DENTAL FLUOROSIS

Polarization-sensitive optical coherence tomography ͑PS-OCT͒ and near-infrared ͑NIR͒ imaging are promising new technologies under development for monitoring early carious lesions. Fluorosis is a growing problem in the United States, and the more prevalent mild fluorosis can be visually mistaken for early enamel demineralization. Unfortunately, there is little quantitative information available regarding the differences in optical properties of sound enamel, enamel developmental defects, and caries. Thirty extracted human teeth with various degrees of suspected fluorosis were imaged using PS-OCT and NIR. An InGaAs camera and a NIR diode laser were used to measure the optical attenuation through transverse tooth sections ͑ϳ200 m͒. A digital microradiography system was used to quantify the enamel defect severity by measurement of the relative mineral loss for comparison with optical scattering measurements. Developmental defects were clearly visible in the polarizationresolved OCT images, demonstrating that PS-OCT can be used to nondestructively measure the depth and possible severity of the defects. Enamel defects on whole teeth that could be imaged with high contrast with visible light were transparent in the NIR. This study suggests that PS-OCT and NIR methods may potentially be used as tools to assess the severity and extent of enamel defects.

The ADA recommends the use of fluoridated dentifrices as soon as the primary teeth erupt, so as to reduce the incidence of dental caries. However young children can ingest a significant amount of dentifrice during normal toothbrushing; this is a potential problem because the permanent teeth are at risk from fluorosis for the first seven years of life. the objective of this paper was to review the literature on the role of fluoride dentifrices in causing dental fluorosis. a search for literature was performed using MEDLINE, OVID with the key words fluorosis, dentifrice, ingestion, and children. The search was limited to English language publications. Subsequently, 31 articles were retrieved, additional relevant articles were collected from the references cited in the initially identified papers. Ultimately, 96 articles were retrieved for review. Fluoride, should be used with caution so that the benefits out-way the adverse affects. Oral health care providers need to systematically as...

In developing countries majority of the population, especially the rural population use chewing sticks to maintain oral hygiene. Fluoride if present in chewing sticks will confer similar protection against dental caries as fluoride dentifrice. Objective: To determine the fluoride content of commonly used chewing sticks in Nigeria. Materials and Methods: Fluoride was determined in 1 gram of each identified plant material commonly used as chewing sticks, by reading it on Atomic Absorption Spectrometer (AAS) at 286.5(µm) wave-length, after dissolving it with 25ml of 10% perchloric acid and 25ml of 10% nitric acid and filtered. Results: Fluoride was detected in all the chewing sticks with mean concentrations of 0.012% -0.407% (54ppm -1845ppm). The chewing stick from Zanthoxylum Zanthoxyloides has the highest mean concentration of fluoride (1845ppm), whilst the chewing stick from Mangifera Indica has the least fluoride (54ppm). Conclusion: Chewing stick from Zanthoxylum Zanthoxyloides has fluoride concentration slightly higher than regular toothpastes. If properly and regularly used it is likely to confer maximum anti-caries effect in users and deserves to be listed under home based topical fluoride products. Fluoride in chewing sticks has great public health implications for oral health community programmes for the prevention of caries in rural areas in developing countries. In developing countries where there have been cases of fluorosis in some communities, it is imperative to examine the other hidden sources of fluoride which evolve around the lifestyle of the people in the community and which could contribute to their total daily consumption of fluoride.

Dental fluorosis is a developmental disturbance of dental enamel, caused by successive exposures to high concentrations of fluoride during tooth development, leading to enamel with lower mineral content and increased porosity. The severity of dental fluorosis depends on when and for how long the overexposure to fluoride occurs, the individual response, weight, degree of physical activity, nutritional factors and bone growth. The risk period for esthetic changes in permanent teeth is between 20 and 30 months of age. The recommended level for daily fluoride intake is 0.05 - 0.07 mg F/Kg/day, which is considered of great help in preventing dental caries, acting in remineralization. A daily intake above this safe level leads to an increased risk of dental fluorosis. Currently recommended procedures for diagnosis of fluorosis should discriminate between symmetrical and asymmetrical and/or discrete patterns of opaque defects. Fluorosis can be prevented by having an adequate knowledge of t...

Resumen: Las anomalías y síndromes dentales, suponen una problemática que puede afectar severamente a la población. Estas, Poseen causantes: genéticos, culturales, de sexo y raza se ven implicados en estas anormalidades que, de ser tratadas desde su primera instancia, pueden proporcionar una significativa mejoría para quienes las padecen. Por esto, es de suma importancia el poder identificar lo antes posible, mediante los métodos y características tanto clínicas como radiológicas, la presencia de factores desencadenantes y concurrentes de las diversas patologías fisiológicas e histológicas bucales. En el siguiente trabajo, se presenta un compendio de las anomalías y síndromes con implicaciones dentales más relevantes, ahondando desde lo etiológico y característico con su respectiva ejemplificación clínica y radiográfica.

Fluoride in drinking water has a profound effect on teeth and bones. Up to a small level (1–1.5 mg/L) this strengthens the enamel. Concentrations in the range of 1.5–4 mg/L result in dental fluorosis whereas with prolonged exposure at still higher fluoride concentrations (4–10 mg/L) dental fluorosis progresses to skeletal fluorosis. High fluoride concentrations in groundwater, up to more than 30 mg/L, occur widely, in many parts of the world. This review article is aimed at providing precise information on efforts made by various researchers in the field of fluoride removal for drinking water. The fluoride removal has been broadly divided in two sections dealing with membrane and adsorption techniques. Under the membrane techniques reverse osmosis, nanofiltration, dialysis and electro-dialysis have been discussed. Adsorption, which is a conventional technique, deals with adsorbents such as: alumina/aluminium based materials, clays and soils, calcium based minerals, synthetic compounds and carbon based materials. Studies on fluoride removal from aqueous solutions using various reversed zeolites, modified zeolites and ion exchange resins based on cross-linked polystyrene are reviewed. During the last few years, layered double oxides have been of interest as adsorbents for fluoride removal. Such recent developments have been briefly discussed.

Developmental defects of the human dentition are not uncommon and can adversely affect the physical and psychological health of children. This paper reviews briefly the most common dental defects that can occur during childhood and discusses in more detail defects of enamel and dentine. Guidelines are provided for clinicians to identify children who deviate from normal dental development in order to provide appropriate interventions or make appropriate referrals.

Fluoride is commonly and widely used to prevent and even arrest caries. The clinical effects of fluorides depend on the chemical compounds utilized and the methods used to apply the fluoride ion to the surface of the tooth. Fluorosis has been reported in conjunction with increased doses of fluoride. A coordinated approach to fluoride delivery is essential to avoid the risk of fluorosis.

Dental fluorosis manifests itself as white stains on the enamel of teeth exposed to excessive doses of fluoride during their formation. Fluorosis usually occurs as a result of the ingestion of dentifrices, gels and fluoridated solutions. It may be diagnosed as mild, moderate or severe, and in some cases, it may cause the loss of the surface structure of dental enamel. The aim of this study was to report the clinical case of a female patient of 18 years with moderate fluorosis, whose smile was reestablished by the use of an enamel microabrasion technique, followed by in-office bleaching. A microabrasion technique with 6% hydrochloric acid associated with silica carbide showed to be a safe and efficient method for removing white fluorosis stains, while dental bleaching was useful for obtaining a uniform tooth shade. The association of these techniques presented excellent results and the patient was satisfied. Both techniques are painless, fast and easy to perform, in addition to prese...

Resumo:A relação entre ambiente e saúde humana é uma temática que tem exigido o envolvimento de diferentes ramos científicos. Nessa perspectiva, estudos que avaliam a distribuição de elementos químicos no ambiente são de grande relevância, dado a correlação entre padrões anormais e efeitos à saúde. Com o intuito de identificar padrões de distribuição dos elementos químicos no Paraná, Licht (2001) realizou um levantamento geoquímico nos hidrossistemas superficiais e subterrâneos do estado. Dentre outros resultados, assinalou, no nordeste paranaense, um desvio dos padrões geoquímicos regionais – 0,16 mg/L, obtidos por meio do cálculo de background. Ademais, estudos epidemiológicos locais assinalaram a ocorrência de fluorose dentária, patologia associada ao consumo de flúor. Visando identificar com maior precisão a extensão espacial desta anomalia, e avançar na avaliação dos impactos à saúde local, foram coletadas 211 amostras de água superficial, in natura, em cinco mananciais de abastecimento público: Rio das Cinzas, Itararé, Tibagi, Paranapanema I e II. Análises químicas laboratoriais, destas amostras, foram realizadas no departamento de Química da Universidade Estadual de Londrina. Para a região, foram elaborados mapas hidrogeoquímicos, por meio método de interpolação Inverse Distance Weighted. Considerando que o Ministério da Saúde (1974) alerta para a necessidade de observância das variações climáticas locais, na presente pesquisa adotou-se como valor médio recomendado – VMR concentrações de flúor entre a faixa de 0,6 mg/L e 0,8 mg/L. O consumo de teores abaixo do VMR são considerados insuficientes na prevenção da cárie dental, por outro lado concentrações acima podem ocasionar a fluorose dentária. A análise dos mapas hidrogeoquímicos permitiu assinalar concentrações de flúor acima do VMR em três amostras. As quais estão situadas localmente em cursos d’água da bacia hidrográfica do Rio das Cinzas, respectivamente nos municípios de Santo Antônio da Platina, no qual obteve-se teores de 1,10 e 1,19 mg/L; e Ribeirão do Pinhal, de 1,15 mg/L. Ao contrário dos padrões hidrogeoquímicos assinalados por Licht (2001), as anomalias identificadas são pontuais, destoando da configuração local. No intento de buscar correlações entre a distribuição espacial dos teores de flúor e efeitos à saúde no contexto investigado, consultou-se, no banco de dados do DATASUS, dados de morbidade hospitalar, nos últimos cinco anos. Considerando a ausência de informações de fluorose dentária no referido banco de dados, realizou-se entrevistas informais com dentistas e odontopediatras nos municípios de Santo Antônio da Platina e Ribeirão do Pinhal. Os resultados obtidos não ensejaram definir quaisquer correlações positivas, mas possibilitaram a articulação de hipóteses. Contudo, é nítida a geração de um “cinturão” alinhavado pela sequência de picos das anomalias de flúor, que coincidem com as bordas de ocorrência das rochas vulcânicas da Formação Serra Geral, as quais por sua vez alojam o Aquífero Serra Geral.

Abstract: The relationship between the environment and human health it’s a theme that has required the involvement of different scientific branches. In that perspective, studies evaluating the environment distribution of chemical elements have great relevance, due to the correlation between abnormal standards and its effect to human health. Litch (2001) conducted a geochemical research on Parana state superficial and undergrounded hydro systems, seeking to identify distribution standards of the chemical elements. Among other results, he pointed out a deviation from the regional geochemistry standard of 0.16 mg/L, obtained by background calculations. Furthermore, local epidemiological studies pointed out the occurrence of dental fluorosis, a fluoride consumption associated pathology. Aiming to identify the space extension of this anomaly with greater accuracy and due to go further with the evaluation of its impact on the local health, 221 samples were collected from surface water, on five public supply fountains, on the rivers: Das Cinzas, Itararé, Tibagi, Paranapanema I e II. The chemical laboratory analyses of this samples, where conducted on the Chemistry department of the State University of Londrina. Hydro geochemistry maps were elaborated for the region, using the Arcgis 9.0 software. Aiming to establish the fluoride RAV of the investigated context, it was considered its effect on the mouth health. Considering the warning of Brazil Health Department (1974) to observe the variations on the local weather, the research considered as average recommended value – ARV fluoride concentrations of 0.6 mg/L to 0.8 mg/L. The ingestion of levels under the ARV are considered as insufficient to dental caries prevention, on the other hand concentrations above the ARV can lead to dental fluorosis. Those are located in watercourses on the hydrographic basin on the river das Cinzas, respectively on the cities of Santo Antônio da Platina, in which afforded 1.10 e 1.19 mg/L levels of fluoride; and Ribeirão do Pinhal with a 1.15 mg/L level. The identified anomalies are punctual, on the contrary of the hydro geochemistry standards pointed out by Licht (2001). Aiming to seek correlations between the space distribution of fluoride and health effects on the investigated context, it was consulted the morbidity data of the last five years on the DATASUS databank. Due to the absence on the databank of teeth fluorosis information, informal interviews were conducted on Santo Antônio da Platina e Ribeirão do Pinhal cities, with dentists. The obtained results didn’t allowed any positive correlation to be defined, but it allowed to articulate some hypothesis. However, it was clear the generation of a “belt” due to some peaks of fluoride anomalies, matching with the edge occurrence of the volcanic rocks of the Serra Geral Formation, witch on the other hand hosts the Serra Geral Aquifer.

Dental fluorosis is a developmental disturbance of dental enamel, caused by successive exposures to high concentrations of fluoride during tooth development, leading to enamel with lower mineral content and increased porosity. The severity of dental fluorosis depends on when and for how long the overexposure to fluoride occurs, the individual response, weight, degree of physical activity, nutritional factors and bone growth. The risk period for esthetic changes in permanent teeth is between 20 and 30 months of age. The recommended level for daily fluoride intake is 0.05 - 0.07 mg F/Kg/day, which is considered of great help in preventing dental caries, acting in remineralization. A daily intake above this safe level leads to an increased risk of dental fluorosis. Currently recommended procedures for diagnosis of fluorosis should discriminate between symmetrical and asymmetrical and/or discrete patterns of opaque defects. Fluorosis can be prevented by having an adequate knowledge of t...

To date, no continuous scale exists for measuring the severity of dental fluorosis (DF). Objectives. The authors developed and validated a visual analog scale (VAS) for DF. They tested the scale in clinical (DFendemic area) and laboratory settings. Methods. Dentists and nondentists (23 per group) were asked to grade the DF severity in photographs of 23 anterior teeth with different DF levels (using a 100millimeter VAS) to create a VAS for DF. Statistical analysis was performed to validate the new scale. The authors used clinical and laboratory (unerupted third molars) analyses to assess the usefulness of the VAS. Results. The authors used an intraclass correlation coefficient (ICC) to assess the interexaminer (ICC = .79: good agreement) and intraexaminer (.88 < ICC < .97: excellent agreement) reliability during creation of the scale. They used the Spearman rank correlation (r s ) to validate the VAS against the gold standards (that is, the Thylstrup-Fejerskov index [TFI] and Dean's index [DI]) (the results showed excellent or good correlation for 45 examiners). Two dentist examiners clinically tested the new VAS, and the results showed excellent (r s = .922, P < .001) correlation and excellent ICC between the examiners (ICC = .96), as well as good ICC between the TFI and the VAS for DF (ICC = .6). The laboratory study showed better correlation between fluoride concentration and the VAS for DF than between fluoride concentration and the TFI. Conclusion. Because of its simplicity, precision and utility in statistical applications, the VAS for DF can be useful in DF studies.

This study was conducted to investigate the high incidence of mottled teeth among residents of an area with hot springs in the Choma District of the Southern Province of Zambia. A survey involving 128 pupils was conducted at a Basic School to collect data on pupil's backgrounds and their main sources of drinking water between birth and age 7. A dental specialist examined the pupils' teeth and samples of drinking water were collected from locations where the majority of the pupils lived. It was analysed for fluorides and other drinking water quality param-eters. Results of the survey showed a highly significant (P < 0.001) association between pupils' main sources of drinking water between birth and age 7 and the incidence of discoloured teeth. All (100%) pupils who drank water from hot springs before age 7 had moderate to severe fluorosis, while the majority (96.7%) of the pupils who drank water from other sources had no dental fluorosis. Fluoride concentrations ranged from 5.95 to 10.09 mg/l in water from hot springs, and from 0.03 to 0.6 mg/l in water from other sources. Fluoride levels in water from hot spring water samples exceeded the 1.5 mg/l WHO guideline value for drinking water, while those in water from other sources were significantly (P < 0.05) lower than this. We conclude that the high prevalence of mottled teeth among residents of the study area is a case of endemic dental fluorosis associated with drinking water from hot springs containing high concentrations of fluoride.

Background: Although the predominant beneficial effect of fluoride occurs locally in the mouth, the adverse effect, dental fluorosis, occurs by the systemic route. The caries attack rate in industrializedcountries, including the Unitedstates and Canada, has decreased dramatically over the past 40 years. However, the prevalence of dental fluorosis in the United States has increased during the last 30 years both in communities with fluoridated water and in communities with nonfluoridated water. Dental fluorosis is closely associated with fluoride intake during the period of tooth development. Methods: We reviewed the major changes in infant feeding practices that have occurred since 1930 and the changes in fluoride intakes by infants and young children associated with changes in feeding practices. Results and Conclusions: Based on this review, we conclude that fluoride intakes of infants and children have shown a rather steady increase since 1930, are likely to continue to increase, and will be associated with further increase in the prevalence of enamel fluorosis unless intervention measures are instituted. Recommendations: We believe the most important measures that should be undertaken are ( I ) use, when feasible, of water low in fluoride for dilution of infant formulas; (2) adult supervision of toothbrushing by children younger than 5 years of age; and (3) changes in recommendations for administration of fluoride supplements so that such supplements are not given to infants and more stringent criteria are applied for administration to children.

Purpose: To investigate the contribution of different sources of fluoride related to dental fluorosis. Methods: This population-based, matched, case-control study (67 pairs) used a representative sample of 271 schoolchildren. Dental fluorosis was measured using Dean's index. Children's caregivers were interviewed about nine risk factors. Data were analyzed using conditional logistic regression. Results: The prevalence of questionable cases was 18.8 percent, and the prevalence of very mild, mild, or moderate cases of dental fluorosis was 11.5 percent, with no severe case. Age of start of toothbrushing, drinking water from wells, frequency of toothbrushing, type of tooth-paste, standard/ children's mouthrinse usage, and fluoride supplements were not significant (P>0.15). Drinking water from wells and using supplements were underpowered (N less than six). Children who frequently ate toothpaste had an odds ratio of 5.56 (95% confidence interval (CI) 1.75 to 17.73) times more fluorosis; those applying toothpaste to cover the bristles had 5.55 times more fluorosis (95% CI 1.44 to 21.42); and those using an adult size toothbrush had 3.17 times more flurosis (95% CI 1.15 to 8.71). There was a significant additive interaction (P<0.01). Conclusion: In a community with water fluoridation, the factors associated with dental fluorosis are intentional toothpaste ingestion and tooth-paste applied on the whole toothbrush.
(Pediatr Dent 2016;38(3):)

The purpose of this study was to assess the fluoride content of Ceylon Tea, which is a popular beverage throughout the world. The fluoride content of tea infusions prepared from different grades of tea leaves collected from different parts of the tea-growing regions (25 samples) of Sri Lanka was measured using a fluoride-selective electrode. Fluoride leaching was found to vary from 0.32 to 1.69 mg F/l, but there were no significant differences in terms of fluoride leaching between tea from different tea-growing regions or between tea of different grades. Dental fluorosis is widespread throughout the dry zone of Sri Lanka, and drinking water has traditionally been considered to be the main contributory factor to the development of fluorosis. However, diet, the consumption of tea in particular, may also contribute to the manifestation of dental diseases.

Integrantes : JAQUELYN GRACIELA ALARCON RAMIREZ AR04064 ROLANDO ROBERTO AGUILAR MARROQUIN AM05060 ANGEL MARCELO CANALES REYES CR05098 NORA ALICIA RODRIGUEZ GUARDADO RG05066 GABRIEL ENRIQUE RAMIREZ MENJIVAR RM05024 Ciudad Universitaria, 23 de Septiembre de 2009 NORma iso 27000 SISTEMAS DE GESTION DE SEGURIDAD INFORMATICA NORma iso 27000 SISTEMAS DE GESTION DE SEGURIDAD INFORMATICA i OBJETIVOS

Objective: This paper reports findings for dental caries and dental fluorosis in 8-1 0-and 13-1 6-year-old schoolchildren who were lifelong residents of communities having either naturally occurring low (Broken Bow and Holdrege, NE; <0.3 ppm) or optimal (Kewanee, IL; 1 ppm) levels of fluoride in drinking water. Methods: Findings are reported for participants who received both dental caries and dental fluorosis examinations (n=495). The DMFS and TSlF indices, respectively, were used to assess dental caries and dental fluorosis. Results: The mean DMFS score adjusted for age, sealantpresence, and fluoride use was significantly lower in Kewanee (1.8) than was the adjusted mean caries score in either Holdrege (2.9) or Broken Bow (3.6). Adjusted mean DMFS scores in Broken Bow and Holdrege were not statistically different. The mean percent of fluorosed tooth surfaces per person, acijusted for age and use of dietary fluoride supplements, was similar in the three communities (approximately 15%); more than 80 percent of tooth surfaces in all participants were fluorosis-free. Conclusions: Findings from the present study suggest that water fluoridation still is beneficial and that dental sealants can play a significant role in preventing dental caries. In addition, findings from this survey appear to support the premise that the difference in dental fluorosis prevalence between fluoridated and nonfluoridated communities has narrowed considerably in recent years. [J Public Health Dent 1998;58(1):28-351 .gov. Ms. Nowjack-Raper and Drs. Kingman, and Driscoll (retired) are affiliated with the NIDR. Findings from this study were reported previously at the 24th Annual Meeting of the American Association for Dental Research, San Antonio, TX, March 1995. Manuscript received 6/10/96; returned to authors for revision: 8/23/96; accepted for publication: 7/1/97.

Background. This article presents evidence-based clinical recommendations for the prescription of dietary fluoride supplements. The recommendations were developed by an expert panel convened by the American Dental Association (ADA) Council on Scientific Affairs (CSA). The panel addressed the following questions: when and for whom should fluoride supplements be prescribed, and what should be the recommended dosage schedule for dietary fluoride supplements? Types of Studies Reviewed. A panel of experts convened by the ADA CSA, in collaboration with staff of the ADA Center for Evidencebased Dentistry, conducted a MEDLINE search to identify publications that addressed the research questions: systematic reviews as well as clinical studies published since the systematic reviews were conducted (June 1, 2006). Results. The panel concluded that dietary fluoride supplements should be prescribed only for children who are at high risk of developing caries and whose primary source of drinking water is deficient in fluoride. Clinical Implications. These recommendations are a resource for practitioners to consider in the clinical decision-making process. As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences. Providers should carefully monitor the patient's adherence to the fluoride dosing schedule to maximize the potential therapeutic benefit.

Abstract– The purpose of this comparative study of caries and dental fluorosis experience in Chilean children was to estimate the optimal range of fluoride concentration in tap water under conditions currently prevailing in Chile. The sample included 2431 schoolchildren 7, 12 and 15 years old, life-long residents of five communities with fluoride concentrations in their tap water in the range 0.07–1.1 mg/L. The study population received an oral clinical examination including caries experience and an enamel fluorosis evaluation of the permanent dentition (Dean's scoring system). For 15-year-old children, the DMFT index changed from 5.06 to 2.60, and for 12-year-olds it changed from 3.10 to 1.36 when fluoride water concentration changed from 0.07 to 1.10 mg/L. For 7-year-old children the dmft index correspondingly changed from 3.67 to 1.59. The relationship between DMFT for 12-year-olds and water fluoride concentration was best fitted by a logarithmic function (r2=0.98). The Community Fluorosis Index (CFI) was used to assess enamel fluorosis in the study population, and it showed a linear relationship (r2=0.983) with increasing fluoride concentration of water for the 12-year-old group. Results obtained suggest that under current Chilean conditions, the optimal range of fluoride concentration in potable water should lie in the 0.5–0.6 mg/L range.

Bongo district in the Upper East Region of Ghana is noted for the high concentration of fluoride in its underground water bodies of which the people depend so much on to meet their drinking needs. As a result of this, majority of the people in the most endemic areas suffer from dental fluorosis, a problem that greatly affects their confidence when they move out of the district to other places. In finding a sustainable and cost effective solution to reducing the fluoride content of their underground waters before being used, a solar water distillation unit was built using local materials from Anaafobiisi. Results from test conducted on the purified water from the solar distiller showed a significant reduction in the levels of fluoride in the water. From an initial concentration of 20.6 mg/l of fluoride in the water from a local borehole, this was reduced to an average of about 0.7 mg/l which is below the WHO acceptable limit for fluoride in drinking water when the solar distillation unit was used to purify it. The solar distillation unit when installed as a decentralised system is an effective means of reducing the high fluoride contamination making the water safe for drinking.

Introducción y Objetivo: La caries dental y la fluorosis dental son problemas de Salud Pública que requieren sistemas de vigilancia y control en edades tempranas. El objetivo fue determinar la prevalencia de fluorosis dental en escolares de 12 años, y la historia de caries en escolares de 5 y 12 años en la Institución Educativa Luis Eduardo Díaz del área urbana del Municipio de Yondó (Antioquia) durante el año 2010. Materiales y Métodos: Estudio transversal en una población de 62 escolares de 5 años y 145 de 12 años. Se realizó examen clínico y se estableció la experiencia de caries dental (índices ceo-d; 5 años, COP-D; 12 años) y la prevalencia de fluorosis dental (Índice de Dean). Se calcularon frecuencias, medianas y promedios por sexo en el caso de caries dental y prevalencia de fluorosis global y por grados de severidad. Cálculo de razones de prevalencia de fluorosis por sexo con sus intervalos de confianza al 95% (RP, IC95%). Se analizaron las principales fuentes de agua del área de estudio. Resultados: El promedio ceo-d a los 5 años fue de 2,37 ±3,39, con experiencia de caries del 61%. A los 12 años se encontró un promedio COP-D de 0,73 ±1,28, y una experiencia de caries del 33,1%. No se encontraron diferencias estadísticamente significativas por sexo. La prevalencia global de fluorosis fue de 97,9%, con mayor prevalencia en hombres, aunque sin diferencias significativas (RP 1,05, IC95% 0,. El análisis fisicoquímico no mostró niveles altos de concentración de flúor en agua. Conclusión: Se encontraron niveles altos de experiencia de caries dental a los 5 años y alta prevalencia de Fluorosis a los 12 años que exigen acciones de mejoramiento y estrategias en salud pública para esta población. Palabras clave: Fluorosis dental, Caries dental, ĺndice dean, Flúor, Población escolar, ceo-d, COP-D. Rev.CES Odont.2011;24(1)9-16 Prevalence of Fluorosis and dental caries experience in a school age group in the urban area of the Municipality of Yondó (Antioquia, Colombia), 2010 Abstract Introduction and Objetive: Dental caries and dental Fluorosis are public health problems, which require surveillance and control systems in primary ages. We aim to determine the prevalence of dental Fluorosis in school children age 12 and the caries experience of school children between 5 and 12 years old at the Institution "Luis Eduardo Diaz", located in the urban area of the Municipality of Yondó (Antioquia, Colombia), during 2010. Materials and Methods: A cross-sectional study was conducted in 62 scholars of 5 years and 145 scholars of 12 years. Clinical examinations were carried out and the caries dental experience was established (DMFT and dmf indexes) and the prevalence of dental Fluorosis (Dean's index). Prevalence, mean and median and for sex were estimated in case of dental caries and the global prevalence of Fluorosis and taking into account severity groups and sex. We calculate the prevalence ratio for sex and the 95% confidence intervals (PR, 95% CI). The main water sources of the study area were analyzed. Results: Mean dmf for 5 years was 2,37(±3,39) and the dental experience was 61%. At 12 years a DMTF mean was 0,73 (±1,28) and the dental experience was 33,1%. No statistical significance was found for sex. The global prevalence of Fluorosis was of 97,9%, the frequency was higher in males but the differences do not have statistical significance (RP 1z5, 95%CI 0,. The physicochemical analysis did not show high levels of fluoride concentrations in water. Conclusion: Higher levels of dental caries in case of scholars of 5 years dental Fluorosis for scholars of 12 years were found. Improvement actions and public health strategies are required for these populations.

Enamel white spots appear on natural teeth in various degrees of demineralization, opacity, and characteristic patterns that may be an esthetic problem for some patients. Research indicates that at least one enamel white spot is expected to occur for 73% of patients undergoing orthodontic treatment. 2 Often, treatment for white-spot lesions is approached like other forms of smooth surface caries using high concentrations of fluoride (greater than or equal to 5,000 ppm) to induce a rapid remineralization of the superficial enamel. The rapid remineralization of superficial enamel can impede the remineralization of the deeper layer of the lesions resulting in white-spot scars or enamel opacities that will not return to the natural opalescence of sound enamel.

Chocolate bars and chocolate cookies are foodstuffs highly appreciated by children. The possibility of having fluorine (F) among their components, associated with an excessive consumption, may make them decisive contributors to the total daily F intake. Thus, they could participate in the establishment of dental fluorosis. The aim of this study was to analyze the fluorine concentration [F] of the chocolates bars (CB) Baton, Confeti, Garoto Ball, Kinder Ovo, M&M's, Milkybar, Nescau, Nescau Ball, Surpresa, Surpresa Bichos, Tortuguita; and of the chocolate cookies (CC) Danyt's, Hipopó, Nescau, Passatempo, Pokémon, Sítio do Pica-Pau Amarelo and Trakinas. Samples were purchased in Bauru, São Paulo, Brazil. Three grams of each product were previously ashed at 525°C (CB and cookies fillings) and at 550°C (cookies dough), during 4 hours. Fluorine was separated from the ash by hexamethyldisiloxane (HMDS)-facilitated diffusion. Fluorine analysis was carried out with the specific electrode. Mean [F]s ± SD and amplitude (unit mg/g) were: CB = 0.30 ± 0.45 (0.07 -1.60, n = 12) and CC = 1.08 ± 2.64 (0.04 -7.10, n = 7). It was concluded that some of the analyzed foods may be important contributors to the total daily F intake. As for the product that had the highest [F] (Danyt's), when only 3 units are consumed just once a day, they may supply up to 40% of the maximum recommended daily F intake (0.07 mg/kg body weight) for a 2-year-old child (12 kg). The [F] in these products should be informed on their labels. DESCRIPTORS: Chocolate; Fluorine; Fluorosis, dental; Child.

Recently, mostly as a result of drinking water fluoridation, the number of young patients affected by fluorosis increased considerably. This study describes a minimally invasive technique, using in-office dental bleaching (35% hydrogen peroxide) and enamel microabrasion (silicon carbide and 12% hydrochloric acid) to eliminate fluorosis like stains. The association of techniques was efficient and can be recommended as a good conservative alternative for the treatment of fluorosis affected teeth.

In Northern Thailand, incidences of fluorosis resulting from the consumption of high-fluoride drinking-water
have been documented. In this study, we mapped the high-fluoride endemic areas and described the relevant
transport processes of fluoride in enriched waters in the provinces of Chiang Mai and Lamphun. Over one thousand
surface and sub-surface water samples including a total of 995 collected from shallow (depth: ≤30 m) and
deep (N30 m) wells were analysed from two unconnected high-fluoride endemic areas. At the Chiang Mai site,
31% of the shallow wells contained hazardous levels (≥1.5 mg/L) of fluoride, compared with the 18% observed
in the deep wells. However, at the Lamphun site, more deep wells (35%) contained water with at least
1.5 mg/L fluoride compared with the shallow wells (7%). At the Chiang Mai site, the high-fluoride waters originate
from a nearby geothermal field. Fluoride-rich geothermal waters are distributed across the area following
natural hydrological pathways of surface and sub-surface water flow. At the Lamphun site, a well-defined, curvilinear
high-fluoride anomalous zone, resembling that of the nearby conspicuous Mae Tha Fault, was identified.
This similarity provides evidence of the existence of an unmapped, blind fault as well as its likely association to
a geogenic source (biotite-granite) of fluoride related to the faulted zone. Excessive abstraction of ground
water resources may also have affected the distribution and concentration of fluoride at both sites. The distribution
of these high-fluoride waters is influenced by a myriad of complex natural and anthropogenic processes
which thus created a challenge for the management of water resources for safe consumption in affected areas.
The notion of clean and safe drinking water can be found in deeper aquifers is not necessarily true. Groundwater
at any depth should always be tested before the construction of wells.

To contrast the sensitivity, specificity, and positive–negative predictive values between dental fluorosis prevalence scored on 28 (DF28) and on six permanent teeth (DF6), we undertook a cross-sectional study on 1,538 adolescents (12 and 15 years old) residing in Hidalgo State, Mexico, a naturally fluoridated (>0.7 ppm) area at an elevated altitude (>2,500 m above sea level). Dental fluorosis was scored using Deans modified index. Using the scores obtained for all teeth present (DF28) as a gold standard, we calculated the sensitivity, specificity, positive–negative predictive values, and receiver operating characteristic and concordance index pertaining to the scores based on six teeth (upper incisors and canines). DF28 fluorosis prevalence was 81.7%; based on DF6, it was 58.7% (23% difference). Among 12 year olds, the difference between DF28 and DF6 was 20.1% (84.5 vs. 64.4%); among 15 year olds, it was 25.4% (79.4 vs. 54%). Among girls, it was 23.2% (81.1 vs. 57.9%) and among boys, 22.8% (82.2 vs. 59.4%). The fluorosis community indices were 1.75 (DF28) and 1.11 (DF6). All positive predictive values reached 100% while negative predictive values were below 45%. Concordance between DF28 and DF6 was 53.9%, and kappa coefficient was 0.40. Partial scoring of fluorosis based on esthetically important permanent teeth underestimated prevalence, compared to full-mouth scoring. The decision to use an abridged Dean’s index protocol must take into account the number of teeth examined, and which specific teeth are examined, to appraise the benefit of reduced data collection effort against possible information loss.