Prevalence of dental fluorosis in children from non-water-fluoridated Halmstad, Sweden: fluoride toothpaste use in infancy

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Abstract
Objectives. To determine the prevalence and severity of dental fluorosis in children aged 7–9 years from non-water-fluoridated Halmstad, Sweden, and to relate the results to their reported fluoride exposure history during infancy. Material and Methods. In Spring 2002, a questionnaire distributed to a cluster random sample of 1039 parents enquired into their child's early oral health behaviors and included a “photographic toothpaste menu”. The permanent upper anterior teeth (13–23) were examined clinically (+10% repeats) using a modified Thylstrup-Fejerskov Index. Results. Complete data were available for 53% (n=548) of the sampled children. The prevalence of fluorosis at any level was 49% (95% CI: 45–54%), and of fluorosis with esthetic concern (TF score ≥3) 4% (95% CI: 3–6%). Based on repeat observations, reliability was good (kappa=0.82). There was no statistically significant increased risk of dental fluorosis prevalence associated with any of the fluoride exposure risk factors examined, including reported usage of (1000 ppm) fluoride toothpaste from time of first deciduous tooth eruption. Conclusions. While there were low levels of dental fluorosis of esthetic concern, half the children had some degree of dental fluorosis. The prevalence of dental fluorosis was not explained by the risk factors, including fluoride toothpaste usage as explored in this study.