Reporting the Extent of Dental Fluorosis and Enamel Opacities Using Different Indices

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Reporting the Extent of Dental Fluorosis and
Enamel Opacities Using Different Indices

• J. McLoughlin1, J. Clarkson1, R. AlAyaha2
• 1Trinity College, Dublin
• 2Riyadh Armed Forces Hospital, Saudi Arabia

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Introduction

• Dental fluorosis levels are increasing in both
  fluoridated and non fluoridated communities
• Studies reporting levels of fluorosis use
  different indices and report results differently
• Comparison of the levels of fluorosis enamel
  opacities from different studies is problematical

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Indices

• Fluorosis
• Deans Index (DI)
• (Dean et al 1942)
• Thylstrup Fejerskov Index (TF)
• (Thylstrup Fejerskov 1978)
• Tooth Surface Index of Fluorosis (TSIF)
• (Horowitz et al 1984)

• Enamel Defects
• Modified Developmental Defects of Enamel Index
  (DDE)
• - (Clarkson OMullane 1989)

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Differences Between Indices
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Studies of Fluorosis Enamel Opacities
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Recording Fluorosis Opacities
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Reporting Fluorosis Opacities
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Aim of the Study

• To determine how standardised reporting of
  results using different indices could provide
  improved information about the public health
  importance of fluorosis and enamel defects

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Materials Methods

• School children (354) in 6th class in primary
  school
• Life time residents in area with fluoridated
  water (0.8-1.0ppm)
• Deans Index, TF and Modified DDE
• Artificial light 1 metre away
• Teeth wet for Deans Index DDE
• Allowed to dry for 2 mins for TF

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Deans Index
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Thylstrup Fejerskov (TF) Index
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Modified Developmental Defects of Enamel Index
(DDE)
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Mean Number of Teeth (SD) Affected by DDE 2 and
TF Scores
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Number and Percentage of Children With up to Half
(1-4) the Index Teeth With the Various TF Scores.
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Number and Percentage of Children With up to Half
(1-5) the Index Teeth With the Various DDE Scores
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Mouth Tooth Prevalence
Tooth Prevalence TFgt 0 57.8 DDE2 24.6
Up to Half Index teeth affected TF1 77 TF2
87 DDE2 73
Mouth Prevalence Dean's 29.7 TF gt 0
74.3 DDE2 51.7
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Variations in the Levels of Fluorosis Enamel
Opacities

• According to the index used
• (Deans, TF, DDE)
• Reporting of data
• (Mouth v tooth prevalence)

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Conclusions

• Reporting the proportion of index teeth affected
  by fluorosis may be useful in determining the
  public health importance of dental fluorosis
• Standardisation of recording and reporting of
  dental fluorosis is required in order to allow
  for valid comparison between studies