Risk of Enamel Fluorosis in Nonfluoridated and Optimally Fluoridated Populations

Author(s): David G. Pendrys
Journal: JADA
Volume (number): Volume 131
Month, Year: June 2000
Major topic: Fluorosis
Minor topic(s): Risk of enamel fluorosis in nonfluoridated and optimally fluoridated populations
Type of Article: case study
Main Purpose: To evaluate the impact of specific fluoride sources on the prevalence of enamel fluorosis in the population
Overview of method of research: Two groups of children 10 to 14 years of age – one group had grown up in nonfluoridated communities and one group had grown up in optimally fluoridated communities. Trained examiners measured enamel fluorosis using the Fluorosis Risk Index and measured early childhood fluoride exposure using a questionnaire completed by the parent. Author then calculated attributable risk percent estimates, or the proportion of cases of mild-to-moderate enamel fluorosis associated with exposure to specific early fluoride sources, based on logistic regression models.
Findings: Enamel fluorosis in the nonfluoridated study sample was attributed to fluoride supplementation and early tooth brushing behaviors. Enamel fluorosis in the optimally fluoridated study sample was attributed to early tooth brushing behaviors, inappropriate fluoride supplementation and the use of infant formula in the form of a powdered concentrate.
Key points/Summary: Enamel Fluorosis – is a hypomineralization of the enamel caused by the ingestion of an amount of fluoride that is above optimal levels during enamel formation. In severe forms actual breaking of enamel may occur with brown staining or pitting. By advising parents about the best early use of fluoride agents, health professionals play an important role in reducing the prevalence of clinically noticeable enamel fluorosis.
Assessment of article: Fluorosis seems to be a recurring theme from early tooth brushing behaviors. Important to inform parents a pea sized amount of toothpaste to be used only after adequate ability to spit. Usually after age two. Are our ECC study patients really not ingesting too much fluoride from the gel kam parents are applying?