Deans fluorosis index definition of deans fluorosis index. Prevalence and severity of dental fluorosis in the united. Deans first fluorosis index set criteria for categorizing dental fluorosis on a. Deans community fluorosis index cfi for dental fluorosis was calculated, from the childrens survey, and was found to be correlated with the prevalence and severity of fluorosis in the areas. Esthetic rehabilitation with direct composite veneering. A system of defining the severity of chronic fluoride toxicity based on enamel defects. Three dentists conducted replicate fluorosis examinations on 202 children in newburgh and kingston, ny. 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. Only two of the individuals tested were found to have df, and none showed higher than a questionable rating on the deans fluorosis index table 2. It is widely used and provides a basis for current and historical comparisons of fluorosis. 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.
Deans fluorosis index is used to assess the severity of dental fluorosis based on the clinical appearance of the teeth. Prevalence of dental fluorosis in mianwali and mardan. Deans fluorosis index article about deans fluorosis. This report describes the interexaminer reliability achieved using dean s index in a study of dental fluorosis, and shows the effect on kappa values of assigning different weights to the various components of dean s index. Prevalence of dental fluorosis in mianwali and mardan districts. Once teeth break through the gums, you cannot develop fluorosis. Synonyms for deans fluorosis index in free thesaurus. In the 20th century, the various indices used for measurement of dental fluorosis are. Use of the tsif in a survey in illinois was able to. Others include the tooth surface fluorosis index horowitz et al. Prevalence and severity of dental fluorosis in relation to fluoride in ground water in the villages of birbhum district, west bengal, india. Deans fluorosis index dfi criteria and scoring on the nhanes dental fluorosis. Once teeth break through the gums, you cannot develop fluorosis fluorosis isnt a disease and doesnt affect the health of your teeth.
O, 1997 the scoring system 04 fluorosis index department of public health dentistry. The present study was conducted to compare three dental fluorosis indices, viz. Using the scores obtained for all teeth present df28 as a gold standard, we calculated the sensitivity. In contrast deans index of fluorosis records only the appearance of dental fluorosis following a judgement of fluorosis by the examiner. Dental fluorosis occurs because of the excessive intake of fluoride either through naturally occurring fluoride in the water, water fluoridation, toothpaste, or other sources. Dental fluorosis refers to changes in the appearance of tooth enamel that are caused by longterm ingestion of fluoride during the time teeth are forming 1.
These include fluorosis specific indices such as deans index. They have concluded that fluoride at the level of 1 ppm in the drinking water would no doubt reduce cite this article. Fluorosis tsif eliminates or reduces some of the shortcomings of deans method. The fluorosis risk index frl, a new index developed for use in analytical epidemiologic studies, is designed to permit a more accurate identification of associations between age. The earliest widely accepted index was developed by trendley dean and published in 1942 dean, 1942.
These dental fluorosis indexes have been compared in several scientific articles table 1. Dental fluorosis prevalence and severity using deans. Deans fluorosis index synonyms, deans fluorosis index. The severity of fluorosis increases with the dose of fluoride the child consumes, and can be exacerbated by nutritional deficiencies and kidney impairment. The traditional criteria the dean index for diagnosing dental fluorosis was developed in. Diagnostic criteria and weighting system for deans index. Public health service, in 1934, 1935, 1938 and 1942. 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. The patient was not satisfied with her smile because of the discolored and pitted appearance of maxillary anterior teeth deans fluorosis index4, figure 1. Exposure to fluoride in optimum amounts about one part per million of fluoride to water is claimed to be. 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. The following classifications of mottled teeth were published by henry trendley dean, d.
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. Looking for online definition of dean s fluorosis index in the medical dictionary. His index of dental fluorosis recorded the appearance of the teeth wet. Deans index of fluorosis 1947 is the oldest index of fluorosis. Fluorosis index department of public health dentistry 10 the fluorosis index set criteria for categorization of dental fluorosis on a 7 point scale. It normally does not affect the function of the teeth or cause pain. Differential diagnosis of dental fluorosis made by. In this index a value is given for each anterior tooth surface not restored buccal and lingual and three values for posterior tooth surfaces buccal, lingual and occlusal. Indexes for measuring dental fluorosis wiley online library. National health and nutrition examination survey, 19992004 and 20112016.
Comparative evaluation of three different recording criteria of dental. The subject should be examined in the upright position, with the examiner facing the subject with his or her back to the light window. If the two teeth are not equally affected score on the least affected. The two main classification systems are described below. The fluorosis community indices elevated altitude 2,500 m above sea level.
The most commonly used indices are the dean index dr trendley dean 18931962, american dentist and the thylstrupfejerskov index named after a. Data quality evaluation of the dental fluorosis clinical. The severity was scored by deans fluorosis index 1942 which follows the who 1997 criteria. Fluorosis index department of public health dentistry 9 9. Note the distribution pattern of any defects and decide if they are typical of fluorosis i. The community fluorosis index cfi is a way of measuring the burden of dental fluorosis in a population. Dental fluorosis prevalence and severity using deans index.
The surface is smooth, glossy, and usually of a pale creamy white colour. To help prevent both tooth decay and dental fluorosis, the centers for disease control and prevention cdc recommends the following. Dental fluorosis will be one of the first indicators of fluorosis. Although no numbers were used it was considered to be on an ordinal scale. If fluorosis is present then decide on the two most severely affected teeth. Criteria for dean s fluorosis index 20 score criteria normal the enamel represents the usual translucent semivitriform type of structure. Pdf dental fluorosis prevalence and severity using deans index. Fluoro sis was detected by deans fluorosis index and the data collected and calculated was statistically analyzed by chisquare test.
Community fluorosis index cfi fluoride action network. The dean study in describing deans early work, the centers for disease control and prevention cdc stated in 1999, dean compared the prevalence of fluorosis with data collected by others on dental caries prevalence among children in 26 states as measured by dmft and noted a strong inverse relation. Studies conducted in the 1930s showed that the severity of tooth decay was lower and dental fluorosis was higher in areas with more fluoride in the drinking water 2. An index for measuring any condition should be sensitive, easy to understand and reliable. This system allows the amount of enamel alteration on each tooth to be classified. Mascarenhas is assistant professor of health services research at ohio state university. Teeth are generally composed of hydroxyapatite and carbonated hydroxyapatite. A comparison of subjectlevel severity scores for deans index resulted in percent agreement ranging from 79. It is a public health problem caused by excess intake of fluoride through drinking waterfood productsindustrial pollutants over a long period. Causes, diagnosis, management and prevention fluorosis is a crippling disease resulted from deposition of fluorides in the hard and soft tissues of body.
As of 2005 surveys conducted by the national institute of dental research in the usa between 1986 and 1987 and by the center of disease control between 1999 and 2002 are the only national sources of data concerning the prevalence of dental fluorosis. This list is usually at the back of a book, and the table of contents is. There is some potential for developing dental fluorosis when young children consume fluoride during the time when teeth are forming under the gums birth through age 8. 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. This report describes the interexaminer reliability achieved using deans index in a study of dental fluorosis, and shows the effect on kappa values of assigning different weights to the various. Dental fluorosis is a slight change in the look of the teeth, usually in the form of very faint white markings. This report describes the interexaminer reliability achieved using dean s index in a study of dental fluorosis, and shows the effect on kappa values of assigning different weights to the various. With increasing severity, the opaque lines merge and more irregular cloudy areas become visible.
The damage in tooth development occurs between the ages of 6 months to 5 years, from the overexposure to fluoride. Fluorotic lesions are bilaterally symmetrical and tend to show a horizontal striated pattern across the tooth. Dental fluorosis prevalence and severity using deans index based on six teeth and on 28 teeth article pdf available in clinical oral investigations 123. Deans modified index 1942, tooth surface index for fluorosis tsif, 1984 and.
Most fluorosis is the result of consuming too much fluoride before the age of. Dental fluorosis was scored using deans modified 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. Oct 26, 20 dental fluorosis comes in various stages of severity. Dental fluorosis, a hypoplasia or hypomineralization of tooth enamel or dentin, ranges in intensity from barely noticeable whitish striations to confluent pitting and staining. Dental fluorosis prevalence and diagnostic test using dean. Megan brickley, rachel ives, in the bioarchaeology of metabolic bone disease, 2008. The dean index was used to determine the presence and absence of dental fluorosis and its degree of severity, ranging from 1 to 5, namely. Pdf dental fluorosis prevalence and severity using deans. Dental fluorosis comes in various stages of severity. 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. Whereas the dean index identifies five types of fluorosis questionable, very mild, mild, moderate, and severe, the tf index identifies nine. Most questionable fluorosis under the dean index classifies as a tf score of 1. This report describes the interexaminer reliability achieved using deans index in a study of dental fluorosis, and shows the effect on kappa values of assigning different weights to the various components of deans index.
Deans fluorosis index legal definition of deans fluorosis index. The dean study national pure water association, in its response to the uk department of healths doh 2012 consultation on fluoridation proposals, included the critique the dean study, from the 2010 book the case against fluoride left. Deans index is scored on the condition of these two teeth. The dean index grades the enamel lesions according to the degree of severity described. Dental fluorosis wikimili, the best wikipedia reader. The thylstrupfejerskov index uses a numerical classification. 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. Synonyms for dean s fluorosis index in free thesaurus. Criteria for deans fluorosis index 20 score criteria normal the enamel represents the usual translucent semivitriform type of structure. This original deans index is a 7 point ordinal scale. Barthel index an objective, standardized tool for measuring functional status. Mild fluorosis is characterized by opaque lines following the perikymata. Deans fluorosis index, upon which we graded, our subjects are given in.
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. Deans fluorosis index definition of deans fluorosis. When scoring, start at the higher end of the index i. Fluorosis is a crippling disease resulted from deposition of fluorides in the hard and soft tissues of body. This means scoring criteria is based on the order i. The tooth surface index of fluorosis tsif eliminates or reduces some of the shortcomings of dean s method. Agreement on the presence or absence of fluorosis using deans definition of fluorosis ranged from 92 to 97 percent and the respective kappa values ranged from 0. Pdf dental fluorosis prevalence and severity using dean. The dean study demolishes the very foundation of fluoridation and is reproduced below. Preventable dental caries is still one of the most common chronic childhood diseases and frequently results in pain, suffering, and loss of time at school and work. Deans fluorosis index article about deans fluorosis index. Fluorosis, difference between dental fluorosis and non fluoride enamel opacities, deans fluorosis index. The individual is scored in a number of areas depending upon independence of performance. Dentists generally use the dean index to diagnose the severity of a childs fluorosis.
Dental fluorosis prevalence and diagnostic test using deans index based on 6. Dean s index is scored on the condition of these two teeth. Among 12 year olds, the difference between df28 and df6 was 20. Percentage weighted dental fluorosis severity levels, based on personlevel deans fluorosis index, among. The traditional criteria the dean index for diagnosing dental fluorosis was developed in the first half of the 20th century by h. Fluorosis definition of fluorosis by medical dictionary.