Two types of intraoral distribution of fluorotic enamel

Different distributions of fluorotic dental enamel within the dentition have been described in the literature. This report describes two patterns of intraoral distribution. In nine Tanzanian low fluorosis communities with a prevalence of pitting fluorosis of less than 2% and in five moderate fluorosis communities with a prevalence of pitting fluorosis of 16-59%, incisors and first molars were the least affected teeth. In four high fluorosis communities with a prevalence of pitting fluorosis of 86-97%, maxillary incisors exhibited lower Thylstrup-Fejerskov Index values than the maxillary canines, premolars and molars. The mandibular teeth exhibited increasing Thylstrup-Fejerskov Index values from the anterior to the posterior region. The curves presenting the intraoral distribution of the severity of dental fluorosis corresponded with the curve presenting the completion time of primary enamel formation of the various tooth types, with the exception of the first molars in high fluorosis communities. The similarity of the curves suggests that the later in life enamel is completed, the higher is the severity of dental fluorosis. This relation seems to be explained by the prevailing feeding and dietary habits, which result in minimal intake of fluoride in the first 18 months of life during breastfeeding, followed by increasing fluoride ingestion in the following years through consumption of tea, seafish and F-containing magadi salt.