title: The association between developmental enamel defects and caries in populations with and without fluoride in their drinking water.
abstract: OBJECTIVE
  The purpose of this study was to consider the association between developmental enamel defects and dental caries in children from areas with different levels of fluoride in their drinking water.
  
  
  METHODS
  children (mean age = 14.1 +/- 0.3 years) were examined from areas with less than 0.1 ppm (n = 267) and 0.7 ppm (n = 196) in their drinking water. These areas were chosen to contain subjects with a similar social profile. Two types of enamel defect were considered: those consistent with the diagnostic criteria of the Thylstrup Fejerskov (TF) index and demarcated opacities. Dental caries was recorded for surfaces at the level of the dentinal lesion.
  
  
  RESULTS
  Subjects with one or more demarcated opacities had more dental caries than those without these opacities present. Children with enamel defects scored with the TF index tended to have less dental caries than those without these defects present. However, the difference was only statistically significant in the area without fluoride in the drinking water.
  
  
  CONCLUSIONS
  Developmental enamel defects may be useful markers of caries susceptibility, which should be considered in the risk-benefit assessment for use of fluoride. Further studies are required to clarify the relationship between developmental enamel opacities and dental caries and the reasons for any associations.
authors.affiliation: Dental Health Unit, Manchester, England.
authors.forename: R P
authors.initials: RP
authors.lastname: Ellwood
authors.forename: D
authors.initials: D
authors.lastname: O'Mullane
mesh_terms: D000293:Adolescent; D001641:Bicuspid / Q000002:abnormalities / Q000473:pathology; D003481:Cuspid / Q000002:abnormalities / Q000473:pathology; D004245:DMF Index; D003731:Dental Caries / Q000145:classification / Q000453:epidemiology*; D003733:Dental Caries Susceptibility; D003743:Dental Enamel / Q000002:abnormalities*; D003804:Dentin / Q000473:pathology; D004739:England / Q000453:epidemiology; D005459:Fluorides / Q000032:analysis*; D006801:Humans; D015203:Reproducibility of Results; D012306:Risk; D018570:Risk Assessment; D012923:Social Class; D014071:Tooth Abnormalities / Q000145:classification / Q000453:epidemiology; D014852:Wales / Q000453:epidemiology; D014881:Water Supply / Q000032:analysis*
chemical_list: D005459:Fluorides