Dental fluorosis in populations from Chiang Mai, Thailand with different fluoride exposures - paper 2: the ability of fluorescence imaging to detect differences in fluorosis prevalence and severity for different fluoride intakes from water.
BACKGROUND
To assess the ability of fluorescence imaging to detect a dose response relationship between fluorosis severity and different levels of fluoride in water supplies compared to remote photographic scoring in selected populations participating in an observational, epidemiological survey in Chiang Mai, Thailand.


METHODS
Subjects were male and female lifetime residents aged 8-13 years. For each child the fluoride content of cooking water samples (CWS) was assessed to create categorical intervals of water fluoride concentration. Fluorescence images were taken of the maxillary central incisors and analyzed for dental fluorosis using two different software techniques. Output metrics for the fluorescence imaging techniques were compared to TF scores from blinded photographic scores obtained from the survey.


RESULTS
Data from 553 subjects were available. Both software analysis techniques demonstrated significant correlations with the photographic scores. The metrics for area effected by fluorosis and the overall fluorescence loss had the strongest association with the photographic TF score (Spearman's rho 0.664 and 0.652 respectively). Both software techniques performed well for comparison of repeat fluorescence images with ICC values of 0.95 and 0.85 respectively.


CONCLUSIONS
This study supports the potential use of fluorescence imaging for the objective quantification of dental fluorosis. Fluorescence imaging was able to discriminate between populations with different fluoride exposures on a comparable level to remote photographic scoring with acceptable levels of repeatability.
School of Dentistry, University of Manchester, Manchester, England. Michael.mcgrady@postgrad.manchester.ac.uk
Michael G
MG
McGrady
Roger P
RP
Ellwood
Patcharawan
P
Srisilapanan
Narumanas
N
Korwanich
Andrew
A
Taylor
Michaela
M
Goodwin
Iain A
IA
Pretty
D000293:Adolescent; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000032:analysis*; D002648:Child; D003296:Cooking; D004305:Dose-Response Relationship, Drug; D016021:Epidemiologic Studies; D005260:Female; D005459:Fluorides / Q000008:administration & dosage / Q000032:analysis*; D009050:Fluorosis, Dental / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007180:Incisor / Q000473:pathology; D008297:Male; D061848:Optical Imaging / Q000295:instrumentation / Q000379:methods*; D023861:Photography, Dental / Q000379:methods; D015995:Prevalence; D012984:Software; D013785:Thailand / Q000453:epidemiology; D014881:Water Supply / Q000032:analysis*
D002327:Cariostatic Agents; D005459:Fluorides