Treatment Of Dental Fluorosis Research Articles

BASIC DIRECTIONS IN FLUOROSIS TREATMENT

The territory of Poltava region belongs to the Buchatsky hydrogeological province, whose groundwater is characterized by an elevated fluorine level content. The cause of endemic dental fluorosis particularly in the children’s population of the region is water consumption with surplus concentration of this chemical element. Also, having fluorosis a condition that develops from a high fluoride concentration in drinking water- causes disorder of hard tooth tissues maturing, mineralizationand teeth germ development. This, in turn, has a negative influence on enamel amelogenin synthesis and violation of the crystals maturing, determines a surface porosity. The chalky spots, brown pigmentation, and enamel erosion destruction lesions are characterized the different severity manifestation of the fluorosis.
 The purpose of our research was to conduct a thorough analysis of all the material we found on this topic, gather all possible information on new trends in recent years in the treatment of dental fluorosis: what are the methods, their origins, indications for use, clinical stages and advantages.
 Dental enamel fluorosis requires different approaches to treatment depending on the severity of clinical manifestations. Obviously, as the leading method is remineralizing therapy. One of the method is offered by Nikolishina E.V. etc. [6], which is carried out in the following way: after carry out of the professional hygiene procedure, next step, individual caps were made of transparent silicone filled with 10% solution «Poltavsky Bishofit» and applied on the fluorosis teeth, daily course consist with 30 minutes and 10-20 procedures.
 Enamel microabrasion is the first minimally invasive treatment method of mild and moderate dental fluorosis using to removes opaque brown spots and surface roughness smoothing, providing a flat and shinier surface. The microabrasion technique involves etching with mild acid in combination with application of abrasive components. Resin infiltration has also become a popular treating dental fluorosis technique without loss of hard tissue.
 Resin infiltration is based on the application of hydrochloric acid to the hard tissues of the tooth and subsequent coating with a low-viscosity resin that penetrates into the microspaces of the tooth enamel. The cloaking effect is based on the refractive index. The optical properties of the affected enamel change and it looks like a healthy enamel surrounding. The indication to dental fluorosis treatment of severity forms in permanent teeth with mature roots is restoration of teeth, veneers, orthopedic crowns, if the microabrasive method hasn’t aesthetic effect efficiency.
 Thus, in cases of aesthetic changes due to fluorosis, minimally invasive restorative approaches that preserve dental hard tissue such as microabrasion method, external bleaching or resin infiltration should be considered before invasive restorative procedures. More invasive treatments may be considered if the results remain unsatisfactory.

Prospective Role of Calcium Supplementation in Prevention of Fluorosis: A Study in Some North Indian Villages

More than a hundred million people from almost twenty-five countries, including India, are affected by fluorosis. An assessment of fluoride in water, a prospective study of dental fluorosis and the role of calcium in preventing or ameliorating dental fluorosis through a long-term community study in endemic high fluoride area in Northern India was done. Water survey from different areas was done to identify high fluoride area in Unnao district of Uttar Pradesh, India. House to house survey of a population of almost 5000 people was done. Biochemical tests were performed in 50 dental fluorotic and 50 non-fluorotic randomized subjects. Clinical and biochemical status was recorded after six months of calcium supplementation. Our results have shown that 28.64% population had dental fluorosis (total fluorosis: 43%), the highest in 13-15 years age group. After six months of calcium supplementation, 44% of cases showed reversal of dental fluorosis, whereas in 40% of them disease did not progress further. An increase in serum calcium and a significant decrease in urinary fluoride was observed post supplementation. In this first large-scale prospective community study of its kind, it is demonstrated that long-term administration of calcium can reverse dental fluorosis especially in children with early grades of fluorosis. Calcium may protect tooth against damage from high fluoride intake and reduces dental fluorosis. With the increase in the prevalence of dental fluorosis, calcium can prove a cheap and effective method for the prevention and treatment of dental fluorosis.

Rationale behind a minimally invasive approach in the treatment of dental fluorosis

Modern epidemiology of dental fluorosis is characterized by its high global prevalence. Dental fluorosis is a chronic disease that develops before teething with prolonged ingestion of water or foods with a high content of fluorine compounds. In Russia, an increased concentration of fluorine in water is detected in more than 20 administrative regions. In addition, endemic areas can be assisted with anthropogenic factors, particularly certain chemical industry. Improvement of the novel treatment methods for fluorosis turns out to be important and relevant. For the treatment of various forms of fluorosis, sufficiently effective materials have been currently developed, characterized by convenience and ease of use, as well as safety for a patient. Their use alone or in combination allows achieving high aesthetic results and maximum patient satisfaction. The aim of this study is to measure the adhesive strength of the composite filling material to the Icon infiltrant (infiltration concept), as well as to compare it with the adhesion strength of the composite to the enamel using various adhesive systems. Icon was developed by the German company DMG and has been used worldwide since 2000. To assess the adhesive peel strength, 60 teeth with fluorosis and 60 intact teeth were examined. The largest values of the adhesive shear strength were identified in group 2 (the All bond universal adhesive system) and group 4 (the Icon etch), i.e. the approaches which contained MDP polymer. Overall, the results of our experimental study allowed considering the combined usage of the Icon infiltrant and the low-modulus composite material as a promising strategy in a routine dental clinical practice.

Treatment of dental fluorosis with mini–invasive techniques

In the Republic of Moldova, fluorosis is a major medical and social problem. We have several endemic areas, where the population suffers from dental fluorosis. The population is not informed about this disease, does not know what are the methods of prevention and treatment, suffering from dysfunctional, aesthetic and social adaptation problems. Minimally invasive methods of treating dental fluorosis have been studied and applied in practice to patients. It has been found that minimally invasive treatment methods are a good solution in combating this pathology and offer patients a better adaptation in society.

A Qualitative and Comprehensive Analysis of Caries Susceptibility for Dental Fluorosis Patients.

Dental fluorosis (DF) is an endemic disease caused by excessive fluoride exposure during childhood. Previous studies mainly focused on the acid resistance of fluorotic enamel and failed to reach a consensus on the topic of the caries susceptibility of DF patients. In this review, we discuss the role of DF classification in assessing this susceptibility and follow the “four factors theory” in weighing the pros and cons of DF classification in terms of host factor (dental enamel and saliva), food factor, bacteria factor, and DF treatment factor. From our analysis, we find that susceptibility is possibly determined by various factors such as the extent of structural and chemical changes in fluorotic enamel, eating habits, fluoride levels in diets and in the oral cavity, changes in quantity and quality of saliva, and/or oral hygiene. Thus, a universal conclusion regarding caries susceptibility might not exist, instead depending on each individual’s situation.

A Minimally Invasive Treatment of Dental Fluorosis: A Case Report

L'action carioprotectrice du fluor par voie topique est reconnue depuis plus d’une cinquantaine d’année. Ce dernier est devenu aujourd’hui, l'un des piliers de la prévention de la maladie carieuse. Toutefois, l’ingestion excessive de cet oligo-élément durant les premières années de la formation des dents peut entrainer l’apparition d’une fluorose dentaire. Il s’agit d’une anomalie de structure acquise pré-éruptive caractérisée par un aspect polymorphe variant en fonction de la sévérité d’atteinte. Elle peut engendrer, dans certains cas, en fonction de son impact sur la couleur et l'aspect de surface de l'émail dentaire, un préjudice esthétique et fonctionnel majeur. Pour pallier cette problématique, la dentisterie moderne propose un vaste champ thérapeutique allant de l’éclaircissement aux restaurations prothétiques. L’objectif principal est d’adopter une thérapeutique adaptée selon chaque situation tout en étant le moins invasif possible. C’est dans cette optique que ce travail se propose de présenter la gestion thérapeutique d’une fluorose dentaire chez une patiente âgée de 14 ans. Le traitement a consisté en la combinaison de deux méthodes : la micro-abrasion et l’éclaircissement externe ambulatoire ce qui a permis d’obtenir un résultat très satisfaisant pour la patiente, tout en respectant le principe d’économie tissulaire.

Etiology, diagnosis, prevention and treatment of dental fluorosis

Dental fluorosis is the most common and prominent symptom in the early stage of chronic fluorosis, which is caused by excessive fluorine intake during tooth development. In severe cases, it may be accompanied by skeletal fluorosis. There are also systemic damages to the nervous system, cardiovascular system, endocrine system and so on. The pathogenesis of dental fluorosis is not totally clear, which may be a complex pathological process involving both genetic and environmental factors. The prevalence of dental fluorosis has an upward trend arround the world, thus certain public prevention and treatment strategies need to be taken. This article focuses on the prevalence, etiology, diagnosis and scoring system, as well as the public prevention and treatment strategies, of dental fluorosis, so that to provide reference for the research and prevention of the disease.

The Prevalence and Willingness for Treatment of Dental Fluorosis in Adult Patients

The Prevalence and Willingness for Treatment of Dental Fluorosis in Adult Patients

Interventions in management of dental fluorosis, an endemic disease: A systematic review.

Objective:Mottling and pitting of enamel due to excess fluoride consumption may affect one's self-esteem due to unaesthetic appearance and also in turn can affect the quality of life. This present study was conducted to assess various treatment approaches available for patients with dental fluorosis.Materials and Methods:Literatures were searched from August 1998 to August 2019 for articles in the management of dental fluorosis. The databases used were National Center for Biotechnology Information (NCBI) and Google Scholar. In NCBI, the filters were modified to randomized controlled trial, clinical trial, human trial, and free full-text articles. The following queries were used in order to search for the article: treatment for dental fluorosis, intervention of dental fluorosis, and management of dental fluorosis.Results:All the five studies selected after screening were randomized controlled trials. Total number of patients included in this study were 304 with the mean age of 17.7 years old. They were treated with microabrasion, bleaching, resin infiltration or combination of microabrasion with bleaching, and resin infiltration with bleaching. Microabrasion resulted in less esthetic improvement compared with bleaching. Meanwhile, resin infiltration showed a greater improvement in esthetics in comparison to bleaching. Resin infiltration with additional infiltration time and combination of resin infiltration with bleaching are the best treatment options.Conclusion:Based on this systematic review, resin infiltration with increased infiltration time is the best treatment approach in treating dental fluorosis.

Aesthetic treatment of dental fluorosis in a 9-year-old girl: Case report

Background/Aim: Dental fluorosis is a specific disturbance of tooth formation caused by excessive intake of fluoride. The discoloration of teeth is the most common reason for parents to seek treatment. The purpose of this paper is to describe the therapeutic management performed in a 9-year-old girl with fluorosis. Case report: A clinical case of a 9-year-old girl diagnosed with fluorosis is reported. The treatment of this clinical case was achieved using microabrasion, which is a minimally invasive method. This technique improves the aesthetics of the teeth without causing significant loss of dental tissue; a characteristic making microabrasion applicable to children as well. Its implementation involved the combined use of 18% hydrochloric acid and pumice on the enamel surface of upper incisors. The improved appearance of the teeth was aesthetically pleasing and, consequently, the patient gained in self-confidence. Conclusions: In the literature, several treatment choices are proposed, depending on the severity of the fluorosis. In our case, microabrasion was applied and the aesthetic outcome satisfied both the patient and the dentist.

Effect of cold light whitening technique combined with infiltration resin in the treatment of dental fluorosis

Effect of cold light whitening technique combined with infiltration resin in the treatment of dental fluorosis

Dental Fluorosis Treatment Can Improve the Individuals’ OHRQoL? Results from a Randomized Clinical Trial

This study aimed to evaluate the effect on oral health-related quality of life (OHRQoL) of two treatment protocols for dental fluorosis in individuals enrolled in a randomized clinical trial. Seventy volunteers, who lived in a fluorosis endemic area in Brazil, and had at least four maxillary anterior teeth showing fluorosis with a Thylstrup and Fejerskov index from 1 to 7, were randomized into two treatment groups (n= 35): GI- enamel microabrasion; or GII- microabrasion associated with at-home bleaching. Microabrasion was performed using 37% phosphoric acid and pumice, and at-home tooth bleaching with 10% carbamide peroxide in a tray. Volunteers completed a questionnaire at baseline and 1-month post treatment to assess changes in OHRQoL, using the Oral Impact on Daily Performance (OIDP). Differences in overall impact scores between and within treatment groups were analyzed with Wilcoxon (within) and Mann-Whitney (between) tests. Changes in performance scores were analyzed using Wilcoxon tests (a< 0.05). One month after treatment, subjects reported improvement in OHRQoL. Both groups showed lower OIDP scores (p< 0.001), but there was no difference between them. Eating, cleaning teeth, smiling and emotional state performance scores were lower after treatment for the whole sample. In conclusion, the treatment with microabrasion improved the OHRQoL in this sample of individuals living in a fluorosis endemic area regardless of the addition of at-home bleaching.

Mineral composition of mixed saliva in patients with dental fluorosis

The aim of the study was to assess the mineral composition of mixed saliva in dental fluorosis patients undergoing treatment with microabrasion and bleaching. The study included 60 patients aged 18-35 years with various forms of dental fluorosis. Group 1 included 40 patients in which enamel microabrasion was performed, group 2 - 20 patients with microabrasion and bleaching. Mixed saliva composition was analyzed with Olimpus automatic analyzing device. Dental fluorosis treatment in both groups resulted in saliva mineral composition changed associated with enamel demineralization which proves the necessity for calcium and phosphate containing compositions in these treatment groups.