Perceptions of Dental Fluorosis

Abstract

Mild dental fluorosis has long been accepted as a side-effect of water fluoridation and, more recently, has been recognized as a consequence of the use of other fluoride-based caries-preventive strategies. Traditionally, dental health professionals have not seen this as being of public health importance, but members of the public have not been asked their opinion. The purpose of the present study was to gather the opinions of lay groups concerning the appearance of the teeth of children with various degrees of fluorosis. Twenty-eight children, born in 1978, who had earlier participated in a study of fluorosis in Perth (Western Australia), allowed 110 observers to look at their upper central incisors under good viewing conditions. Fluorosis in these teeth ranged from TF score 0 (no fluorosis) to TF score 3. The observers were university students, parents, public servants, or dentists. They responded to statement items about the appearance of the teeth. The results, based on just over 3000 responses, showed that lay and dental observers could distinguish between different fluorosis levels. In response to a statement that the teeth appeared pleasing, a large majority agreed when the TF score was 0, but agreement declined as the TF score increased; when the TF score was 3, most people disagreed. Similarly, observers felt that the appearance would increasingly embarrass the child as the TF score increased. Observers, except the dentists, tended to feel that higher TF scores indicated neglect on the part of the child.(ABSTRACT TRUNCATED AT 250 WORDS)

Aesthetically objectionable fluorosis in the United Kingdom

“…Only 14% of the population were found to perceive mildly fluorosed teeth as aesthetically objectionable, a result which is lower than has been reported previously. 6,[8][9][10]12,13 In past studies the percentage of subjects regarding mild fluorosis as unacceptable has ranged from 19% 9 to 45%. 8 In the current study 45% of the sample also perceived moderate fluorosis as aesthetically objectionable, again a level lower than in previous reports, eg 58% by Clark et Past studies used different methods to assess aesthetically objectionable fluorosis; variations have included differences in the indices used to grade fluorosis and in the way 'aesthetically objectionable' or 'unacceptable' was measured.…”

“…Groups included students, parents and dentists. 6 Although differences are therefore known to exist, use of a large sample, selected randomly, would however seem the most appropriate method for policy making for the population in the first instance.…”

“…3,5 Severe levels of dental fluorosis are widely perceived as aesthetically objectionable by both professionals and the public. [6][7][8][9][10] However perceptions of mild and moderate levels remain controversial. The findings from studies of perceptions of fluorosis have varied widely.…”

“…Researchers have shown that children, adults, lay groups and professionals have differing perceptions of dental fluorosis. 6,8 Current health agendas are moving towards empowering people and planning services to meet professional and individual expectations. In this context, in the United Kingdom, where less than 10% of the country is currently fluoridated but where other sources of fluoride are widely available, clear understanding of the likely public impact of expanding water fluoridation is essential.…”

Non-carious tooth conditions in children in the UK, 2003

“…9 A TF score of 3 was also the point at which some of 3,000 observers in Australia, began to find teeth unattractive. 25 This is the threshold used in the current survey, where 20% of 12-year-olds were judged to have diffuse opacities alone or in combination with other defects. Of those, 65% were symmetrical and 10% were judged to be above the threshold level.…”