Distribution patterns of enamel fluorosis in permanent dentition. 2012

Kudlur Maheswarappa Sudhir, and Sanikommu Suresh, and Goudar Manjunath Prashant, and Vulavala Venkata Subba Reddy, and Mohammed Shafiulla, and Gourapura Natraj Chandu
Department of Public Health Dentistry, Narayana Dental College and Hospital, Nellore, Andhra, Pradesh, India. drsudhirkm@gmail.com

OBJECTIVE To describe the different patterns of the intraoral distribution of enamel fluorosis in permanent dentition. METHODS This cross-sectional analysis was conducted in Nalgonda district of Andhra Pradesh, India. A group of 1000 school children aged 13-15 years were selected by stratified cluster sampling from four different areas with different levels of naturally occurring fluoride in the drinking water. Fluorosis was recorded using the Thylstrup and Fejerskov index (TFI). RESULTS The prevalence of fluorosis (TFI score >=1) was 100% at all four fluoride levels. This study revealed two patterns of fluorotic enamel changes in dentition. In high fluoride areas, incisors exhibited lower TFI values than canines, premolars and molars, with the maximum affected being second molars followed by first molars. In low fluoride areas, a steeper profile of dental fluorosis, starting from incisors and first molars through canine and premolars to second molars, was noticed. CONCLUSIONS With the exception of permanent second molars and permanent first molars in high fluoride communities, the intraoral distribution of different degrees of dental fluorosis was related to the completion of primary enamel formation.

UI MeSH Term Description Entries
D007180 Incisor Any of the eight frontal teeth (four maxillary and four mandibular) having a sharp incisal edge for cutting food and a single root, which occurs in man both as a deciduous and a permanent tooth. (Jablonski, Dictionary of Dentistry, 1992, p820) Incisors
D007194 India A country in southern Asia, bordering the Arabian Sea and the Bay of Bengal, between Burma and Pakistan. The capitol is New Delhi. Republic of India
D008297 Male Males
D008334 Mandible The largest and strongest bone of the FACE constituting the lower jaw. It supports the lower teeth. Mylohyoid Groove,Mylohyoid Ridge,Groove, Mylohyoid,Grooves, Mylohyoid,Mandibles,Mylohyoid Grooves,Mylohyoid Ridges,Ridge, Mylohyoid,Ridges, Mylohyoid
D008437 Maxilla One of a pair of irregularly shaped bones that form the upper jaw. A maxillary bone provides tooth sockets for the superior teeth, forms part of the ORBIT, and contains the MAXILLARY SINUS. Maxillae,Maxillary Bone,Bone, Maxillary,Bones, Maxillary,Maxillary Bones,Maxillas
D008963 Molar The most posterior teeth on either side of the jaw, totaling eight in the deciduous dentition (2 on each side, upper and lower), and usually 12 in the permanent dentition (three on each side, upper and lower). They are grinding teeth, having large crowns and broad chewing surfaces. (Jablonski, Dictionary of Dentistry, 1992, p821) Molars
D009050 Fluorosis, Dental A chronic endemic form of ENAMEL HYPOMINERALIZATION caused by drinking water with a high fluorine content during the time of tooth formation, and characterized by defective calcification that gives a white chalky appearance to the enamel, which gradually undergoes brown discoloration. (Jablonski's Dictionary of Dentistry, 1992, p286) Dental Fluorosis,Mottled Enamel,Mottled Teeth,Dental Fluoroses,Fluoroses, Dental,Enamel, Mottled,Mottled Enamels,Teeth, Mottled
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D003481 Cuspid The third tooth to the left and to the right of the midline of either jaw, situated between the second INCISOR and the premolar teeth (BICUSPID). (Jablonski, Dictionary of Dentistry, 1992, p817) Canine Tooth,Canine Teeth,Cuspids,Teeth, Canine,Tooth, Canine
D003743 Dental Enamel A hard thin translucent layer of calcified substance which envelops and protects the dentin of the crown of the tooth. It is the hardest substance in the body and is almost entirely composed of calcium salts. Under the microscope, it is composed of thin rods (enamel prisms) held together by cementing substance, and surrounded by an enamel sheath. (From Jablonski, Dictionary of Dentistry, 1992, p286) Enamel,Enamel Cuticle,Dental Enamels,Enamel, Dental,Enamels, Dental,Cuticle, Enamel,Cuticles, Enamel,Enamel Cuticles,Enamels

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