A photographically recorded assessment of enamel hypoplasia in fluoridated and non-fluoridated areas in England

Abstract

This study assesses the effect on enamel formation of the use of fluoride toothpaste in a fluoridated area. The prevalence of enamel hypoplasia in 251 9-10-year-old children born and raised in a fluoridated city (Birmingham) was compared with that in 319 similar children born and raised in a non-fluoridated city (Leeds). Observer bias was eliminated by the use of a new photographic technique, enabling colour slides of both groups to be assessed together in a random order. Scoring was done using both the Jackson-Al-Alousi (J-A) index, which is designed to record nonspecific hypoplasias and the Tooth Surface Index of Fluorosis (TSIF). Both were compared to the results from conventional clinical recording using the J-A index. The results showed that the photographic method was highly reproducible and more sensitive than conventional recording and showed a higher level of mild fluorosis in the fluoridated area. However, no evidence of an increase in the higher grades of fluorosis was found. It is concluded that the use of fluoride toothpaste by young children in fluoridated areas is unlikely to produce aesthetically unacceptable levels of enamel fluorosis.

Enamel Defects in 8-Year-Old Children in Fluoridated and Non-Fluoridated Parts of Cheshire

“…The only major source of fluoride would have been fluo ride in toothpaste. In a recent study conducted in the United Kingdom [Levine et al, 1989] significantly higher levels of mild mottling were also found. How ever, all the children examined came from low socio economic families and therefore their conclusions on the effect of fluoride dentifrice on the developing den tition were limited.…”

Prevalence of caries and developmental defects of enamel in 9-10 year old children living in areas in Brazil with differing water fluoride histories

“…However, direct comparisons of results between studies need to be made with caution because of differences in the study conditions and in the index used. In this study estimates of the prevalence of developmental defects of enamel were made through clinical examination of upper incisor teeth alone and with the use of natural light; the prevalence of children affected may consequently be lower than in studies using photographs, for example, 38,39 or when more teeth were included. The proportions of children recorded as having diffuse opacities who had been continuous residents in the area fluoridated since 1963 were, nevertheless, similar to those reported for children from fluoridated areas in Ireland 3 but were lower than those seen in children from England where there is little fluoridation.…”

Dental Enamel Opacities in Three Groups with Varying Levels of Fluoride in Their Drinking Water

“…They also have the ad vantage that films from different populations may be exam-ined blindly. Several recent photographic studies [Levine et al, 1989;Dooland and Wylie. 1989;Ellwood et al.…”