title: Adult perceptions of dental fluorosis and select dental conditions-an Asian perspective.
abstract: OBJECTIVE
  To compare lay people's perceptions with regard to various levels of dental fluorosis and select dental defects versus normal dentition.
  
  
  METHODS
  Adults rated digitally created photographs made showing lips (without retraction) and teeth depicting the following conditions: no apparent aesthetic defects (normal, Thylstrup- Fejerskov score 0 - TF0), 6 levels of fluorosis (TF1-6), carious lesions (two cavitated and one noncavitated), malocclusions (Class II, Class III, anterior open bite and greater spacing), extrinsic staining and an incisal chip. The photographs were displayed on colour-calibrated iPads(™) . Participants used a self-administered questionnaire to rate their perceptions on (Item 1) how normal teeth were, (Item 2) how attractive the teeth were, (Item 3) need to seek correction of teeth, (Item 4) how well the person took care of their teeth and (Item 5) whether the person was born like this. Data from Item 5 were excluded due to low reliability.
  
  
  RESULTS
  Ratings for Item 1 showed that TF1-4 was similar or significantly better than TF0. For Item 2, TF1 and TF4 were significantly better than TF0, with TF2 and TF3 being similar. For Item 3, there was significantly lower need to seek correction with TF2 and TF4 versus TF0, whereas TF1 and TF3 were similar to TF0. TF5 and TF6 were rated significantly lower than TF0 for Item 1 and Item 2, and significantly higher rating for Item 3 (need to seek correction). Ratings for Item 4 were similar, with TF1, TF2 and TF4 being rated significantly higher than TF0, and TF5 and TF6 being rated lower. Cavitated caries and staining were generally perceived as being significantly less favourable than TF6, with higher need to seek correction as well. Noncavitated carious lesion and incisal chip were rated similar to TF0. Cavitated carious lesions were rated aesthetically similar or significantly worse than TF0 and TF6.
  
  
  CONCLUSIONS
  Severe fluorosis (TF5 and 6) was perceived to be less aesthetically pleasing and received higher ratings for need to seek correction than normal teeth. Mild-to-moderate fluorosis (TF1-4) showed similar or better aesthetic perceptions and similar or lower need to seek correction, when compared to normal teeth (TF0). Easily visible cavitated dental caries was rated worse than teeth with severe fluorosis (TF6) and normal teeth (TF0).
authors.affiliation: ARCPOH, School of Dentistry, University of Adelaide, Adelaide, SA, Australia.|Oral Sciences, National University of Singapore, Singapore, Singapore.
authors.forename: Rahul
authors.initials: R
authors.lastname: Nair
authors.affiliation: National Healthcare Group, Singapore, Singapore.
authors.forename: Janice Cheah Ping
authors.initials: JC
authors.lastname: Chuang
authors.affiliation: National Dental Centre of Singapore, Singapore, Singapore.
authors.forename: Pauline Shih Jia
authors.initials: PS
authors.lastname: Lee
authors.affiliation: Singapore Health Services (Singhealth), Singapore, Singapore.
authors.forename: Song Jie
authors.initials: SJ
authors.lastname: Leo
authors.affiliation: Health Promotion Board, Singapore, Singapore.
authors.forename: Naomi QiYue
authors.initials: NQ
authors.lastname: Yang
authors.affiliation: Oral Sciences, National University of Singapore, Singapore, Singapore.
authors.forename: Robert
authors.initials: R
authors.lastname: Yee
authors.affiliation: Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore.
authors.forename: Huei Jinn
authors.initials: HJ
authors.lastname: Tong
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004955:Esthetics, Dental; D005260:Female; D009050:Fluorosis, Dental / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D010781:Photography; D015203:Reproducibility of Results; D012846:Singapore
keywords: attitude to health; dental caries/prevention; dental/psychology; fluorides/adverse effects; fluorosis