Objectives: This study aims to determine the prevalence of dental fluorosis and the factors associated with dental fluorosis among 12-15 years old female school children in southern sub-population of Saudi Arabia. Methodology: A community-based, cross-sectional survey of 486 school children (females), 12-15 years age group in southern subpopulation of Saudi Arabia using. Clinical examinations were performed using the Dean's index by WHO 2013. A pretested questionnaire was used to gather exploratory data on Demographics, Socioeconomic conditions, Access to dental service and exposure to various sources of fluoride. Bivariate associations were examined using the Chi-square and Chisquare trend tests to evaluate the association of selected risk factors with the presence or absence of dental fluorosis. Samples of water were collected from water sources consumed and analyzed. Results: The overall prevalence of dental fluorosis in our study sample was 59.05% and the Community Fluorosis Index (CFI) was 0.4. Questionable fluorosis (50.21%) was the commonest fluorosis seen. The principal factor associated with the presence of dental fluorosis was the frequency of tooth brushing and the use of fluoride supplements with a p-value of 0.04060 and 0.0497 respectively. No significant association was seen between dental fluorosis and socioeconomic status or parental education, drinking water and the intake of tea/coffee, consumption of any type of fish. Conclusions: Dental fluorosis is a major public health issue in the southern sub-population of Saudi Arabia. This study showed borderline public health significance with a CFI of 0.4. The principal factor associated with the presence of dental fluorosis in this tested model was the frequency of tooth brushing and the use of fluoride supplements. Active steps/strategies must be taken to educate the community on the correct frequency of tooth brushing during childhood development and the medical practitioners on the correct prescription of fluorides supplements during the stages of tooth development.
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