No abstract

This review of the literature was undertaken to demonstrate the changing trends in the prevalence of dental fluorosis in North America. Using Dean's early work to establish a baseline for the prevalence of dental fluorosis, results of more recent prevalence surveys were used to establish a range for the occurrence of dental fluorosis today. These results suggest that the prevalence of dental fluorosis now ranges somewhere between 35% and 60% in fluoridated communities and between 20% and 45% in nonfluoridated areas, depending on the influence of different local conditions. While the increase has occurred primarily in the very mild and mild categories of dental fluorosis, there is also some evidence that the prevalence is increasing in the moderate and severe classifications as well.

Increasing prevalence of dental fluorosis for children both from fluoridated and non-fluoridated communities are now well documented. Along with recent studies purporting possible adverse health effects from fluorides, this proven public health intervention is again being challenged. This study was undertaken to determine the prevalence of dental fluorosis for children from fluoridated and non-fluoridated areas in British Columbia. In addition, children and parents were provided with an opportunity to express concerns about the aesthetics of the child's anterior teeth. Children from representative schools in two communities were surveyed using the Tooth Surface Index of Fluorosis (TSIF). Questionnaires were sent home to parents to detail their child's use of various fluoride preventive practices and residence histories. Completed questionnaires were returned and exams were performed on 1131 children. Of those examined, 60% had dental fluorosis on at least two tooth surfaces, only 8% had scores ranging from "2" to "6", and 52% were classified with a score of "1". Parental and child ratings on the aesthetics or color of the child's teeth suggests that there are few children with aesthetic problems in the TSIF category of "1". While concerns of parents were more common, the actual source of those concerns was not assessed in the questionnaire. Not unexpectedly, children with fluorosis on anterior teeth ranging between TSIF scores of "2" to "6" appear to have increased concerns about tooth color. Data from children with confirmed residence histories from fluoridated communities suggest that the occurrence of aesthetic problems in these children is rare.

The difference between the 10% chlorhexidine varnish and placebo treatments is considered to be highly clinically significant for root caries increment (41% reduction) and for total caries increment (25% reduction) but only for coronal caries increment (14%).

Results suggest that the prevalence of esthetic problems is low in the communities surveyed, and that exposure to any number of fluoride technologies in the third year of life can increase a child's risk for this problem.