title: Prevalence of dental fluorosis among 4- to 14-year-old children from the town of Dimitrovgrad (Bulgaria).
abstract: BACKGROUND
  There has been no study on the prevalence of dental fluorosis in Bulgaria of today where people have free access to some fluoride-containing products.
  
  
  OBJECTIVE
  The aim of the study was to investigate the prevalence of dental fluorosis among children 4 to 14 years old from the town of Dimitrovgrad, where due to unsatisfactory qualities of tap water people consume bottled water including such with fluoride levels higher than 1.5 mg/l.
  
  
  METHODS
  The study included 1504 randomly selected children. We analysed subjects with dental fluorosis according to Dean's modified criteria. The following severity levels were defined: 0 - normal; 0.5 - suspicious; 1 - very mild; 2 - mild; 3 - moderate; 4 - severe. Data were analyzed separately for the different types of dentitions.
  
  
  RESULTS
  Results showed that 54.52% of all children included in the study had dental fluorosis in different degrees. Primary teeth were affected by dental fluorosis less frequently than permanent teeth (P < 0.001). In mixed dentition cases 41.41% of the children had fluorosis of permanent teeth only, 1.64% had dental fluorosis of primary teeth only and 12.50% had both their primary and permanent teeth affected. The proportion of individuals with the lowest degree of severity - 0.5, was the greatest both for the primary and permanent teeth. Comparison with the proportions of children with more severe degrees of fluorosis revealed significant differences (P < 0.001).
  
  
  CONCLUSIONS
  The results of the study showed excessive fluoride intake during tooth development and suggested a need for further research of risk factors.
authors.affiliation: Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University, Plovdiv 15A Vassil Aprilov St, 4002 Plovdiv, Bulgaria.
authors.forename: Maria P
authors.initials: MP
authors.lastname: Kukleva
authors.forename: Alexandra V
authors.initials: AV
authors.lastname: Isheva
authors.forename: Veselina K
authors.initials: VK
authors.lastname: Kondeva
authors.forename: Mariana M
authors.initials: MM
authors.lastname: Dimitrova
authors.forename: Svetla G
authors.initials: SG
authors.lastname: Petrova
mesh_terms: D000293:Adolescent; D002031:Bulgaria / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005459:Fluorides / Q000008:administration & dosage; D009050:Fluorosis, Dental / Q000453:epidemiology*; D006801:Humans; D008297:Male; D014881:Water Supply / Q000032:analysis
chemical_list: D005459:Fluorides