Dental fluorosis

Fluorosis : is a cosmetic condition that affectsthe teeth. It’s caused by overexposure to fluorideduring the first eight years of life. This is thetime when most permanent teeth are beingformed .

• Structurally, an increase in fluoride intake results inan increase in degree and extent of porosity of theenamel.

• the enamel changes described may be a result of afluoride damage of secretory ameloblasts

• This can either be due to a fluoride-induced change incomposition of enamel matrix, or be a result of adisturbance of the cellular processes during enamelmaturation.

• Mottled enamel is a condition indicates the fluorosischaracterized by minute white flecks, or yellow or brownspots or areas, scattered irregularly or streaked over thesurface of a tooth

• It is scored according to a method described by Al alousi’et al as follow:

• Type A:white areas less than 2mm

• Type B:white areas more than 2mm

• Type C:brown areas less than 2mm

• Type D:brown areas less than 2mm

• Type E:horizontal white lines

• Type F:horizontal brown lines

Smooth, glossy, palecreamy-white,translucent surface

Normal

questionableranging from a fewwhite flecks tooccasional white spots

Very mild

Small opaque, paper whiteareas scattered irregularly overthe tooth but not involving asmuch as 25% of the toothsurface.

Mild

The white opaque areas in theenamel of the teeth are moreextensive but do not involve asmuch as 50% of the tooth

moderate

All enamel surfaces of the teeth areaffected, and the surfaces subjectto attrition show wear. Brownstain is frequently a disfiguringfeature

Severe

All enamel surfaces are affected ,discrete or confluent pitting.Brown stains are widespread andteeth often present a corroded-likeappearance

Although the enamel defectcaused by dental fluorosis ispermanent, the toothdiscoloration that fluorosis causescan be reduced, and sometimeseliminated, through cosmetictreatment

1. microabrasion (conservative removal ofthe outer most layer of enamel)followed by teeth whitening can makethe brown discoloration less apparent.

2. Bonding, which coats the tooth with ahard resin that bonds to the enamel

3. Crowns

4. Veneers, which are custom-made shells that cover the front of the teeth to improve their appearance

• To prevents the fluorosis the fluoridation ofdrinking water shouldn’t exceed the normalrange (0.7- 1.2) ppm

• Fluoride supplements should only prescribed forchildren living in non fluoridated areas.

• Use only acceptable amount of toothpaste forchildren under 6 years

It’s also important to monitor the child’s use of

fluoridated toothpaste. It’s important to teach the

child to spit out the toothpaste after brushing

instead of swallowing it. To encourage spitting, avoid

toothpastes containing flavors that children may be

likely to swallow.

1) http://www.webmd.com/children/fluorosis-symptoms-causes-treatments

2) Fluoride action network/ http://fluoridealert.org/issues/fluorosis

3) Clinical and structural features and possible pathogenic mechanisms of dental fluorosis\, M. JOOST LARSEN\European Journal of Oral Sciences

4) Wael S Alalousi , B.D.S.,M.D.Sc. /methods for a survey of the oral health of secondary schools in iraq / the iraqi journal of dental research

5) American dental association

6) http://www.webmd.com/children/fluorosis-symptoms-causes-treatments

7) American dental association/fluoridation facts 2005/dr.herschel horowitz