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. 2017 Sep-Dec;21(3):345-350.
doi: 10.4103/jomfp.JOMFP_247_16.

The effect of fluorosis on human teeth under light microscopy: A cross-sectional study

Maya Ramesh  1 , Malathi Narasimhan  2 , Ramesh Krishnan  3 , Rita Mary Aruna  4 , Sarah Kuruvilla  5
Affiliations

The effect of fluorosis on human teeth under light microscopy: A cross-sectional study

Maya Ramesh et al. J Oral Maxillofac Pathol. 2017 Sep-Dec.

Abstract

Background: Fluoride is needed for the normal development of bone and teeth; in high levels, it affects developing teeth and bone. Dental fluorosis (DF) is caused by ingestion of excess fluoride mainly through drinking water.

Aim: The present study aims to observe and understand the histological changes of fluorosed teeth under light microscope (LM).

Materials and methods: Teeth which were indicated for extractions for orthodontic or periodontal problems were selected. Thirty extracted teeth were selected with varying degrees of DF based on modified Dean's fluorosis index. Ground sections of these teeth were prepared and the sections were studied under binocular LM. Photomicrographs were taken under high power objective using 15 megapixels Nikon camera.

Results and conclusion: Qualitative histologic changes in different grades of fluorosed teeth were evaluated in enamel, dentin, cementum and between their junctions. Fluoride interacts with enamel in both mineral phases and organic macromolecules by strong ionic and hydrogen bonds resulting in incomplete crystal growth at prism peripheries. This presents as hypomineralization of enamel and dentin, increased interglobular dentin, increased secondary curvatures and changes in cementum such as diffuse cementodentinal junction and increased thickness of Tomes' granular layer. Changes in the structure of the teeth with Dean's index below 2 and teeth with Dean's index of 2 and above were compared using Chi-square test. P value was found to be highly significant being 0.00047. Many of the features of dental fluorosis seen in the present study under light microscope are comparable to those results studied under specialized microscopes.

Keywords: Dean's index; dental fluorosis; dentinoenamel junction; hole damage in enamel; hypomineralization; interglobular dentin; light microscopy; secondary curvatures.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Enamel showed thin areas which were white in the subsurface due to demineralization
Figure 2
Figure 2
Mild demineralisation in DEJ in cusp and disturbance in gnarled enamel pattern
Figure 3
Figure 3
Moderate Dental fluorosis - whiter areas becoming broader representing more areas of demineralization in deeper areas
Figure 4
Figure 4
Moderate demineralization near dentinoenamel junction
Figure 5
Figure 5
Severe dental fluorosis
Figure 6
Figure 6
Moderate and Severe with darker and broader incremental lines
Figure 7
Figure 7
Severe dental fluorosis with hole damage seen in enamel
Figure 8
Figure 8
Normal dentinal tubules
Figure 9
Figure 9
Irregular and curved dentinal tubules in Dental fluorosis
Figure 10
Figure 10
More interglobular dentin
Figure 11
Figure 11
Dental fluorosis with more dead tracts
Figure 12
Figure 12
Dental fluorosis with numerous secondary curvatures
Figure 13
Figure 13
Dental fluorosis with diffuse boundary between cementum and dentin
Figure 14
Figure 14
F Teeth – Wider Tom's Granular layer
Graph 1
Graph 1
Comparison of light microscopic changes in teeth structures
See this image and copyright information in PMC

References

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