Relevance of epidemiological indices for assessing dental fluorosis

The aim of the study described in this article is to propose a suitable index for epidemiological surveys. The authors define the characteristics of a good index to evaluate a presumed pathology, dental fluorosis, whoever the examiner and whatever the circumstances. The earliest and most commonly used index is Dean's because it permits data comparison among studies. But it has shortcomings due to the low accuracy of its definitions. The TSIF proposed by Horowitz et al. does not bring any noteworthy improvement to the Dean index. The new TF index devised by Thylstrup & Fejerskov is a logical improvement of the Dean index and can reliably be compared with Dean's. The sensitivity of this index come from its 9 stages reflecting the histopathology and fluoride content in the enamel. At the moment it is the most outstanding index for evaluating the severity of fluorosis.