title: Dental fluorosis and caries prevalence in children residing in communities with different levels of fluoride in the water.
abstract: OBJECTIVE
  This study investigated the prevalence of dental fluorosis and caries in 7-14-year-old children residing in communities with negligible (NF: 0.2 ppm), optimal (OPF: 1.0 ppm), and four-times optimal (4X OPF: 4.0 ppm) naturally occurring fluoride in their water systems.
  
  
  METHODS
  Examinations were performed on 344 children who were lifetime residents of their communities.
  
  
  RESULTS
  Whether using the tooth surface index of fluorosis or Dean's index, children examined in the 4X OPF community had the highest prevalence of dental fluorosis. While the severity of fluorosis seen in the OPF and NF communities was mild in appearance, the results indicate that fluorosis does occur in optimally and negligibly fluoridated communities. Compared to the NF community, DMFT and DMFS scores in the OPF community were 9.2 percent and 21.2 percent lower, respectively.
  
  
  CONCLUSIONS
  The ingestion of water containing 1 ppm or less fluoride during the time of tooth development may result in dental fluorosis, albeit in its milder forms. However, in these times of numerous products containing fluoride being available, children ingesting water containing 1 ppm fluoride continue to derive caries protection compared to children ingesting water with negligible amounts of fluoride. Thus, the potential for developing a relatively minor unesthetic condition must be weighed against the potential for reducing dental disease.
authors.affiliation: Oral Health Research Institute, Indianapolis, IN 46202-2876, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Jackson
authors.forename: S A
authors.initials: SA
authors.lastname: Kelly
authors.forename: B P
authors.initials: BP
authors.lastname: Katz
authors.forename: J R
authors.initials: JR
authors.lastname: Hull
authors.forename: G K
authors.initials: GK
authors.lastname: Stookey
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D004245:DMF Index; D003731:Dental Caries / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control; D005260:Female; D005457:Fluoridation / Q000706:statistics & numerical data*; D005459:Fluorides / Q000032:analysis*; D009050:Fluorosis, Dental / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D008297:Male; D009805:Odontogenesis / Q000187:drug effects; D015995:Prevalence; D014070:Tooth / Q000473:pathology; D014881:Water Supply / Q000032:analysis*
chemical_list: D005459:Fluorides