title: Dental fluorosis in permanent incisor teeth in relation to water fluoridation, social deprivation and toothpaste use in infancy.
abstract: OBJECTIVE
  To determine the prevalence and severity of fluorosis in permanent incisor teeth in young children in a fluoridated and a fluoride-deficient community and to establish what relationship, if any, there was between the occurrence of dental fluorosis and the reported use of fluoride toothpaste in childhood.
  
  
  METHODS
  A prevalence study of children aged 8-9 years who had been continuous residents in fluoridated Newcastle or fluoride-deficient Northumberland.
  
  
  METHODS
  The permanent maxillary central incisor teeth were examined clinically and photographically by one examiner using the Thylstrup-Fejerskov index; the photographs were read blind to child identity and clinical score. A closed-response questionnaire enquired into the child's early experiences of toothbrushing and use of fluoride toothpastes. Social deprivation was measured by a Jarman score. The study took place in 1998.
  
  
  METHODS
  Prevalence of dental fluorosis measured by the Thylstrup-Fejerskov index.
  
  
  RESULTS
  Complete data were available for 78% (n = 409) and 79% (n = 403) of eligible sampled children in the two areas, respectively. Clinical and photographic results agreed closely and had high reproducibility. The prevalence of fluorosis was 54% in the fluoridated area and 23% in the fluoride-deficient area when all grades (> 0) of fluorosis were included; percentage prevalence of mild to moderate fluorosis (> or = 3) was 3% and 0.5% in the two areas, respectively. Multivariate analysis indicated that area of residence (odds ratio = 4.5), Jarman score (odds ratio = 0.99 per Jarman unit) and type of toothpaste (odds ratio = 1.6) were statistically significantly related to presence or absence of fluorosis: the risk factors were--fluoridated area, affluence, and use of adult toothpaste.
  
  
  CONCLUSIONS
  The prevalence of aesthetically important dental fluorosis was low, although higher in the fluoridated area. Use of a child's toothpaste (with lower fluoride concentration) could decrease risk in a fluoridated area. Adherence to the guidelines published by the British Society of Paediatric Dentistry is recommended.
authors.affiliation: Newcastle City Health NHS Trust, Walkergate Centre, Newcastle upon Tyne. Tabari@BTinternet.com
authors.forename: E D
authors.initials: ED
authors.lastname: Tabari
authors.forename: R
authors.initials: R
authors.lastname: Ellwood
authors.forename: A J
authors.initials: AJ
authors.lastname: Rugg-Gunn
authors.forename: D J
authors.initials: DJ
authors.lastname: Evans
authors.forename: R M
authors.initials: RM
authors.lastname: Davies
mesh_terms: D002648:Child; D019229:Dentition, Permanent; D004739:England / Q000453:epidemiology; D005457:Fluoridation / Q000009:adverse effects*; D005459:Fluorides / Q000008:administration & dosage / Q000009:adverse effects*; D009050:Fluorosis, Dental / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D007180:Incisor / Q000473:pathology; D007223:Infant; D008437:Maxilla; D015999:Multivariate Analysis; D016017:Odds Ratio; D010781:Photography; D011203:Poverty; D015995:Prevalence; D015203:Reproducibility of Results; D012923:Social Class; D011795:Surveys and Questionnaires; D014100:Toothpastes / Q000009:adverse effects* / Q000737:chemistry
chemical_list: D014100:Toothpastes; D005459:Fluorides