Prevalence of Dental Fluorosis in the Primary Dentition


Send correspondence and reprint requests to Dr. Warren, N-337 Dental Science Building, University of Iowa, Iowa City, IA 52242-1010. E-mail: Drs. Levy and Kanellis are affiliated with the Departments of Preventive and Community Dentistry and Pediatric Dentistry, both at the University of Iowa, College of Dentistry. The study was supported by NIH grants 2R01-DE09551, 2P30-10126, and CRC-RR00059. The results of this study were presented at the 78th Annual Session of the International Association for Dental Research, Washington, DC, April 6, 2000.


Objectives: This paper presents data on the prevalence of primary tooth fluorosis among children residing in Iowa, and the relationships between fluorosis prevalence and selected measures of fluoride exposures. Methods: Children in the study cohort were followed prospectively during the first year of life. This study assessed their home water fluoride concentrations and use of fluoride dentifrice or dietary fluoride supplements. A total of 637 children (320 females and 317 males) were examined for fluorosis using a modification of the TSIF index at age 4 1/2 to 5 years, with 90.4 percent having intact primary dentitions. Results: 74 children (11.6%) had fluorosis present on one or more of their primary teeth, and 71 children (11.1%) had two or more teeth affected. Nearly all fluorosis was mild, with the primary second molar teeth most commonly affected. Fluorosis was significantly associated with higher water fluoride concentration, but not with the use of dentifrice or fluoride supplements. Conclusions: The results of this study show that primary tooth fluorosis is relatively uncommon, but is most frequently seen on the posterior teeth, particularly the primary second molars, which form at later stages of development. This finding suggests that primary tooth fluorosis is mostly a postnatal phenomenon, and is associated with higher water fluoride levels.