title: Risk factors for dental fluorosis in pediatric dental patients.
abstract: OBJECTIVE
  Concerns have been raised recently about whether a substantial amount of dental fluorosis is resulting from the increased use of fluoride from various sources. The purposes of this study were to determine the prevalence and severity of dental fluorosis in a sample of pediatric patients seeking dental treatment in a university pediatric dental clinic and to evaluate sources of fluoride as risk factors for dental fluorosis.
  
  
  METHODS
  A convenience sample of 157 children aged 8 to 17 years were examined for dental fluorosis using the Tooth Surface Index of Fluorosis (TSIF). Fluoride history questionnaires assessing previous exposure to fluoride during the first eight years of life were completed by the children's parents. Fluoride exposures were compared among 54 cases and 54 matched controls using a case-control retrospective design.
  
  
  RESULTS
  Fluorosis was found in 72 percent of the children, but was generally quite mild. The risk of fluorosis was significantly greater for children who had greater exposure to fluoridated water and who used larger amounts of fluoridated toothpaste up to age eight.
  
  
  CONCLUSIONS
  This study provided evidence that increased use of fluoride toothpaste may be a risk factor for dental fluorosis. The results suggest prudent use of dentifrice by young children to minimize the risk of fluorosis.
authors.affiliation: Department of Pediatric Dentistry, College of Dentistry, University of Iowa, Iowa City 52242-1001, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Skotowski
authors.forename: R J
authors.initials: RJ
authors.lastname: Hunt
authors.forename: S M
authors.initials: SM
authors.lastname: Levy
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005457:Fluoridation / Q000009:adverse effects; D005459:Fluorides / Q000008:administration & dosage / Q000009:adverse effects*; D005460:Fluorides, Topical / Q000009:adverse effects; D009050:Fluorosis, Dental / Q000453:epidemiology / Q000209:etiology*; D005527:Food, Fortified / Q000009:adverse effects; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D009067:Mouthwashes / Q000009:adverse effects; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014100:Toothpastes / Q000009:adverse effects*
chemical_list: D005460:Fluorides, Topical; D009067:Mouthwashes; D014100:Toothpastes; D005459:Fluorides