Dental Fluorosis

Excerpt

Early accounts of a distinctive Colorado brown stain were paramount to discovering the link between excessive fluoride ingestion and developing a hypoplastic dentition that would later be termed dental fluorosis. Dental fluorosis is a common condition affecting both primary and secondary dentitions; however, the effects on secondary dentition are arguably more profound due to its permanency.

The element fluorine is found most abundantly in its fluoride form in nature. Certain geographical locations have relatively high naturally occurring fluoride concentrations in the water, for example, Pakistan, China, and India. Excessive fluoride intake is associated with the development of pathological conditions, the impact of which is contingent on when the exposure occurs, the length of exposure, and the concentration of fluoride involved. Several conditions may develop depending on the abovementioned factors, including dental fluorosis, skeletal fluorosis, and fluoride toxicity.

The most common route of fluoride ingestion is via drinking water. Alternative sources include plants, which similarly obtain fluorides through water uptake. Fluorides can also be inhaled. This occupational hazard is associated with mining and smelting metals, including aluminum. Equally, fluoride deficiency is associated with deleterious effects, most notably an increased vulnerability to dental caries.

The provision of systemic fluoride supplements, artificial water fluoridation, and the direct topical application of fluoride-containing dentifrices are preventative measures employed to reduce the risk of caries development. These measures can also inadvertently lead to excessive fluoride intake and potentially cause dental fluorosis. The prevalence of dental fluorosis has increased significantly in the US and is estimated to be 65% in those aged 12-15 years, with 30.4% of diagnoses being classed as moderate to severe.