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Developmental enamel defects in children with different fluoride supplementation--a follow-up study
K A Hiller1, G Wilfart, G Schmalz
1Department of Operative Dentistry and Periodontology, University of Regensburg, Germany karl-anton.hiller@klink.uni-regensbyrg.de
Caries Research
|September 24, 1998
Summary
Fluoride supplements in children may increase the risk of dental fluorosis, characterized by enamel defects. This study found higher rates of enamel opacities in children receiving fluoride tablets compared to controls.
Area of Science:
- Dental Public Health
- Pediatric Dentistry
- Fluoride Toxicology
Background:
- Dental fluorosis is a condition resulting from excessive fluoride intake during tooth development.
- Enamel defects, including opacities and hypoplasia, are key indicators of dental fluorosis.
- Assessing the impact of structured fluoride supplementation on enamel development is crucial for public health guidelines.
Purpose of the Study:
- To investigate the association between structured fluoride tablet supplementation and the prevalence of developmental enamel defects in children.
- To compare the incidence of specific enamel defect types (demarcated opacities, diffuse opacities, hypoplasia) between supplemented and non-supplemented groups.
Main Methods:
- A study was conducted in a non-fluoridated area in Germany involving 158 children (8.5-10 years old) in three fluoride tablet groups (F1, F2, F3) and 158 matched controls.
- Fluoride supplementation varied in dosage (0.25-0.75 mg F-/day) and initiation age (birth to 7 months).
- Developmental enamel defects were assessed using the Modified Developmental Defects of Enamel (Mod DDE) Index, categorizing defects into scores 1 (demarcated opacity), 2 (diffuse opacity), and 3 (hypoplasia).
Main Results:
- Children in the fluoride tablet groups exhibited significantly higher proportions of Mod DDE scores 1, 2, or 3 (40%) compared to the control group (20%).
- Diffuse opacities (Mod DDE score 2) were significantly more prevalent in the supplemented groups (18%) than in controls (8%).
- No cases of hypoplasia (Mod DDE score 3) were observed, and demarcated opacities (Mod DDE score 1) showed a trend towards higher prevalence in supplemented groups (25% vs. 17%).
Conclusions:
- Structured fluoride tablet supplementation, particularly in early childhood, may be associated with an increased risk of developing dental fluorosis, manifesting as enamel opacities.
- The findings suggest a need for careful consideration of fluoride supplementation protocols and monitoring for enamel defects.
- While uncontrolled variables exist, the study highlights a potential link between fluoride tablet intake and enamel alterations in a non-fluoridated environment.