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Fulltext Past Fluoride Exposure From Ingested Toothpaste Extrapolated From Younger Siblings And Fluorosis Status

Tan, B.S., Razak, I.A., Foo, L.C.

Ann Dent, 2004;11(1):-.
MyJurnal

The aim of the study was to assess the association between past fluoride exposures from ingested toothpaste and current fluorosis manifestations in 10- 11 year old index subjects. Fluorosis was assessed with the Dean’s Index in 1343 10-11 year old index subjects. Two hundred index subjects who had younger 4-5 year old siblings were sub sampled and fluoride exposures from ingested toothpaste in their younger siblings (proxy subjects) were determined. The values for the fluoride ingested per brushing of the proxy subjects were utilised together with past frequency of toothbrushing of index subjects to extrapolate on the past exposure of index subjects. The mean extrapolated past fluoride exposure from ingestion of toothpaste was highly variable; 671.7 ug ± 739.3 ug (sem= 56.9). It was higher in the subjects with fluorosis (697.3 ug) than in those without fluorosis (646.89 ug) but differences were not of statistical significance. This approach of extrapolation has not been reported elsewhere and need to be validated. The implications of the present methodology to estimate past fluoride exposure is discussed.

Matched MeSH terms: Fluoride Poisoning
Fulltext Blending the appearance of all-ceramic crowns in fluo-rosis condition with direct chair-side technique

Siti Mariam Ab Ghani, Ahmad Syahir Ahmad Zu Saifudin, Muhammad Aliff Ikram Noor Zari, Teh Adilla Mustaza

Compendium of Oral Science, 2015;2(1):47-51.
MyJurnal

Dental fluorosis incidence had been reported to be affecting children widely, especially in water-fluoridated ar-ea. As these children grow into young adults, perceived aesthetic problems arise mainly due to their concern with generalized mottled and stained teeth appearance. Fixed prosthodontics treatment involving single anterior tooth in patients with generalized fluorosis condition had been found challenging due to aesthetic restorability to blend with fluorosis condition. Clinical considerations: A simplified procedural direct chair-side technique of mimicking fluorosis condition onto anterior all-ceramic crowns are discussed in this paper. The mimicked fluoro-sis is reversible and has the opportunity to be adjusted according to the patient’s fluorosis condition thus hinder-ing the need to redo the crown in the future. Conclusions: The appearance of anterior all-ceramic crowns with direct chair-side staining technique provided blended and harmonized well with the dental fluorosis condition in both patients thus, giving natural looking smile.

Matched MeSH terms: Fluoride Poisoning
Fulltext Fluoride Level In Dentifrices

Abdul Kadir, R., Latifah Abdol Latif

Ann Dent, 1998;5(1):-.
MyJurnal

To date, fluorides has remained to be the best means of controlling dental caries. Fluoride is given either systematically via fluoridated water or topically through other supplements including toothpastes. In recent years increasing prevalence of enamel defects or fluorosis is observed in both populations receiving or not receiving water fluoridation. It is suspected that excessive ingestion of a "standard" 1000 to 1500 ppm fluoride from toothpastes might be a contributing factor to the presence of such defects. In Malaysia, reports of enamel defects occurring amongst 12 to 16 year-old schoolchildren ranged between 67 to 88 percent. Where water fluoridation is available, the amount of fluorides received from the home is between 0.3 to 0.5 ppm F. However, almost all toothpastes sold locally contains fluoride, the content of which is unknown to the consumers. This study reports on the analysis of fluoride levels carried out on 20 toothpaste samples sold locally. Results showed that fluoride levels in all 20 samples ranged between 20 to 1970 ppm F. Only two of the 20 samples analyzed, however, indicated having a level anywhere near the "standard" level. In addition, only two type~ of children's toothpaste with a fluoride concentration of 20 and 450 ppm F were commonly available as compared to adult toothpastes in all the samples studied.

Matched MeSH terms: Fluoride Poisoning
Fulltext The effect of fluorosis on human teeth under light microscopy: A cross-sectional study

Ramesh M, Narasimhan M, Krishnan R, Aruna RM, Kuruvilla S

J Oral Maxillofac Pathol, 2017 Sep-Dec;21(3):345-350.
PMID: 29391706 DOI: 10.4103/jomfp.JOMFP_247_16

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.

Matched MeSH terms: Fluoride Poisoning
Fulltext The prevalence of dental fluorosis and its associated factors in Salem district

Ramesh M, Narasimhan M, Krishnan R, Chalakkal P, Aruna RM, Kuruvilah S

Contemp Clin Dent, 2016 6 17;7(2):203-8.
PMID: 27307668 DOI: 10.4103/0976-237X.183061

CONTEXT: There are various regions in India that have high levels of fluoride in drinking water sources. Many people residing in such places suffer from dental fluorosis (DF).
AIMS: To evaluate the prevalence of DF in children residing in Salem and also to find any correlation between DF and other related factors.
MATERIALS AND METHODS: One school from each block of Salem (total 21 blocks) was selected for the study. A single examiner had evaluated untreated caries, lesions, and DF (for permanent anterior teeth and molars) using the Dean's fluorosis index, in all children. Water fluoride level determination at each school was done using the Tamil Nadu Water Fluoridation and Drainage Board field kit. Other factors that may have contributed to DF were assessed using a questionnaire, which was provided to each student. The data obtained were statistically analyzed using the SPSS software version 11.5.
STATISTICAL ANALYSIS: Chi-square test was used for statistical analysis.
RESULTS: DF was present in 56.9% of the children examined. It was mostly seen in 9 years old (72%) and male (59%) children. A positive correlation was found between the occurrence of DF and the duration of residence in a place with high water fluoride content, consumption of borewell water (64%), the parts per million of fluoride in drinking water, consumption of black tea (59%). However, no correlation was found between DF, dental caries, consumption of milk, or consumption of foods cooked in aluminum vessels.
CONCLUSION: There was a correlation between DF and factors such as male gender, bore well water consumption, black tea consumption and the duration of residence in a place with high water fluoride content.

Matched MeSH terms: Fluoride Poisoning
Fulltext Mothers’ knowledge of fluoride toothpaste usage by their preschool - children

Tay HL, Jaafar N

Malaysian Dental Journal, 2008;29(2):140-148.
MyJurnal

Background: Mothers play an important role in preventing fluorosis due to inadvertent swallowing of fluoridated toothpaste and enhancing the effectiveness of toothbrushing amongst preschool children through proper supervision.
Aim: To investigate the knowledge of mothers with regards to the benefits and risks of fluoride toothpaste usage among preschool children and to assess the level of parental supervision during toothbrushing. In additional, we wish to investigate the toothpaste purchasing behaviour of mothers in relation to brand, price, flavour, fluoride content and the influence of advertisement.
Methodology: Cross-sectional study of a representative random sample of 373 mothers of 5-6 year old preschool children through self-administered questionnaires.
Result: The response rate was 90.3% (337). The majority (61.7%) of the mothers reported that the amount of toothpaste their children used was half-length. Most mothers (70.6%) claimed they usually apply toothpaste for their child. About one-half (50.4%) reported the children applied the toothpaste themselves. Only 41.2% of the respondents supervised their children every time during toothbrushing. The mean age at which the child started brushing and using toothpaste was about 34 months (S.D. 14.9) and 37 months (S.D.14.8) respectively. Almost all (95.8%) reported that their children rinsed their mouth after toothbrushing. The mothers’ choice of toothpaste for their child was influence by brand (91.4%), flavour (91.4%) and fluoride content (84.6%) with price being the least of the factors. The majority of the respondents (82.7%) had average to good overall knowledge scores. There was significant association (P=0.034) between the level of education of the mothers and their level of knowledge on fluoride toothpaste usage.
Conclusion: Future oral health messages for preschool children and mothers in Perlis should target areas found lacking in terms of knowledge and practices with regards to fluoride toothpaste usage. This includes regular supervision of preschool children during toothbrushing by parents and using only a small amount of toothpaste for young children.

Matched MeSH terms: Fluoride Poisoning
Psychological impacts of dental fluorosis among malaysian school children

Mohd Nor, M., Sheiham, A., Tsakos, G.

Malaysian Dental Journal, 2008;29(1):20-24.
MyJurnal

The objectives were to assess the prevalence, severity, the psychological and social impacts of fluorosis among school children and their parents in the Kuala Pilah area, Negeri Sembilan, Malaysia. Methods: A convenience sample of 431 students aged 16-17 years old from 3 secondary schools in Kuala Pilah, Negeri Sembilan were selected. The students were assessed for presence of dental fluorosis using Dean’s Index and to assess impacts. Questionnaires were administered to all the dental fluorosis students and selected matched students with no fluorosis. They constituted a control group for the case control study. Questionnaires were sent to the parents of dental fluorosis and control non fluorosis cases. Results: The prevalence of dental fluorosis was 27.8%; 82% of the fluorosis cases were questionable to mild and 18% moderate to severe fluorosis. 16.1% of students with dental fluorosis and 8.5% of non-fluorosis students had psychological impacts. 12.8% of the parents of children with fluorosis reported that their child had an impact. More girls with fluorosis (35.7%) had psychological impacts compared than boys (25.0%). In the 16.1% of fluorosis cases who had psychological impacts, difficulty smiling and showing teeth, affected 35.7% of girls and 25 % of boys. The percentage of students with dental fluorosis who had psychological impacts on carrying out school work was 2.7%, and 3.6% had impacts related to going out with friends. Conclusions: There were considerable psychological impacts on smiling and showing teeth among Malaysian teenagers with dental fluorosis and some of their parents were concerned about the fluorosis. But the impacts were mild and do not have a major impact on students’ lives. Dental fluorosis is not aesthetically displeasing to most subjects but does have psychological and social impacts on a small percentage with fluorosis.

Matched MeSH terms: Fluoride Poisoning
Fulltext Dental Fluorosis And Caries Status Among 12-13 Year-old School Children In Klang District, Malaysia

Esa, R., Razak, I.A.

Ann Dent, 2001;8(1):-.
MyJurnal

Several national studies have been undertaken to assess the prevalence of fluorosis utilizing the Dean's Index. However, the latest national study undertaken in 1997 (1) had utilized the DDE Index and hence does not allow comparisons to be made with the earlier set of national data. This cross-sectional study was undertaken to evaluate the prevalence of dental fluorosis using the Dean's Index in a sample of 12-13 year-old schoolchildren and to assess the relationship between fluorosis and their caries status. The sampling procedure involved a multistage, clustered and stratified random sampling. The sample comprised of 1519 schoolchildren attending 20 secondary government and governmentaided schools in fluoridated urban and rural areas of Klang District in Peninsular Malaysia. There were 772 males and 747 females. Each subject was administered a questionnaire to elicit the demographic information. Intra-oral examination for dental fluorosis and caries was performed for each subject. The results demonstrated that more than half of the subjects (54 %) had no fluorosis, 13.2% had questionable fluorosis, 31.3% had very mild to mild fluorosis, 1.4% had moderate fluorosis and only 0.1 % exhibited severe fluorosis. The mouth prevalence was 32.8 %. The Community Fluorosis Index was 0.48 indicating a borderline score for public health significance. Fifty-two percent of the children were caries free. The mean DMFT for all subjects was 1.1, F(0.6) being the main component. Although girls had a higher mean DMFT score as compared to boys this difference was not significant. Significant differences in DMFT scores were observed by urbani rural distributions and ethnic groups (p < 0.01). No significant correlation was found between fluorosis and caries status. It is concluded that dental fluorosis does not appear to be a public health problem. Further coordinated in-depth research using similar criterias for assessing dental fluorosis is highly recommended.

Matched MeSH terms: Fluoride Poisoning