‘controls’ for a subsequent case–control study. Records of fluoride concentrations in groundwater used for household supply corresponding to resident and number of years by age of each child during 2008–2015 were retrieved. Other exposure variables were measured using a questionnaire. Prevalence ratio (PR), a measure indicating the relative effect of different levels of fluoride on dental fluorosis, was obtained from Poisson regression with robust standard error.ResultThere were 157 children with very mild to moderate dental fluorosis (54.3% prevalence). The univariable analysis revealed that the prevalence of dental fluorosis among children with fluoride concentrations in water sources of 0.7–1.49 (index category 1) and ≥ 1.5 ppm (index category 2) was 1.62 (95% CI; 0.78, 3.34) and 2.75 (95% CI; 1.42, 5.31) times the prevalence among those with fluoride < 0.7 ppm (referent category). After adjusting for all covariates, the adjusted prevalence ratios in both index categories were 1.64 (95% CI; 0.24, 11.24) and 2.85 (95% CI; 0.44, 18.52) which were close to their corresponding crude estimates. Since the magnitude of confounding, measured by (PRcrude–PRadjusted)/PRadjusted, were less than 10% for both index categories; this indicated the limited confounding effect of all covariates.ConclusionsIn fluoride endemic areas, groundwater containing natural fluoride utilized for household consumption resulted in high dental fluorosis prevalence, particularly in the groundwater with fluoride concentrations of ≥ 1.5 ppm.

Prevalence and Severity of Dental Fluorosis among Primary School Children Aged 12–14 Years in Abosied and Alfetehab Localities, Omdurman, Sudan

Background: Dental fluorosis is a disease of dental hard tissues resulting from excess fluoride intake during the developmental stages of teeth causing hypomineralization of the enamel. This study aimed to assess the prevalence of dental fluorosis among school children in Omdurman locality.&#x0D; Methods: Students in the sixth grade of school were examined to determine the prevalence of dental fluorosis using Dean’s index.&#x0D; Results: The prevalence of dental fluorosis was 68.3%. The majority of students were diagnosed with very mild (23.2%) and mild (26.5%) forms. There was no difference in the grade of fluorosis between children who were born outside and in Omdurman.&#x0D; Conclusion: Prevalence of dental fluoride was found to be very high among school children with no difference between males and females.&#x0D; Keywords: fluorosis, Sudan, school children