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14-Apr-09

Measuring Dental Fluorosis
PDS 372
Dr. Asim Al-Ansari

Introduction
• What is dental fluorosis (DF)?
– Hypomineralization of the dental enamel caused
by the excessive ingestion of fluoride during tooth
development

• Severity of DF depends on:
– Quantity and timing of F ingestion
– Clinical appearance from
barely noticeable to
very dark brown stains

Introduction

1
14-Apr-09

Measuring Dental Fluorosis
• How can we measure fluorosis?
– Dean’s Fluorosis Index
– Community Fluorosis Index (CFI)
– Tooth Surface Index of Fluorosis
– Fluorosis Risk Index
– Developmental Defects of Dental Enamel Index

Dean’s Fluorosis Index
• Introduced in early1930s
• Seven-point ordinal scale

Dean’s Fluorosis Index
• Introduced in early1930s
• Seven-point ordinal scale
• In 1942, it was revised to be a six-point scale

2
14-Apr-09

Dean’s Fluorosis Index
• Introduced in early1930s
• Seven-point ordinal scale
• In 1942, it was revised to be a six-point scale

Dean’s Fluorosis Index
• Introduced in early1930s
• Seven-point ordinal scale
• In 1942, it was revised to be a six-point scale

Dean’s Fluorosis Index
•
•
•
•
•

Introduced in early1930s
Seven-point ordinal scale
In 1942, it was revised to be a six-point scale
Each tooth is rated according to the scale
The individual’s score depends on the most
two severe teeth
• Commonly used in “prevalence” studies due
to its simplicity

3
14-Apr-09

Community Fluorosis Index (CFI)
• Modification of the Dean’s Index
• Numerical value is given to each category
• Its mainly used for comparative studies

• Criticism
of Dean’s
Index

Tooth Surface Index of Fluorosis (TSIF)
• Developed in 1984
• Measures the prevalence and severity of
fluorosis that is of public health significance
• More sensitive than Dean’s Index in
identifying the mildest forms of fluorosis
• A scale from 0 – 7 to each tooth in the mouth
• No need to dry teeth
• It can be used in primary and permanent
dentitions

4
14-Apr-09

Fluorosis Risk Index
• Designed for use in analytic studies
• Help identify risk factors for fluorosis
• Relates the risk factor to the developmental
stage

Fluorosis Risk Index
• Divides the buccal and occlusal surfaces of
each tooth into four zones based on the age at
which calcification begins
• Each zone is classified as
– Class 1: formation began in 1st year of life
– Class 2: formation began 3-6 years of life

Developmental
Defects of Dental Enamel Index
• It is a descriptive index
• Depends on the type and number (or
demarcation) of enamel defects on buccal and
lingual surfaces of all teeth

5
14-Apr-09

Developmental
Defects of Dental Enamel Index
• It is a descriptive index
• Depends on the type and number (or
demarcation) of enamel defects on buccal and
lingual surfaces of all teeth

Summary

6

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Measuring Florosis

  • 1. 14-Apr-09 Measuring Dental Fluorosis PDS 372 Dr. Asim Al-Ansari Introduction • What is dental fluorosis (DF)? – Hypomineralization of the dental enamel caused by the excessive ingestion of fluoride during tooth development • Severity of DF depends on: – Quantity and timing of F ingestion – Clinical appearance from barely noticeable to very dark brown stains Introduction 1
  • 2. 14-Apr-09 Measuring Dental Fluorosis • How can we measure fluorosis? – Dean’s Fluorosis Index – Community Fluorosis Index (CFI) – Tooth Surface Index of Fluorosis – Fluorosis Risk Index – Developmental Defects of Dental Enamel Index Dean’s Fluorosis Index • Introduced in early1930s • Seven-point ordinal scale Dean’s Fluorosis Index • Introduced in early1930s • Seven-point ordinal scale • In 1942, it was revised to be a six-point scale 2
  • 3. 14-Apr-09 Dean’s Fluorosis Index • Introduced in early1930s • Seven-point ordinal scale • In 1942, it was revised to be a six-point scale Dean’s Fluorosis Index • Introduced in early1930s • Seven-point ordinal scale • In 1942, it was revised to be a six-point scale Dean’s Fluorosis Index • • • • • Introduced in early1930s Seven-point ordinal scale In 1942, it was revised to be a six-point scale Each tooth is rated according to the scale The individual’s score depends on the most two severe teeth • Commonly used in “prevalence” studies due to its simplicity 3
  • 4. 14-Apr-09 Community Fluorosis Index (CFI) • Modification of the Dean’s Index • Numerical value is given to each category • Its mainly used for comparative studies • Criticism of Dean’s Index Tooth Surface Index of Fluorosis (TSIF) • Developed in 1984 • Measures the prevalence and severity of fluorosis that is of public health significance • More sensitive than Dean’s Index in identifying the mildest forms of fluorosis • A scale from 0 – 7 to each tooth in the mouth • No need to dry teeth • It can be used in primary and permanent dentitions 4
  • 5. 14-Apr-09 Fluorosis Risk Index • Designed for use in analytic studies • Help identify risk factors for fluorosis • Relates the risk factor to the developmental stage Fluorosis Risk Index • Divides the buccal and occlusal surfaces of each tooth into four zones based on the age at which calcification begins • Each zone is classified as – Class 1: formation began in 1st year of life – Class 2: formation began 3-6 years of life Developmental Defects of Dental Enamel Index • It is a descriptive index • Depends on the type and number (or demarcation) of enamel defects on buccal and lingual surfaces of all teeth 5
  • 6. 14-Apr-09 Developmental Defects of Dental Enamel Index • It is a descriptive index • Depends on the type and number (or demarcation) of enamel defects on buccal and lingual surfaces of all teeth Summary 6