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

Abstract

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 Bibliometric Analysis of the Top 100 Most-Cited Papers Concerning Dental Fluorosis

“…The condition was related to high levels of fluoride ingestion during the period of amelogenesis, called DF, only 30 years after the first reports [Churchill, 1931]. Enamel with DF presents lower hardness and elastic modulus due to hypomineralization and is less resistant to wear and fracture [Li et al, 2021]. Clinically, mild DF appears as white lines in isolated areas.…”

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

“…The analysis showed a higher fluoride content in the enamel of fluorotic human teeth than in healthy teeth enamel. The findings of studies conducted by other authors suggest a link between the presence of clinical symptoms of fluorosis and increased fluoride content in enamel, which in the case of erupted teeth, accumulate predominantly in the outer third of the enamel, reaching its highest values on its surface [ 58 , 59 , 60 , 61 ]…”

Aesthetic problem in the appearance of permanent teeth in children and adolescents - dental fluorosis.

“…Obecnie coraz więcej lekarzy opiera się na minimalnie inwazyjnym podejściu do leczenia pacjenta. Najczęściej wykorzystywanymi metodami leczniczymi są wybielanie zębów, mikrodermabrazja, infiltracja żywicą, uzupełnienia kompozytowe, licówki lub korony protetyczne [2,5,6,[9][10][11][12]20,23]. Wybielanie zębów Wybielanie zębów może być bardzo skuteczną metodą leczniczą w przypadku łagodnej postaci fluorozy zębów.…”

“…Wysoce prawdopodobne jest to, że jest to związane z większą trudnością utrzymania prawidłowej higieny jamy ustnej poprzez rutynowe oczyszczanie jamy ustnej u pacjentów z cięższą postacią fluorozy zębów [7,19]. [20]. Pierwszym objawem fluorozy jest zmiana koloru, objawiająca się licznymi cienkimi białymi poziomymi liniami biegnącymi przez powierzchnie zębów, z białymi przebarwieniami na nowo wyrosłych brzegach siecznych.…”