Occurrence and management of dental fluorosis

The prevalence of dental fluorosis is on the increase in different parts of the world, even in areas with fluoride-deficient public water supplies. This may be due to increased use of fluoride in preventive dentistry. In some countries, exposure to apparently low fluoride concentrations in drinking water has resulted in severe dental fluorosis in some children. This underscores the importance of taking into consideration all sources of fluoride intake in a community before prescribing fluoride supplements or recommending appropriate fluoride concentration for the public water supply. Preventive management of dental fluorosis includes de-fluoridation of drinking water in endemic areas, cautious use of fluoride supplements and supervision of the use of fluoride toothpaste by children aged below 5 years. Aesthetically objectionable discolouration of fluorosed teeth may be managed by bleaching, micro-abrasion, veneering or crowning. The choice between these treatments depends on the severity of the fluorosis and this may be satisfactorily determined by the Thylstrup and Fejerskov index.