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Enlightening Diagnosis and Differential Diagnosis of Dental Fluorosis—A Hidden Entity in a Crowd
Aim To provide diagnosis as well as differential diagnosis of dental fluorosis.
Background Dental fluorosis is a developmental defect of enamel, due to consecutive exposures of tooth during the formative stage of development to the higher concentration of fluoride, resulting in enamel with lesser mineral content and enhanced porosity. Several epidemiological indices have been utilized for diagnosis and assessment of dental fluorosis on the basis of clinical appearance. Fluorosis of the deciduous teeth occurs less commonly and is milder than that of permanent teeth.
Highlights The diagnostic difficulties are usually associated between fluorotic and nonfluoride opacities. A complete history of the clinical condition, teeth affected with specific areas, pattern of lesion, color and its method of detection are the few important diagnostic criteria for differentiating dental fluorosis from nonfluoride discolorations of the teeth.
Conclusion This review article has enlightened the diagnosis and differential diagnosis of dental fluorosis among various nonfluoride tooth discolorations. A correct diagnosis results in an appropriate and early management of dental fluorosis and plays an important role in oral epidemiology and public health.
18 March 2021 (online)
© 2021. Bhojia Dental College and Hospital affiliated to Himachal Pradesh University. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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- 1 Sinha S, Vorse KK, Noorani H, Kumaraswamy SP, Varma S, Surappaneni H. Microabrasion using 18% hydrochloric acid and 37% phosphoric acid in various degrees of fluorosis - an in vivo comparision. Eur J Esthet Dent 2013; 8 (03) 454-465
- 2 Soto-Rojas AE, Martínez-Mier EA, Ureña-Cirett J, Jackson RD, Stookey GK. Development of a standardisation device for photographic assessment of dental fluorosis in field studies. Oral Health Prev Dent 2008; 6 (01) 29-36
- 3 Alvarez JA. Dental fluorosis: exposure, prevention and management. J Clin Exp Dent 2009; 1: 14-18
- 4 Ritter AV. Ritter. Talking with patients. Dental Fluorosis. J Esthet Restor Dent 2005; 17: 326-327
- 5 Fejerskov O, Ekstrand J, Burt BA. Fluoride in Dentistry. 2nd ed. Copenhagen: Munksgaard 1996: 42–46,132–34
- 6 Cutress TW, Suckling GW. Differential diagnosis of dental fluorosis. J Dent Res 1990; 69 (Spec No) 714-720
- 7 Thylstrup A. Distribution of dental fluorosis in the primary dentition. Community Dent Oral Epidemiol 1978; 6 (06) 329-337
- 8 Fejerskov O, Thylstrup A, Larsen MJ. Clinical and structural features and possible pathogenic mechanisms of dental fluorosis. Scand J Dent Res 1977; 85 (07) 510-534
- 9 Murray JJ, Rugg-Gunn AJ. Fluorides in Caries Prevention. 3rd ed. Mumbai: Varghese Publishing 1999: 262–65
- 10 Mabelya L, van ’t Hof MA, König KG, van Palenstein Helderman WH. Comparison of two indices of dental fluorosis in low, moderate and high fluorosis Tanzanian populations. Community Dent Oral Epidemiol 1994; 22 (06) 415-420
- 11 Rozier RG. Epidemiologic indices for measuring the clinical manifestations of dental fluorosis: overview and critique. Adv Dent Res 1994; 8 (01) 39-55
- 12 Thylstrup A, Fejerskov O. Clinical appearance of dental fluorosis in permanent teeth in relation to histologic changes. Community Dent Oral Epidemiol 1978; 6 (06) 315-328
- 13 Horowitz HS, Driscoll WS, Meyers RJ, Heifetz SB, Kingman A. A new method for assessing the prevalence of dental fluorosis–the Tooth Surface Index of Fluorosis. J Am Dent Assoc 1984; 109 (01) 37-41
- 14 Granath L, Widenheim J, Birkhed D. Diagnosis of mild enamel fluorosis in permanent maxillary incisors using two scoring systems. Community Dent Oral Epidemiol 1985; 13 (05) 273-276
- 15 Horowitz HS. Indexes for measuring dental fluorosis. J Public Health Dent 1986; 46 (04) 179-183
- 16 Burger P, Cleaton-Jones P, du Plessis J, de Vries J. Comparison of two fluorosis indices in the primary dentition of Tswana children. Community Dent Oral Epidemiol 1987; 15 (02) 95-97
- 17 Clark DC, Hann HJ, Williamson MF, Berkowitz J. Aesthetic concerns of children and parents in relation to different classifications of the Tooth Surface Index of Fluorosis. Community Dent Oral Epidemiol 1993; 21 (06) 360-364
- 18 van Palenstein Helderman WH, Mabelya L, van’t Hof MA, König KG. Two types of intraoral distribution of fluorotic enamel. Community Dent Oral Epidemiol 1997; 25 (03) 251-255
- 19 Anya. Vieira PGF, Lawrence HP, Limeback H, Sampaio FC, Grynpas M. A visual analogue scale for measuring dental fluorosis severity. J Am Dent Assoc 2005; 136: 895-901
- 20 Martins CC, Chalub L, Lima-Arsati YB, Pordeus IA, Paiva SM. Agreement in the diagnosis of dental fluorosis in central incisors performed by a standardized photographic method and clinical examination. Cad Saude Publica 2009; 25 (05) 1017-1024
- 21 Adelário AK, Vilas-Novas LF, Castilho LS, Vargas AM, Ferreira EF, Abreu MH. Accuracy of the simplified Thylstrup & Fejerskov index in rural communities with endemic fluorosis. Int J Environ Res Public Health 2010; 7 (03) 927-937
- 22 Mohamed AR, Thomson WM, Mackay TD. An epidemiological comparison of Dean’s index and the Developmental Defects of Enamel (DDE) index. J Public Health Dent 2010; 70 (04) 344-347
- 23 Pretty IA, McGrady M, Zakian C. et al. Quantitative light fluorescence (QLF) and polarized white light (PWL) assessments of dental fluorosis in an epidemiological setting. BMC Public Health 2012; 12: 366
- 24 Sudhir KM, Suresh S, Prashant GM, Reddy VV, Shafiulla M, Chandu GN. Distribution patterns of enamel fluorosis in permanent dentition. Oral Health Prev Dent 2012; 10 (02) 167-174
- 25 McGrady MG, Ellwood RP, Taylor A. et al. Evaluating the use of fluorescent imaging for the quantification of dental fluorosis. BMC Oral Health 2012; 12: 47
- 26 Sabokseir A, Golkari A, Sheiham A. Distinguishing between enamel fluorosis and other enamel defects in permanent teeth of children. PeerJ 2016; 4: e1745
- 27 Neville B, Damm DD, Allen C, Chi A. Oral and Maxillofacial Pathology. 1st South Asia ed. New Delhi: Elsevier 2015: 49–105
- 28 Shafer H. Levy: Textbook of Oral Pathology. 7th ed. New Delhi: Elsevier 2012: 50–58
- 29 Allazzam SM, Alaki SM, El Meligy OA. Molar incisor hypomineralization, prevalence, and etiology. Int J Dent 2014; 2014: 234508
- 30 Marin PD, Bartold PM, Heithersay GS. Tooth discoloration by blood: an in vitro histochemical study. Endod Dent Traumatol 1997; 13 (03) 132-138
- 31 Satyanarayan U, Chakrapani U. Biochemistry. 4th ed. New Delhi: Elsevier 2013: 352–53
- 32 Tandon S. Textbook of Pedodontics. Vol. 1. 3rd ed. Hyderabad: Paras Medical Publisher 2018: 335,338
- 33 Pourghadiri M, Longhurst P, Watson TF. A new technique for the controlled removal of mottled enamel: measurement of enamel loss. Br Dent J 1998; 184 (05) 239-241