Dental Fluorosis In India- Oral Pathology-Deans Index-Modified Classification with pictures

1. BHARATI VIDYAPEETH DENTAL
COLLEGEAND HOSPITAL,
SANGLI
DEPARTMENT OF ORAL PATHOLOGY
“DENTAL FLUOROSIS”

2. WHAT IS DENTAL FLUOROSIS?
• Dental fluorosis is a common disorder characterized by hypo-
mineralization of the tooth enamel caused by ingestion of
excessive fluoride during enamel formation.
• Seen where Water consumed contains Fluoride >1ppm.
• Severity of the condition depends on: Dose
Duration
Age during exposure

3. PREVALANCE
• Worst-affected states in
India-
Gujarat
Rajasthan
Andhra Pradesh

4. DEAN’S FLUOROSIS INDEX
• Given by: Dr. Trendley H. Dean
(1934)
• Purpose: To assess presence and
severity of mottled enamel
• Individual’s fluorosis score is based
on the most severe form of
fluorosis found on 2 or more
teeth.

5. ORIGINAL CRITERIA- 1934
NORMAL QUESTIONABLE VERY MILD
MILD MODERATELY SEVEREMODERATE
SEVERE

6. MODIFIED CRITERIA-1942
• It is a 6-point ordinal scale.
• Combines ‘moderately severe’ and ‘severe’ and is used
extensively today.
• Recommended by the World Health Organization in its
basic survey manual (1997).
• Scaling system used- 0(normal) to 4(severe).

7. NORMAL- 0
• Enamel is the usual
translucent, semi- vitriform.
• Smooth, glossy and usually
pale creamy white in colour.
• No white spots, pitting or
brownish discolouration
seen.

8. QUESTIONABLE- 0.5
• Slight aberration from
translucency of normal
enamel, ranging from a few
white flecks to occasional
white spots.
• White spots if present can
range 1-2mm in diameter.

9. VERY MILD - 1
• Small opaque paper white
areas scattered irregularly
over the tooth not involving
more than 25% of the tooth.
• Less than 1-2mm opacity on
the summits of cusps of
bicuspid and 2nd molars.

10. MILD - 2
• White opaque areas.
• More extensive.
• Less than 50% of the tooth.

11. MODERATE - 3
• All enamel surfaces of the
teeth are affected.
• Surfaces subjected to attrition
show wear.
• Brown staining is a frequent
disfiguring feature.

12. SEVERE - 4
• All enamel surfaces are
affected.
• Marked hypoplasia.
• Major diagnostic sign- Discrete
or confluent pitting and
widespread brown stains.
• Corroded like appearance.