The prevalence, causes and cosmetic importance of dental fluorosis in the United Kingdom: a review.
OBJECTIVE
To determine the prevalence of fluorosis and other developmental defects of enamel (DDE) in the United Kingdom over the last 40 years. To examine the risk factors that may have influenced the prevalence of fluorosis.


METHODS
All relevant publications between 1956-1995 on the prevalences of DDE and fluorosis in the UK were critically reviewed in addition to publications from other countries where these added substantial information about the risk factors involved in the latter.


RESULTS
The likely overall prevalence of DDE in the UK is approximately 40 per cent of which diffuse opacities account for about half. In areas benefiting from water fluoridation the overall prevalence of DDE is around 70 per cent with diffuse opacities accounting for two thirds. No substantial evidence of increases in either DDE or fluorosis could be identified. Risk factors for fluorosis include inappropriate use of fluoride supplements and fluoride toothpaste during early childhood and life-time residence in an optimally fluoridated area.


CONCLUSIONS
Fluorosis does not appear to be of public health concern in the UK at present. However, the inadequacies of the data and paucity of in-depth studies highlight the need for further co-ordinated research using agreed methods of monitoring prevalence, multivariate analysis to identify risk factors and a societal norm to discover its cosmetic impact.
Holloway
P J
PJ
Dental Health Unit, Manchester, UK.
Ellwood
R P
RP
D000293:Adolescent; D002648:Child; D004955:Esthetics, Dental; D005457:Fluoridation / Q000706:statistics & numerical data; D009050:Fluorosis, Dental / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D009017:Morbidity / Q000639:trends; D015995:Prevalence; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology