Academic literature on the topic 'Deans Fluorosis Index'

Abstract Objective: To study the shear bond strength (SBS), sites of failure, and micromorphology of bonded molar tubes used on teeth affected by dental fluorosis. Materials and Methods: This in vitro study included 140 first molars classified according to Dean's index for dental fluorosis. Samples were divided into seven groups: (1) healthy teeth etched for 15 seconds, (2) teeth with moderate fluorosis (MOF) etched for 15 seconds, (3) teeth with MOF etched for 150 seconds, (4) teeth with MOF microabrasion etched for 15 seconds, (5) teeth with severe fluorosis (SEF) etched for 15 seconds, (6) teeth with SEF etched for 150 seconds, and (7) teeth with SEF microabrasion etched for 15 seconds. All samples were incubated and were then submitted to the SBS test and evaluated with the modified adhesive remnant index (ARI) and analyzed by using a scanning electronic microscope. Results: The SBS mean value for healthy enamel was 20 ± 10.2 MPa. For the group with MOF, the etched 150-second mean value was the highest (19 ± 7.6 MPa); for the group with SEF treated with microabrasion and etched for 15 seconds, the mean value was (13 ± 4.1 MPa). Significant differences (P ≤ .05) were found in the ARI between healthy and fluorosed groups. Conclusions: Fluorotic enamel affects the adhesion of bonded molar tubes. The use of overetching in cases of MOF and the combination of microabrasion and etching in SEF provides a suitable adhesion for fixed appliance therapy.

Introdução: Medidas de saúde de amplo impacto (fluoretação da água, dentifrícios fluoretados e aplicação de flúor), mas sem devidos controles, podem resultar no aumento da prevalência e gravidade da fluorose. A avaliação demedidas subjetivas da saúde bucal na qualidade de vida, favorecida pela incorporação de dimensões clínicas e psicossociais, é requerida para estudos epidemiológicos de fluorose. Objetivos: descrever a prevalência e gravidade da fluorose dentária em escolares de uma Organização Não Governamental (ONG) e avaliar o impacto desse agravo na qualidade de vida. Metodologia: estudo de corte transversal, com crianças e adolescentes entre 10 a 17 anos de uma ONG do distrito Cabula-Beirú, Salvador-Bahia. A fluorose foi classificada através do Índice de Dean e seus impactos subjetivos avaliados através do Child Perception Questionnaire (adaptado ao Brasil). Resultados: Na amostra de 116 alunos, a prevalência da fluorose foi 65,5%, tendo o nível leve ocorrido em maior frequência (28,5%). Os escolares com fluorose relataram maior insatisfação com suas condições bucais do que aqueles sem este agravo (p<0,005). Conclusão: A alta prevalência da fluorose entre os jovens estudados aponta a necessidade de monitoramento da concentração de flúor na água daquela região e do uso de fluoretos nos dentifrícios nessa população. O impacto negativo da fluorose na qualidade de vida requer medidas de combate a esse problema de saúde.Abstract Introduction: Wide-ranging health measures such as fluoridation of water, use of fluoride dentifrices and application of fluoride when used without control can increase the prevalence and severity of fluorosis. Assessment of subjective measures of oral health related to quality of life combined with clinical and psychosocial dimensions is needed for epidemiological studies of fluorosis. Objectives: To describe the prevalence and severity of fluorosis in school children of a non-governmental organization – Cabula-Beirú district, Salvador-BA – and to assess its impact related to quality of life. Methodology: cross-sectional epidemiological study with children and adolescents, from 10 to 17 years old. Fluorosis was classified with Dean’s Index. Subjective impacts of oral health were assessed through the Child Perception Questionnaire (adapted to Brazil). Results: From the sample of 116 students, the prevalence of fluorosis was 65.5%, and the mild level was 28.54%. Students with fluorosis reported greater dissatisfaction with their oral conditions than those without fluorosis (p <0.005). Conclusion: The results revealed that fluorosis prevalence was higher and this situation requires monitoring the concentration of fluoride in the water of that region and the use of fluorides in dentifrices in this population. The negative impact of fluorosis on quality of life requires measures to combat this health problem.

The microhardness is an essential property of tooth enamel; there may be many factors that alter or diminish this quality causing weakness, one of which is dental fluorosis. The aim of this study was evaluate the surface microhardness of fluorotic enamel compared with healthy enamel. Two hundred forty extracted human molars were classified into four groups: Healthy (H), mild (MI), moderate (MO) and severe (S) fluorosis according to the Dean index. All samples were analyzed by Micro Vickers Hardness Tester. Average, standard deviation and ranges were calculated for quantitative variables, the ANOVA and Tukey test was used to identify differences between groups. The mean values of surface microhardness in HVN were: H, 333.4; MI, 290.3; MO, 266.1; S, 252.0. The differences between mean surface microhardness among healthy group and fluorotic groups were statistically significant (p

The currently popular scoring systems used to diagnosis fluorosis use different measurement units, evaluate variable numbers of sites per person, and involve non-comparable groupings of clinical symptoms. Although none of these factors is related to the level of fluoride exposure in the examined population, their combined effect produces fluorosis prevalence values for a population which vary considerably among and within these scoring systems. Intrinsic factors for a scoring system include the inclusion of a questionable category, the minimal level of fluorotic involvement, and the number of affected sites within a subject required for case definition. Thus, a case definition of fluorosis for each scoring system, although not mandatory, would certainly be desirable so that dental epidemiologists and clinical investigators can interpret fluorosis scores relative to risk assessment. On the other hand, ratios of fluorosis prevalence magnitudes, as evidenced by odds ratios, can be more stable between scoring systems when groups with different fluoride exposure levels are compared. There is a strong correlation between extent and specific measures of fluorosis severity for Dean's Index (DI) and the Tooth Surface Index of Fluorosis (TSIF) scoring system, as well as within each scoring system separately. Parallel patterns in fluorosis severity were found among groups with different fluoride exposures for the DI and TSIF scoring systems. The effects of fluoride exposure on severity levels of fluorosis may be better understood by using relative measures rather than by using differences in severity levels.

A wide variety of terms and definitions are used to describe various developmental defects of enamel. Some are simple descriptive clinical terms, and others are linked with the causative agent or the histopathology of the defect. Some confusion exists as to the most appropriate type of index to use to measure defects of enamel due to fluoride ingestion (dental fluorosis). This is primarily due to difficulties some researchers have in distinguishing between defects of fluoride and non-fluoride origin. This problem has resulted in the development of specific fluorosis indices and purely descriptive indices. The main fluorosis indices are those of Dean, Thylstrup and Fejerskov, and the TSIF Index. Dean's Index does not provide adequate information on the distribution of fluorosis within the dentition and is not sensitive at high fluorosis levels. The Thylstrup and Fejerskov Index is related to the histology of fluorosis; however, the initial minute changes observed on dry enamel surfaces are of little esthetic importance. The TSIF Index does overcome some of the limitations of Dean's Index. The DDE Index has replaced the Al-Alousi Index as the main descriptive index. The DDE Index is time-consuming, and the analyses of data are complicated. Modifications have now been proposed to make it simpler to use and the data more meaningful. Further research needs to be carried out into both the validity of the fluorosis indices and making the DDE Index more universally acceptable.

Introduction and Objective: To analyze retrospectively the fluoride level in the public water supply of two cities of the south Santa Catarina and to verify whether 12-year-old schoolers, who had used public water supply had dental fluorosis. Material and methods: 97 schoolers of the cities of Cocal do Sul and Morro da Fumaça were evaluated. Dental fluorosis was determined through Dean index. The annual averages of the fluoride concentrations in waters between the years of 2004 and 2015 were verified by reports supplied by the responsiblecompany. Results: The averages of the fluoride concentrations in the water supply in the cities of Cocal do Sul and Morro da Fumaça, during the analyzed period, were 0.86 and 0,85 ppm of fluoride, respectively, without statistically significant difference. The smaller concentration was found in 2006, in the city of Morro da Fumaça, with 0.64 ppm of F; the greatest concentration occurred in Cocal do Sul, in 2007, with 1.1 ppm of F. The prevalence of dental fluorosisin Cocal do Sul was 24.5% and in Morro da Fumaça was 14.6%, without statistically significant differences. All 12-year-old schoolers who had dental fluorosis were classified as light according to Dean index. Conclusion: Most of the 12-year-old schoolers did not show any fluorosis degree. The cases of dental fluorosis were classified as little severity and with low esthetic impairment. It can be concluded that the fluoride levels in water supply were within the adequate and safe limits with low risk of dental fluorosis.

Several indices have been used to describe the clinical appearance of dental fluorosis. The purpose of this paper is to describe and compare the three principal ones in use today: those developed by Dean (1934, 1942), Thylstrup and Fejerskov (1978), and Horowitz et al. (1984). A recent index (Fluorosis Risk Index) developed by Pendrys (1990) is also included in this review. The continued use of Dean's classification system and derived index (CFI) for more than a half century is testimony to its simplicity and utility. The index has been criticized because the unit of analysis is the person, because criteria are unclear for some categories, or that they lack sensitivity, particularly for severe fluorosis, and because of the way in which data are summarized and reported. The Thylstrup and Fejerskov Index is appealing to clinicians and epidemiologists alike in that it corresponds closely to histological changes that occur in dental fluorosis and to enamel fluoride concentrations, thereby having biological validity. The TSIF described by Horowitz et al. makes a useful contribution because it provides clearer diagnostic criteria and provides for an analysis based on esthetic concerns. The Fluorosis Risk Index appears to be particularly useful for analytical epidemiologic studies, because it is designed to permit a more accurate identification of associations between age-specific exposures to fluoride and the development of dental fluorosis. All three indices in common use today provide useful indices for the study of dental fluorosis. The utility of the Fluorosis Risk Index will be determined as it receives wider use. The selection of one of these indices for use in an epidemiologic study depends in large measure on the purpose of the study. Research needs to continue on the validity of these indices, particularly for mild fluorosis, and on the public's perception of the cosmetic appearance of teeth with different severity levels of fluorosis.

The communities within Binh Dinh province in the Central Vietnam are reliant on groundwater as their primary supply of domestic and potable water. Meanwhile, it is seriously contaminated with fluoride that causing fluorosis problem for people. This study aims to investigate the link between severity of dental fluorosis rate in a population and fluoride concentration in drinking water in Tay Son area. A total of 50 well-water samples were collected and 220 people were surveyed by questionnaire from 50 households at 3 villages: Tay Phu, Binh Tuong, Tay Giang of Tay Son district, Binh Dinh province, Vietnam. The quantitative assessment of severity of dental fluorosis was done by calculating the Community Fluorosis Index (CFI) using Dean’s classification. Result of this study showed that fluoride concentration in well-water varied from 0.31 mg/L to 7.69 mg/L (mean 2.66 mg/L, SD: 2.18 mg/L) with 70 % of well-water samples above the maximum permissible limit of 1.5 mg/L of World Health Organization (WHO) drinking water standard. 100 % people surveyed was suffered from dental fluorosis and Dean scale of dental fluorosis ranged from level 2 to level 5. CFI varied from 3.45 to 4.13 above limit value (0.6). The community seriously suffered from dental fluorosis. The fluoride concentrations and Dean Index have high correlation (r = 0.580, p < 0.0001). Based upon results of this study, it is recommended that the government should supply drinking water with appropriate fluoride content for this community.

A cross-sectional study was conducted among the residents of three villages of Doda district, J&K. A total of 391 individuals (202 males and 189 females) were examined from 60 households by house to house survey for recording the prevalence and severity of dental fluorosis by using Dean’s Index (1942) along with WHO health assessment form (1997b) and Community fluorosis Index. Of the total studied population 299 (76.47%) have found to be affected with various grades of dental fluorosis with moderate (33.5%) level of fluorosis to be the most frequent category observed. Prevalence of dental fluorosis was more in males (86.61%) than females (63.49%). No significant relation (P>0.05) between prevalence of dental fluorosis to the socioeconomic status was found. Community fluorosis Index was found to be 2.05 which denotes “marked” category of public health significance. High prevalence and high community fluorosis Index suggest that fluorosis is a major public health problem in the area.

Masters of Public Health - see Magister Public Health<br>Dental fluorosis is an endemic condition in a number of regions of South Africa, varying in degree of affliction according to the drinking water fluoride concentration in the area. Objective: While a number of South African studies have reported on the relationship between fluorosis and fluoride concentration in the drinking water, the purpose of this study was to determine perceptions of dental fluorosis in the Central Karoo District of the Western Cape. Methods: Learners aged 12-15 years and who had been lifelong residents in their respective areas were selected from schools in Leeu Gamka, Merweville, Nelspoort and Murraysburg. All the children meeting the inclusion criteria were included realising a total sample of 189. Drinking water fluoride concentration of each town was determined and concomitant fluorosis affliction was assessed. An interviewer administered questionnaire was used to determine respondents’ self-rated perceptions of fluorosis as well as their responses to a set of statements on clinically defined fluorosis. To this end four photographs, each depicting a different degree of fluorosis: (No fluorosis; Mild fluorosis; Moderate fluorosis; Severe fluorosis) were shown to the respondents. Results: In Leeu Gamka, with the highest fluoride concentration ([F] = 1.62ppm), 82% of respondents were aware of fluorosis stains as opposed to 6%-20% awareness in Merweville ([F] = 0.68), Nelspoort ([F] = 0.70) and Murraysburg ([F] = 0.56). Two thirds of respondents in Leeu Gamka found the appearance of their teeth embarrassing compared to only 2%-10% in the other 3 areas. The majority of respondents in Leeu Gamka (82%) indicated that they would want to remove the fluorosis spots with only 4%-20% in the lower fluoride areas. Two thirds (67%) of the Leeu Gamka respondents were teased compared to 2%-6% in the other areas. Most of the respondents have not tried to do anything to the appearance of the teeth, even in the higher fluoride area of Leeu Gamka. The average response varied little for all the photographs across the geographic areas (the minimum and maximum scores varied between 4.00 and 5.00) and reflected a greater tendency towards strongly disagreeing with the statement on aesthetics-even for the photographs depicting no fluorosis and mild fluorosis. The average response varied between 1 and 2 among all four geographic regions showing a tendency to “agree” and “strongly agree” to the statement on embarrassment. The average response to the statement on neglect varied little for all the photographs across the geographic areas as the minimum and maximum average response scores varied between 1.36 and 2.39 (agree and strongly agree). The response to the statement on disadvantage varied little for all the four photographs across the geographic areas (minimum=1.00, maximum=2.07) and reflected a greater tendency toward strongly agreeing and agreeing with the statement. Conclusion: The respondents from the higher fluoride area were more aware of dental fluorosis, had a greater perception of embarrassment and the strongest desire to remove the fluorosis staining. There was little variation in the average response to the statements on clinically defined fluorosis across the geographic areas. The learners erroneously believed that dental fluorosis was due to neglect, which is an indication that many learners are not aware of the cause of dental fluorosis in their community. The general consensus of the communities was that fluorosis was judged with feelings of negativity (embarrassment and a disadvantage for the child into adulthood).

Introdução: O consumo de água fluoretada e o recurso a outros métodos de administração de flúor tem sido utilizado eficazmente, há várias décadas, na prevenção de cárie dentária, no entanto, tem sido associado a um aumento da prevalência de fluorose dentária. Objectivos: Avaliar a prevalência de cárie dentária e fluorose dentária numa amostra de jovens de um meio com água naturalmente fluoretada (Ponta Delgada) e de um meio sem água fluoretada (Viseu). Relacionar o índice CPOD e o índice de Dean com variáveis sócio-demográficas, hábitos de higiene oral, consumo de alimentos açucarados e acesso a diferentes formas de administração de flúor. Metodologia: Realizou-se um estudo-piloto desenhado como estudo epidemiológico observacional transversal que avaliou uma amostra de 157 jovens de Ponta Delgada e 98 de Viseu, entre os 10 e 17 anos, com uma média de idades de 12,77 e 11,21 anos, respectivamente, através da realização de um exame intra-oral, para análise do índice CPOD e índice de Dean, e de um questionário para avaliação das características sócio-demográficas, comportamentos de saúde oral e acesso a diferentes formas de administração flúor. Na inferência estatística foram utilizados o teste do Qui-Quadrado e o teste exacto de Fisher para identificar a existência de dependência entre as variáveis em análise. Resultados: Os resultados revelaram, em Ponta Delgada, uma menor prevalência de cárie dentária (CPOD: 2,20 vs. 1,60) e uma prevalência de fluorose dentária 4 vezes superior à de Viseu (15,3 vs. 4,1%). Identificou-se um maior consumo de alimentos açucarados, em Ponta Delgada, mas também melhores práticas de higiene oral. Apesar de menos de 30% dos jovens na amostra de Ponta Delgada consumirem água fluoretada da rede de abastecimento público, um em cada quatro apresentava fluorose dentária. Conclusão: O efeito terapêutico do flúor presente naturalmente na rede de abastecimento público de água de Ponta Delgada, associado a uma melhor higiene oral e ao acesso disseminado a múltiplas formas de administração de flúor alternativas, condiciona, comparativamente com Viseu, onde não há acesso a água fluoretada, uma redução da prevalência e severidade de cárie dentária. Contudo, este efeito protector da fluoretação natural da água é contraposto por uma prevalência de fluorose dentária quatro vezes superior àquela encontrada em Viseu<br>Introduction: Fluoridated water consumption alongside other means of fluoride administration have been efficiently used for many decades in the prevention of dental caries. However, its use has been associated with a raising prevalence of dental fluorosis. Objectives: To evaluate and compare dental caries and dental fluorosis prevalence among a sample of students from a region with fluoridated water (Ponta Delgada, Azores) and another sample from a non-fluoridated region (Viseu). To relate DMFT and Dean's Indexes with socio-demographic variables, oral health behaviours, sugar consumption and access to different sources of fluoride administration. Methods: A cross-sectional study was conducted to evaluate a sample of 157 students from Ponta Delgada and 98 from Viseu, aged 10 – 17 years old, with an age average of 12,77 and 11,21 years, respectively. An intra-oral examination to identify the DMFT and Dean's Indexes was performed in every student, whom was also asked to fill in a questionnaire to assess socio-demographic data, oral health behaviours and access to different means of fluoride administration. Statistical analysis was completed using the Qui-square test and Fisher's exact test to identify dependence among the variables included in the study. Results: The results revealed a lower prevalence of dental caries in Ponta Delgada (DMFT: 2,20 vs. 1,60 ) but an almost 4 times higher prevalence of dental fluorosis (15,3 vs. 4,1%). The students from Ponta Delgada had a higher sugar consumption, although they revealed better oral health behaviours. Despite only less than 30% of the sample from Ponta Delgada used to drink water from the public fluoridated water supply, in this subgroup that did, one in every four students had dental fluorosis. Conclusion: The therapeutic effect of the natural presence of fluoride in the water supply system of Ponta Delgada, alongside better oral health behaviours and widespread access to alternative sources of fluoride, led to a lower prevalence and severity of dental caries, when compared to Viseu, a non-fluoridated region. However, this beneficial effect of fluoridated water found in Ponta Delgada is counter-balanced by an almost 4 times higher prevalence in dental fluorosis.