From Volume 40, Issue 10, December 2013 | Pages 836-839
Exposure to excessive fluoride intake during the early childhood years can disrupt the normal development of enamel, resulting in dental fluorosis. This varies in severity, ranging from white opacities in mild cases to more severe black and brown discoloration or enamel pitting. This article aims to give the reader a better understanding of the aetiology, diagnosis and subsequent treatment of dental fluorosis in the paediatric patient.
Dental fluorosis is defined as a developmental disturbance of the enamel structure, caused by excessive exposure to high concentrations of fluoride. This results in a reduction of the mineral content of the enamel, and subsequently an increase in enamel porosity.
The spectrum of clinical presentation ranges from small white opaque areas of enamel to more severe discoloration, including black and brown stains. The enamel may also be pitted and rough in appearance. More severe fluorosis is less prevalent than the milder forms.
It is difficult to give an accurate figure of the prevalence of fluorosis in the United Kingdom. A review by Holloway and Ellwood found that 40% of the UK population are likely to have enamel defects and approximately half of these (20% of the population) are likely to have dental fluorosis, mainly in its mildest forms.2 Studies by the Medical Research Council, and other researchers who have found the prevalence of fluorosis of aesthetic concern, have found it to be 1% of the population in non-fluoridated areas and 3–4% in fluoridated areas.3 The 2003 UK Child Dental Health Survey found a 1% prevalence of aesthetically concerning fluorosis throughout the UK.4
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