Enamel Changes and Dental Caries in 7-Year-Old Children Given Fluoride Tablets from Shortly after Birth

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In a retrospective study in two different regions of Germany, 1,041 fifteen-year-old pupils were examined for dental fluorosis. The adolescents had taken part in different caries prevention programmes. There were 746 subjects in the study group and 295 subjects in the control group. For each participant, specific aspects of early development, diet and fluoride exposure in group prevention programmes and at home were determined by means of questionnaires. The Thylstrup-Fejerskov index was used to classify the fluorosis scores on the buccal surfaces of teeth 11, 12, 13, 14, 15 and 16 after compressed air drying of the teeth. Binary logistic stepwise regression analyses were conducted to identify associations between fluorosis and potential influence factors. A distinction was made between early and late developing tooth parts. The significance level was set at α = 0.05. Fluorosis prevalence in the regions studied was 7.1 and 11.3%, respectively. The difference was not statistically significant (p = 0.052; chi square). Binary logistic stepwise regression analysis revealed that ‘early start of toothbrushing’ was a statistically significant predictor of dental fluorosis in the early-mineralizing enamel (OR = 1.99, p = 0.027). For the late-mineralizing enamel no single independent variable was identified as a significant predictor of dental fluorosis.

Section: Discussionmentioning

confidence: 99%

Prevalence of Dental Fluorosis in German Schoolchildren in Areas with Different Preventive Programmes

Momeni

Neuhäuser²,

Renner³

et al. 2007

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“…This observation may help in an under standing of the often reported lower fre quency of nonfluoride opacities noted in op timally fluoridated areas [Richards et al, 1967;Thylstrup et al, 1979]. The various forms of enamel opacities of different etiol ogy have nevertheless been considered to gether in several studies as a single entity, 'mottling' [for review see Small and Mur ray, 1978], This approach based on objec tive clinical criteria gives useful information relative to the cosmetic effect of water borne fluoride, though less information can be derived from such studies concerning an individual's exposure to fluoride during the period of tooth formation.…”

mentioning

confidence: 92%

Dental Fluorosis and Localized Enamel Opacities in Fluoride and Nonfluoride Danish Communities

Wenzel¹,

Thylstrup²

1982

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Assessment of dental fluorosis and localized enamel opacities was performed amongst children resident in areas having < 0.2, 1.0 and 2.4 parts/10⁶ F^- in the drinking water. Evaluation of dental fluorosis was done by Dean’s classification system as well as the clinicohistological system described by Thylstrup and Fejerskov in 1978. F_ci was 0.02, 0.56 and 1.33 respectively, and the pattern of dental fluorosis within the dentition followed that previously described for high fluoride areas. The dental fluorosis score for the buccal surface of the first maxillary premolar was disclosed by statistical analysis as representative for the dentition. Corroboration between Dean’s and the clinicohistological scoring system occurred in 47% of cases. Localized enamel opacities were observed in 43, 37 and 33% of children of the three areas respectively. An observed marked tendency towards decreasing proportions of localized enamel opacities in teeth with more pronounced dental fluorosis indicated that fluoride-induced enamel porosities mask localized opacities. Thus, the clinicohistological classification system is considered the most appropriate method for describing an individual’s exposure to fluoride during the period of tooth formation.

“…He came to the conclusion that fluoride supplements are not particularly effective because of compliance problems. It should also be taken into account that fluoride supplementation increases the risk of fluorosis [Thylstrup et al, 1979;Riordan, 1993Riordan, , 1999.…”

mentioning

confidence: 99%

Systemic versus Topical Fluoride

Hellwig

Lennon²

2004

100

The actual mechanism of fluoride action is still a subject of debate. A dogma has existed for many decades, that fluoride has to be ingested and acts mainly pre-eruptively. However, recent studies concerning the systemic effect of fluoride supplementation concluded that the caries-preventive effect of fluoride is almost exclusively posteruptive. Moreover, epidemiologists have cast doubt on the validity of the ‘old’ studies dealing with fluoride use. The concept of the posteruptive fluoride effect is supported by in vitro and in situ investigations demonstrating that the mode of action of fluoride can be attributed mainly to its influence on de- and remineralization kinetics of dental hard tissues. Therefore, topical fluoride application (e.g. in the form of fluoridated dentifrices) should be encouraged. There are still important questions open that need to be answered despite existing knowledge about the caries-preventive effect of fluoride.