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Kavand G, Broffitt B et al. J Public Health Dent 2012; 72: 164–171

The Iowa Fluoride Study, ironically cited by the anti-fluoridation lobby, has quantified fluoride exposures and the health of 698 children from birth. This paper focuses on dental aesthetics, and comprises just one aspect of this longitudinal study. The investigators used the Fluorosis Risk Index to quantify fluorosis. They also asked the children and their parents to answer questionnaires about the child's dental aesthetic. From the original cohort, 550 13-years-olds were recruited although a further 174 were excluded because they were receiving orthodontic treatment. One quarter of children demonstrated fluorosis. When the variable was the 'parsimonious' number of maxillary anterior zones exhibiting fluorosis, both the adolescents (p = 0.03) and their parents (p = 0.002) reported they were concerned with the dental appearance.