Summaries abstract
British Dental Journal 189, 211 (2000)
Published online: 26 August 2000 | doi:10.1038/sj.bdj.4800724
Paediatric dentistry:
A prevalence study of dental fluorosis in infancy
Peter Rock1
- Dental fluorosis is linked to fluoride ingestion in early childhood.
- Children in fluoridated Newcastle had more dental fluorosis than children in fluoride-low Northumberland, although the severity was so mild as to be aesthetically unimportant.
- Advising that young children begin toothbrushing with a children's toothpaste is probably sensible, as recommended in the British Society of Paediatric Dentistry's policy document on fluoride dietary supplements and fluoride toothpastes for children.
Abstract
Objectives
To determine the prevalence and severity of fluorosis in permanent incisor teeth in young children in a fluoridated and a fluoride-deficient community and to establish what relationship, if any, there was between the occurrence of dental fluorosis and the reported use of fluoride toothpaste in childhood.
Design
A prevalence study of children aged 8–9 years who had been continuous residents in fluoridated Newcastle or fluoride-deficient Northumberland.
Method
The permanent maxillary central incisor teeth were examined clinically and photographically by one examiner using the Thylstrup-Fejerskov index; the photographs were read blind to child identity and clinical score. A closed-response questionnaire enquired into the child's early experiences of toothbrushing and use of fluoride toothpastes. Social deprivation was measured by a Jarman score. The study took place in 1998.
Outcome measure
Prevalence of dental fluorosis measured by the Thylstrup– Fejerskov index.
Results
Complete data were available for 78% (n = 409) and 79% (n = 403) of eligible sampled children in the two areas, respectively. Clinical and photographic results agreed closely and had high reproducibility. The prevalence of fluorosis was 54% in the fluoridated area and 23% in the fluoride-deficient area when all grades (> 0) of fluorosis were included; percentage prevalence of mild to moderate fluorosis (
3) was 3% and 0.5% in the two areas, respectively. Multivariate analysis indicated that area of residence (odds ratio = 4.5), Jarman score (odds ratio = 0.99 per Jarman unit) and type of toothpaste (odds ratio = 1.6) were statistically significantly related to presence or absence of fluorosis: the risk factors were – fluoridated area, affluence, and use of adult toothpaste.
Conclusions and recommendations
The prevalence of aesthetically important dental fluorosis was low, although higher in the fluoridated area. Use of a child's toothpaste (with lower fluoride concentration) could decrease risk in a fluoridated area. Adherence to the guidelines published by the British Society of Paediatric Dentistry is recommended.
- Senior Lecturer in Orthodontics, University of Birmingham School of Dentistry