Decline in Dental Fluorosis Severity during Adolescence: A Cohort Study

Curtis, Alexandra; Levy, Steven M.; Cavanaugh, Joseph E.; Warren, John J.; Kolker, Justine L.; Weber‐Gasparoni, Karin

doi:10.1177/0022034520906089

Cited by 13 publications

(19 citation statements)

References 14 publications

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“…As occurred in the 2006–2008 birth cohorts, which showed DF frequencies of 73.0% (2015) and 98.7% (2018), the variation between the birth cohorts suggests the presence of different associated factors according to the period. Older children (2000–2002) showed the lowest DF frequency in 2018 (88.8%), which might indicate that some mild lesions may become clinically invisible over time, due to wear, leading to lower frequencies [ 24 ]. The age at which the clinical examination is performed is crucial to detect the disease clinically [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Dental Fluorosis according to Birth Cohort and Fluoride Markers in an Endemic Region of Colombia

Saldarriaga

Restrepo

Rojas‐Gualdrón

et al. 2021

The Scientific World Journal

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Objectives. To analyze changes in the dental fluorosis (DF) incidence according to a birth cohort and explore current exposure to DF in a case series. Methods. Repeated cross-sectional study of two periods: 2015 and 2018. Two standardized examiners registered DF using the Thylstrup-Fejerskov index in permanent teeth of children aged 7–18 years. Period and birth cohort frequencies were estimated by a generalized linear model, binomial family, and logarithmic link function. Period estimates are presented as prevalence ratios (PR) and birth cohort estimates as cumulative incidence ratios (RR); 95% confidence intervals and P values are reported. In a subsample of 37 volunteers (12.29 ± 2.63 years), the fluoride (F) concentration in toenails was measured using the HMDS diffusion method and an ion-specific electrode. Other samples from the local environment such as food, soil, and coal were also collected. Results. In 274 children, we found that nonsignificant increases between periods (PR = 1.17; 95% CI: 0.89–1.55) were not explained by birth cohort effects. A total of 37.8% of the subsample had a toenail F concentration ≥2 μg F/g. The salty snacks and seasoning had the highest F concentrations among local environmental samples. Conclusion. In this population with a high DF frequency according to birth cohort and the evaluated period, the study of soil, coal, and food samples indicated a continued F exposure. F concentration found in the toenails shows a moderate F exposure; nearly a third of the children and adolescents exceeded the adopted threshold of 2 μg F/g. It is important to monitor and explore changes in exposure in highly affected population.

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Section: Discussionmentioning

confidence: 99%

Dental Fluorosis according to Birth Cohort and Fluoride Markers in an Endemic Region of Colombia

Saldarriaga

Restrepo

Rojas‐Gualdrón

et al. 2021

The Scientific World Journal

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“…In the scientific literature, there is an unconfirmed theory that the prevalence of fluorosis and its severity increases over time after tooth eruption. However, recent studies have shown that very mild, mild and moderate fluorosis tends to decrease in severity in adolescence [29]. This trend continues into young adulthood and then slows down at the age of twenty.…”

Section: Discussionmentioning

confidence: 98%

Immediate Result of Icon Infiltration in White Spot Lesions Caused by Fluorosis: A Case Report

et al. 2022

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The Icon technique is designed to effectively restore non-cavitary lesions (porosity in deor hypomineralized enamel). Infiltration of the composite resin increases the strength of demineralized enamel. The results of clinical application indicate the effectiveness of the Icon infiltration method in combination with microabrasion and professional whitening, as well as an excellent aesthetic effect for 2 years after treatment. The Icon method may be a minimally invasive alternative to various methods of remineralization, especially in pediatric practice. Certain limitations in the application of the Icon method include its relatively high cost. This publication presents favorable treatment outcomes, obtained within a short time, in the therapy of fluorosis of permanent incisors in a 7-year-old girl after the application of the Icon infiltration method. This clinical case may be of practical interest to dentists in the wider use of this technique in pediatric dentistry, especially in the regions of endemic fluorosis. Before disseminating the results of the treatment, we obtained written informed consent from the patient's mother. We used the Icon infiltration method and obtained fast and reliable results, which was a key aspect to choose the treatment approaches in this clinical case. There were no restrictions as to the application of this approach in this clinical case. In the scientific literature, there is an unconfirmed theory that the prevalence of fluorosis and its severity increases over time after tooth eruption. However, recent studies have shown that very mild and moderate fluorosis tends to decrease in severity in adolescence. This trend continues into young adulthood and then slows down at the age of twenty. Given this information, the clinical effect reported by the manufacturers after treatment with Icon might be even longer than the declared period of 2 years after treatment for fluorosis.

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“…Caries development in the primary dentition sets children on a steep trajectory toward further disease experience in the permanent dentition (Hall-Scullin et al 2017). Dental fluorosis, on the other hand, does not progress and may decline in severity over time (Do et al 2016; Curtis et al 2020). The trend of increasing fluorosis that prompted introduction of the policy measures has stabilized.…”

Section: Discussionmentioning

confidence: 99%

Impact of Reducing Water Fluoride on Dental Caries and Fluorosis

et al. 2020

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Guidance intended to reduce fluoride toothpaste ingestion in early childhood was introduced in Ireland in 2002. In 2007, water fluoride concentration was adjusted from 0.8–1.0 to 0.6–0.8 ppm. The objective of this study was to determine the difference in caries and fluorosis levels following introduction of these 2 policy measures. A before-and-after study compared caries and fluorosis in random samples of 8-y-olds in Dublin ( n = 707) and Cork-Kerry ( n = 1148) in 2017 with 8-y-olds in Dublin ( n = 679) and Cork-Kerry ( n = 565) in 2002. Dentinal caries experience (primary teeth, d3vcmft(cde)) and fluorosis (permanent teeth, Dean’s index of very mild or higher) were clinically measured. Lifetime exposure to community water fluoridation (CWF) was classified as “full CWF”/“no CWF.” Effect of examination year on caries prevalence and severity and fluorosis prevalence was assessed using multivariate regression adjusting for other explanatory variables. There was little change in commencement of fluoride toothpaste use at ≤24 mo following introduction of toothbrushing guidance. Among children with full CWF, there was no statistically significant difference in caries prevalence or severity between 2017 and 2002. In 2017, caries prevalence was 55% in Dublin (full CWF) and 56% in Cork-Kerry (full CWF), and mean d3vcmft(cde) among children with caries was 3.4 and 3.7, respectively. Caries severity was less in 2017 (mean 4.2) than 2002 (mean 4.9) among children with no CWF ( P = 0.039). The difference in caries severity between children with full CWF and no CWF was less in 2017 than in 2002 (interaction P = 0.013), suggesting a reduced benefit for CWF in 2017. In 2017, fluorosis prevalence was 18% in Dublin (full CWF) and 12% in Cork-Kerry (full CWF). Fluorosis was predominantly “very mild” with no statistically significant difference between 2017 and 2002. CWF at 0.6 to 0.8 ppm is an effective caries-preventive measure. Results suggested low uptake of toothbrushing guidance, a reduced caries-preventive effect for CWF in primary teeth, and no reduction in fluorosis following introduction of the policy measures.

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Decline in Dental Fluorosis Severity during Adolescence: A Cohort Study

Cited by 13 publications

References 14 publications

Dental Fluorosis according to Birth Cohort and Fluoride Markers in an Endemic Region of Colombia

Dental Fluorosis according to Birth Cohort and Fluoride Markers in an Endemic Region of Colombia

Immediate Result of Icon Infiltration in White Spot Lesions Caused by Fluorosis: A Case Report

Impact of Reducing Water Fluoride on Dental Caries and Fluorosis

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