Strategies for improving the assessment of dental fluorosis: focus on optical techniques

In its milder forms, enamel fluorosis is characterized clinically by diffuse opacities. The appearance is due to optical properties of a subsurface or surface porous layer with lower mineral content. These areas usually have texture and color similar to those of initial caries lesions but generally another shape and location. Therefore, several optical methods, previously used to diagnose initial caries lesions, were applied to fluoride-induced opacities on extracted premolars and on incisors of four subjects in vivo. These methods included light-scattering measurements, white light illumination, violet light illumination, ultraviolet illumination, and laser fluorescence. Video images were captured with a charge-coupled-device (CCD) camera, digitized, and computer-processed. It is concluded that the light-scattering monitor can be used for the determination of the local porosity of fluorotic enamel and that the laser fluorescence method might be developed into a method applicable for the assessment of the severity of enamel fluorosis.