Exposure to fluoride in optimum amounts about one part per million of. In contrast deans index of fluorosis records only the appearance of dental fluorosis following a judgement of fluorosis by the examiner. Data quality evaluation of the dental fluorosis clinical. Instead of just measuring the overall prevalence of fluorosis i. Using the scores obtained for all teeth present df28 as a gold standard, we calculated. Dean s index has been used for scoring dental fluorosis because of its simplicity and usefulness in making comparisons with numerous earlier studies.
The dean s index helps to classify the fluorosis intensity and hence one can determine how extensive the treatment should be it is our duty to place the best options in front of the patient and then they can choose what they want. Nidr survey is available in the publicuse data file documentation and survey methodology. The level of hypomineralization and clinical appearance of the fluorotic enamel varies from mild to severe fig. Kids should use fluoridated toothpaste twice a day a smear for children under 3 and a peasized amount for children older than 3. Thus, depending on the severity of fluorosis, the two teeth are scored normal 0, questionable 0. This original deans index is a 7 point ordinal scale. We have used deans index to grade the fluorosis in. They have concluded that fluoride at the level of 1 ppm in the drinking water would no doubt reduce cite this article. Dean, with others, went on to publish their famous twopart, twentyonecity study in 1942. This list is usually at the back of a book, and the table of contents is.
Dental fluorosis occurs because of the excessive intake of fluoride either through naturally occurring fluoride in the water, water fluoridation, toothpaste, or other sources. Causes, diagnosis, management and prevention fluorosis is a crippling disease resulted from deposition of fluorides in the hard and soft tissues of body. Dental fluorosis is a common disorder, characterized by hypomineralization of tooth enamel. Abstract to contrast the sensitivity, specificity, and positive negative predictive values between dental fluorosis prevalence scored on 28 df28 and on six permanent teeth df6, we undertook a crosssectional study on 1,538 adolescents 12 and 15. It is a public health problem caused by excess intake of fluoride through drinking waterfood productsindustrial pollutants over a long period. We have used this index many times in surveys of oral health in ireland, we have trained examiners in many different countries to use it, it is always a challenge to standardise examiners in its use. The traditional criteria the dean index for diagnosing dental fluorosis was developed in the. Pdf dental fluorosis trends in us oral health surveys. The dean index grades the enamel lesions according to the degree of severity described. The most commonly used indices are the dean index dr trendley dean 18931962, american dentist and the thylstrupfejerskov index named after a. Treatment of dental fluorosis milena peneva department of childrens dental medicine faculty of dental medicine, medical university sofia, bulgaria journal of imab annual proceeding scientific papers 2008, book 2 summary dental fluorosis is the result of chronic endogenic intake of fluorides in amounts exceeding the optimal daily dose. Cdcnchs, national health and nutrition examination survey, 1999 2004 although the effects of the most prevalent forms of dental fluorosis are primarily aesthetic, health professionals should identify all possible sources of fluoride before.
While the dean index is still widely used in surveys of fluorosis including the cdcs national surveys of fluorosis in the united states dental researchers have developed more finely tuned diagnostic scales. Pdf dental fluorosis prevalence and severity using deans. Use of the tsif in a survey in illinois was able to discriminate between the prevalence and severity of fluorosis in four groups of communities with different concentrations of fluoride in their drinking water. Deans fluorosis index legal definition of deans fluorosis index. Dental fluorosis is the appearance of faint white lines or streaks on the teeth that only occurs when younger children consume too much fluoride, from any source, over long periods when teeth are developing under the gums. Deans index of fluorosis 1947 is the oldest index of fluorosis. This means scoring criteria is based on the order i. Dental fluorosis will be one of the first indicators of fluorosis. An index of fluorosis was needed when the initial investigations of fluorosis began in the 1930s see chapter 22. Pdf dental fluorosis prevalence and severity using deans index.
Dean s index is scored on the condition of these two teeth. Dean s index assigns a score to the two most affected teeth. These include fluorosis specific indices such as dean s index. The traditional criteria the dean index for diagnosing dental fluorosis was developed in the first half of the 20th century by h. The dental fluorosis clinical assessment proceeded toothbytooth in a similar manner as. Dental fluorosis prevalence and severity using dean s index based on six teeth and on 28 teeth article pdf available in clinical oral investigations 123. Record the fluorosis score for the most affected pair of teeth for teeth 12, 11, 21 or 22. Feb 03, 2014 classification of fluorosis measuring indices fluorosis specific descriptive deans index developmental defects of enamel index thylstrup and ferjeskov tooth surface index for fluorosis fluorosis risk index jackson alalousi index murray shaw index 6. Dental fluorosis has been assessed only 3 times in nationally representative oral health surveys in the united states. Deans classification of dental fluorosis is presented in table1. Although no numbers were used it was considered to be on an ordinal scale.
Deans earliest research on fluoride began with investigations into dental fluorosis. Additional information for the 19861987 nidr survey is available in the publicuse data file documentation and survey methodology report. Dean devised an index for assessing the presence and severity of mottled enamel. This system allows the amount of enamel alteration on each tooth to be classified. Deans fluorosis index definition of deans fluorosis index. Dental fluorosis is defined as having very mild, mild, moderate, or severe forms and is based on deans fluorosis index. In clinical work one of the most widely used methods of classifying and recording dental fluorosis is the dental fluorosis index dfi formulated by dean 1942. Dean fluorosis index definition of dean fluorosis index. Fluorotic lesions are bilaterally symmetrical and tend to show a horizontal striated pattern across the tooth. Both surveys included intraoral assessment of all permanent teeth conducted by trained and standardized dental examiners who used the deans fluorosis index.
Fluorosis index department of public health dentistry 10 the fluorosis index set criteria for categorization of dental fluorosis on a 7 point scale. The 201112 nhanes figures documented another 31% overall increase. Several indices were developed to measure dental fluorosis in the 20th century. The community fluorosis index cfi is a way of measuring the burden of dental fluorosis in a population. Our mouths contain bacteria that combine with sugars in the foods we eat and the beverages we drink to produce an acid that harms our teeth. It is well documented that fluoride can have both beneficial and detrimental effects. Dental fluorosis prevalence and severity using deans index based on six teeth and on 28 teeth article pdf available in clinical oral investigations 123. The inconsistent prevalence of fluorosis for a given level of fluoride in. This article is licensed under the gnu free documentation license. Barthel index an objective, standardized tool for measuring functional status. Start studying scoring system for deans fluorosis index. Dental fluorosis prevalence and diagnostic test using dean. To contrast the sensitivity, specificity, and positive negative predictive values between dental fluorosis prevalence scored on 28 df28 and on six permanent teeth df6, we undertook a crosssectional study on 1,538 adolescents 12 and 15 years. How do i protect my childs teeth without causing fluorosis.
The dean study demolishes the twentyonecity study by dean et al using research by the late. An index of fluorosis was calculated for each community. Criteria for deans fluorosis index 20 score criteria normal the enamel represents the usual translucent semivitriform type of structure. The vast majority of cases are mild, and only about 2% are considered moderate. Fluorosis facts a resource for parents and caregivers. The individual is scored in a number of areas depending upon independence of performance. Dean conducted a survey in 1931 and develop an index for fluorosis in 1934 known as deans index clinically, mild enamel fluorosis is seen as diffuse white spots or white opaque lines or striations or a white parchment like appearance of the tooth surface that run horizontally across the enamel. Looking for online definition of dean s fluorosis index in the medical dictionary. While the dean index is still widely used in surveys of fluorosis including the cdc s national surveys of fluorosis in the united states dental researchers have developed more finely tuned diagnostic scales. Dean to assess the prevalence and severity of dental fluorosis in various communities in the united states 2. If fluorosis is present then decide on the two most severely affected teeth. Dean s fluorosis index was developed in 1942 and is currently the most universally accepted classification system.
Two of the most widely used fluorosis indices are dean s index and thylstrup and fejerskov index tfi. Learn vocabulary, terms, and more with flashcards, games, and other study tools. When scoring, start at the higher end of the index i. Mascarenhas is assistant professor of health services research at ohio state university. Cdcnchs, national health and nutrition examination survey, 19992004. Fluorosis was evaluated using deans index of fluorosis see section 2. Sign up or login to train in dean s index of fluorosis. The diagnosis of the degree of dental fluorosis was performed by applying deans index di 18, 19 and the thylstrupfejerskov index tf, which is more sensitive for individual classifications of dental organs in ten categories. Prevalence and severity of dental fluorosis in the united. Three dentists conducted replicate fluorosis examinations on 202 children in newburgh and kingston, ny. Among 12 year olds, the difference between df28 and df6 was 20.
Exposure to fluoride in optimum amounts about one part per million of fluoride to water is claimed to be. Teeth are generally composed of hydroxyapatite and carbonated hydroxyapatite. Once teeth break through the gums, you cannot develop fluorosis fluorosis isnt a disease and doesnt affect the health of your teeth. In contrast dean s index of fluorosis records only the appearance of dental fluorosis following a judgement of fluorosis by the examiner. The damage in tooth development occurs between the ages of 6 months to 5 years, from the overexposure to fluoride. Disagreement on personlevel deans fluorosis index values assigned by dental examiner and reference examiner for participants aged 619 years with available gold standard observations, by 6year survey period. National health and nutrition examination survey, 19992004 and 20112016. Treatment of dental fluorosis milena peneva department of children s dental medicine faculty of dental medicine, medical university sofia, bulgaria journal of imab annual proceeding scientific papers 2008, book 2 summary dental fluorosis is the result of chronic endogenic intake of fluorides in amounts exceeding the optimal daily dose. O, 1997 the scoring system 04 fluorosis index department of public health dentistry. It is uncomplicated and provides a whole mouth score in one code. Most questionable fluorosis under the dean index classifies as a tf score of 1.
The severity of the condition is dependent on the dose, duration. Deans fluorosis index is used to assess the severity of dental fluorosis based on the clinical appearance of the teeth. Dean s index of fluorosis 1947 is the oldest index of fluorosis. Dental fluorosis is a common disorder, characterized by hypomineralization of tooth enamel caused by ingestion of excessive fluoride during enamel formation it appears as a range of visual changes in enamel causing degrees of intrinsic tooth discoloration, and, in some cases, physical damage to the teeth.
Deans fluorosis index dfi criteria and scoring on the nhanes dental. Although deans index has been in use for over 50 years, it is not without shortcomings. An individual s fluorosis score is based on the most severe form of fluorosis found on two or more teeth. Exposure, prevention and management introduction dental fluorosis is a developmental disturbance of dental enamel, caused by successive exposures to high concentrations of fluoride during tooth development, leading to enamel with lower mineral content and increased porosity. Fluorosis, difference between dental fluorosis and non fluoride enamel opacities, dean s fluorosis index, thylstrup and fejerskov, tooth surface fluorosis imde slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.
The tooth surface index of fluorosis tsif eliminates or reduces some of the shortcomings of dean s method. The fluorosis index set criteria for categorisation of dental fluorosis on a 7point scale. Dental fluorosis prevalence and severity using deans. Dean, tf and tsif dental fluorosis indexes have been extensively used to classify the severity of dental fluorosis in children. Using the scores obtained for all teeth present df28 as a gold standard, we calculated the sensitivity, specificity, positivenegative predictive values, and receiver operating characteristic and concordance index pertaining to the scores based on six teeth upper incisors and canines. Fluorosis, chronic intoxication with fluorine usually combined with some other element to form a fluoride that results in changes in the skeleton and ossification of tendons and ligaments. Dean s index the dean s index is of historical interest because most of the older studies have used this index. The surface is smooth, glossy, and usually of a pale creamy white colour. Dental fluorosis was then regarded as an unfortunate sideeffect of fluoride s cariesprotective benefits, and attempts to play down the possible toxic effect of fluoride on develo p ing dental enamel often led the dental profession to present dental fluorosis as merely a cosmetic problem. Fluorosis, difference between dental fluorosis and non fluoride enamel opacities, deans fluorosis index.
Dental fluorosis is defined as having very mild, mild, moderate, or severe forms and is based on dean s fluorosis index. In deans index, each individual is given one score, as a score for the. Fluoride action network community fluorosis index cfi. Deans index is scored on the condition of these two teeth. Dean 1934 developed a fluorosis index which classified individuals into 5 categories, depending on the degree of enamel alteration, and which was based on the identification of the 2 most severely affected teeth, giving ordinal numbers as the severity of the enamel alteration increased. The fluorosis classification for each child was based on the degree of fluorosis recorded for two or more teeth. Distinguishing between enamel fluorosis and other enamel defects in.
Dental fluorosis was scored using deans modified index. These include fluorosis specific indices such as deans index. Less than onequarter of persons aged 649 had dental fluorosis. Dean s index developed in usa in 1930s classifies fluorosis into five types. Fluorosis affects nearly one in every four americans ages 6 to 49. Fluorosis dean s index fluorosis dean s index this index records a fluorosis score for the anterior permanent maxillary incisors for respondents aged 6 12. If the two teeth are not equally affected, record the score for the less affected of the two. Fluorosis diseases and conditions in dentistry wiley. Oct 09, 2016 fluorosis, difference between dental fluorosis and non fluoride enamel opacities, deans fluorosis index, thylstrup and fejerskov, tooth surface fluorosis imde slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Deans fluorosis index synonyms, deans fluorosis index. Although no numbers were used it was considered to be on ordinal scale.
If the two teeth are not equally affected score on the least affected. The surface of the tooth is smooth, glossy, and usually has a pale creamy white color. Dean s first fluorosis index set criteria for categorizing dental fluorosis on a sevenpoint ordinal scale. Distinguishing between enamel fluorosis and other enamel defects. Dental fluorosis is a pathologic condition characterized by hypomineralization of the enamel due to excessive exposure to fluoride during enamel mineralization. Diagnosis for fluorosis fkanlabknowledge wiki github. The mechanism of fluorosis has been related to alteration of the enamel mineralisation process caused by a delay in the removal of amelogenins at the early. Deans fluorosis index definition of deans fluorosis. It is widely used and provides a basis for current. It is widely used and provides a basis for current and historical comparisons of fluorosis.
A system of defining the severity of chronic fluoride toxicity based on enamel defects. Percentage weighted dental fluorosis severity levels, based on personlevel dean s fluorosis index, among. Dean s fluorosis index was used to evaluate each tooth in the mouth of each study participant. By 1942 dean had revised his fluorosis index into a sixpoint scale, including. Disagreement on personlevel dean s fluorosis index values assigned by dental examiner and reference examiner for participants aged 619 years with available gold standard observations, by 6year survey period. Dental fluorosis is a developmental disturbance of dental enamel, caused by. Synonyms for dean s fluorosis index in free thesaurus. Pdf dental fluorosis prevalence and severity using dean.
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