Dental fluorosis is caused by ingesting too much fluoride while the teeth are developing. Poltava region belongs to Buchach fluorine hydrogeological province which ground waters are characterized by a high content of fluorine. Such districts as Myrgorod, Lubny, Gadyach, Globino, Mashivka, Shyshaky and Novy Sanzshary have fluoride concentration in drinking water from 2,5 tо 7 mg/l. It is known that the overdose of fluoride has deleterious effect on enamel development, generating a hypomineralized porous subsuperfacial enamel. Mild fluorosis transforms into moderate fluorosis with brown pigmentation over time and increasing the severity of fluorosis is associated with increasing the patient`s dissatisfaction. There are a few different ways that dental fluorosis can be treated. Local remineralisation therapy is the most careful way to reduce or eliminate fluorosis spots. Enamel microabrasion removes the outer porous enamel with pumice after it has been partly demineralized by the acid; topical fluoride that remineralized the enamel follows microabrasion. A teeth whitening can return teeth to their former glory in a single visit. Infiltration technique is the novel approach to fluorosis management which masks white spots. Veneers or crowns are the next option that restores teeth gleaming appearance. Unfortunately, previous reviews that have analyzed contemporary methods of fluorosis treatment didn’t determine their indications depending on the disease severity and the enamel maturation. Purpose of the study was to systematize the methods of dental fluorosis management offered last years and to determine the indications for their use depending on the severity of the disease and the maturity of the tooth enamel. Searching strategy for identification of scientific publications published between the years 2009 - May 2019 was conducted by reviewers independently through Google. The search strategy included keywords "dental fluorosis management", «teeth whitening», «teeth microabrasion», «infiltration for fluorosis treatment» and it was complementated by checking references of the relevant review articles and the eligible studies for additional useful publications. Over the last 10 years few articles were dealt with minerals, vitamins, adaptogens, antitoxicants prescription for fluorosis management. Such tooth pastes as «R.O.C.S» and «Novyi zhemchuh calcium» showed efficacy in local remineralisation therapy of fluorosis in children. Infiltration technique was used for mild fluorosis management and in combination with whitening for moderate fluorosis treatment in children. Different tooth whitening techniques were offered and only some of them include local remineralisation therapy that can stabilize clinical result. Carbamide and orthophosphoric acid were utilized for whitening of immature fluorosis teeth. Microabrasion in children's teeth was effective in combination with following fluoridation, for example Tooth Moose. Direct and indirect restorations are considered the treatment of choice for moderate to severe cases of fluorosis given the optimum aesthetics, wear resistance, biocompatibility, and long-term results. Whereas veneers and crowns are indicated in mature fluorosis teeth, choice of direct composite restorations doesn’t depend on tooth maturity. Treatment of fluorosis of various severities in children should include endogenous use of medicines that increase the enamel remineralisation. Local remineralisation therapy is indicated for mild fluorosis in immature teeth and for moderate fluorosis in combination with bleaching and microabrasion. Infiltration technique is recommended for mild fluorosis management and in combination with whitening for moderate fluorosis treatment in children. In the case of inefficiency of minimally invasive methods or severe fluorosis, direct or indirect restorations are conducted. Promising direction in fluorosis treatment is the development of new methods for fluorosis management, including general and local remineralization therapy, as well as infiltration technique.

An attempt has been made to display a picture of carious pathology and other dental diseases based on the study of the general status and reconstruction of cultural and everyday traditions of the early Iron Age society of Poltava and adjacent regions of Ukraine for introduction into the scientific base with the interaction of the formula: disease - social conditions, for a particular territory, specific society, one historical time. The materials of the study were the skeletons of 223 individuals with preserved dental-maxillary area (discovered and collected during the archaeological excavations of mounds 1998–2017 by expeditions of the Center for the Preservation and Research of Monuments of Archeology of the Department of Culture of the Poltava Regional State Administration) of the early Iron Age (mid-5th-6th centuries). BC, hereinafter - RHW) of the territory of Poltava and adjacent areas: 40 skeletons of children, 79 - women, 104 - men. In the analysis of pathology, we used our own method of studying the bones of ancient people and studying the pathology on anthropological material. Studied age-related changes in the skeleton, social labeling (if possible, determined the type of occupation, special social characteristics - decoration of the teeth, effects on the teeth when initiating into adult life, technical use of the masticatory organs, etc.). The social portrait of society shows the clinical picture of caries, other deviations from the generally accepted norm, which can be used as a starting point when comparing caries indicators to earlier or later communities with their social characteristics and economic structure. So, a pathology change curve can be created, with the creation of an intermediate picture of the disease and prediction at any time in the future. Having such a formula of pathological processes in a given population in a given territory at a given time with a given social characteristic, we can further obtain information on the pathology of close and distant communities, which will provide new methods for dating and recreating life. For medicine, it is important to trace causal relationships. It is, therefore, possible to derive diagrams of diseases at the level of similar conditions of life and management (expect a similar status of the oral cavity in similar societies).

The territory of Poltava region belongs to the Buchatsky hydrogeological province, whose groundwater is characterized by an elevated fluorine level content. The cause of endemic dental fluorosis particularly in the children’s population of the region is water consumption with surplus concentration of this chemical element. Also, having fluorosis a condition that develops from a high fluoride concentration in drinking water- causes disorder of hard tooth tissues maturing, mineralizationand teeth germ development. This, in turn, has a negative influence on enamel amelogenin synthesis and violation of the crystals maturing, determines a surface porosity. The chalky spots, brown pigmentation, and enamel erosion destruction lesions are characterized the different severity manifestation of the fluorosis. The purpose of our research was to conduct a thorough analysis of all the material we found on this topic, gather all possible information on new trends in recent years in the treatment of dental fluorosis: what are the methods, their origins, indications for use, clinical stages and advantages. Dental enamel fluorosis requires different approaches to treatment depending on the severity of clinical manifestations. Obviously, as the leading method is remineralizing therapy. One of the method is offered by Nikolishina E.V. etc. [6], which is carried out in the following way: after carry out of the professional hygiene procedure, next step, individual caps were made of transparent silicone filled with 10% solution «Poltavsky Bishofit» and applied on the fluorosis teeth, daily course consist with 30 minutes and 10-20 procedures. Enamel microabrasion is the first minimally invasive treatment method of mild and moderate dental fluorosis using to removes opaque brown spots and surface roughness smoothing, providing a flat and shinier surface. The microabrasion technique involves etching with mild acid in combination with application of abrasive components. Resin infiltration has also become a popular treating dental fluorosis technique without loss of hard tissue. Resin infiltration is based on the application of hydrochloric acid to the hard tissues of the tooth and subsequent coating with a low-viscosity resin that penetrates into the microspaces of the tooth enamel. The cloaking effect is based on the refractive index. The optical properties of the affected enamel change and it looks like a healthy enamel surrounding. The indication to dental fluorosis treatment of severity forms in permanent teeth with mature roots is restoration of teeth, veneers, orthopedic crowns, if the microabrasive method hasn’t aesthetic effect efficiency. Thus, in cases of aesthetic changes due to fluorosis, minimally invasive restorative approaches that preserve dental hard tissue such as microabrasion method, external bleaching or resin infiltration should be considered before invasive restorative procedures. More invasive treatments may be considered if the results remain unsatisfactory.