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Dental fluorosis in permanent incisor teeth in relation to water fluoridation, social deprivation and toothpaste use in infancy

Lookup NU author(s): Elizabeth Tabari, Emeritus Professor Andrew Rugg-Gunn, David Evans


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Objectives: To determine the prevalence and severity of fiuorosis 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. © British Dental Journal 2000.

Publication metadata

Author(s): Tabari ED, Ellwood R, Rugg-Gunn AJ, Evans DJ, Davies RM

Publication type: Article

Publication status: Published

Journal: British Dental Journal

Year: 2000

Volume: 189

Issue: 4

Pages: 216-220

ISSN (print): 0007-0610

ISSN (electronic): 1476-5373

Publisher: Nature Publishing Group


PubMed id: 11036750