Deans index of fluorosis 1947 is the oldest index of fluorosis. Deans index of dental fluor osis deans index of dental fluorosis figure 2. If all defects are recorded, a retrospective attempt to reconstruct which of them are fluorosis is inappropriate. Smith et al 1931 1931 shoe leather survey by trendley h. Dental fluorosis prevalence and severity using deans index based on six teeth and on 28 teeth article pdf available in clinical oral investigations 123. Dean s fluorosis index was first published in 1934 by h.
Public health service in 1950, it was believed that the community fluorosis index in areas with 1 ppm fluoride in water would be between 0. Percentage weighted dental fluorosis severity levels, based on personlevel deans fluorosis index, among. While the dean index is still widely used in surveys of fluorosis including the cdcs national surveys of fluorosis in the united states dental researchers have developed more finely tuned diagnostic scales. Dean s index is scored on the condition of these two teeth. Dean devised an index for assessing the presence and severity of mottled enamel. The dean study demolishes the twentyonecity study by dean et al using research by the late. Dental fluorosis is a chronic fluoride induced condition in which an excess of fluoride is incorporated in the developing tooth enamel and disrupt the enamel formation of the tooth. On examination he had mild grade of fluorosis according to dean s fluorosis index in his teeth 23 and 33 43 figure 1. It is widely used and provides a basis for current and historical comparisons of fluorosis. Deans fluorosis index article about deans fluorosis. The statistical analysis was done using spss version 16. Fluorosis is a crippling disease resulted from deposition of fluorides in the hard and soft tissues of body. Dean provided a standard classification system for clinical. The fluorosis was quantitated as per deans fluorosis index.
Exposure, prevention and management introduction dental fluorosis is a developmental disturbance of dental enamel, caused by successive exposures to high concentrations of fluoride during tooth development, leading to enamel with lower mineral content and increased porosity. National health and nutrition examination survey, 19992004 and 20112016. Consequently, it is assumed that the level of urinary fluoride and dental fluorosis could increase due to fluoride emissions from brick kilns and groundwater fluoride. In the 20th century, the various indices used for measurement of dental fluorosis are. The fluorosis index set criteria for categorisation of dental fluorosis on a 7point scale. Aug 15, 2017 fluorosis is a crippling disease resulted from deposition of fluorides in the hard and soft tissues of body. When scoring, start at the higher end of the index i. Deans fluorosis index definition of deans fluorosis index. Dental fluorosis prevalence and severity using deans index. Megan brickley, rachel ives, in the bioarchaeology of metabolic bone disease, 2008. The mean iq scores did not vary with the severity of dental fluorosis as classified by deans fluorosis index. Community fluorosis index cfi fluoride action network.
The method of microabrasion was applied employing the readymade product opalustre, and the remineralisation employing tooth mousse. The first phase of treatment involved oral prophylaxis. Deans classification of dental fluorosis is presented in table1. Using the scores obtained for all teeth present df28 as a gold standard, we calculated the sensitivity. This list is usually at the back of a book, and the table of contents is. Indexes for measuring dental fluorosis horowitz 1986 journal. Fluoride action network community fluorosis index cfi. Deans fluorosis index article about deans fluorosis index. Fluorosis has most commonly been recorded using clinical examinations and photographs. Prevalence of dental fluorosis and fluoride content of drinking water in rural areas of malappuram district, kerala. O, 1997 the scoring system 04 fluorosis index department of public health dentistry. Percentage % prevalence of dental fluorosis in the studied population of the study sites.
Source year of age sample water fluorosis index publication yr size fluoride prevalence level ppm fluoridated segreto et al. These include fluorosis specific indices such as deans index. Fluorosis index department of public health dentistry 9 9. If fluorosis is present then decide on the two most severely affected teeth. The prevalence of dental caries among children was 56. In clinical work one of the most widely used methods of classifying and recording dental fluorosis is the dental fluorosis index dfi formulated by dean 1942. Fluorosis deans index fluorosis deans index this index records a fluorosis score for the anterior permanent maxillary incisors for respondents aged 6 12. The community fluorosis index cfi is a way of measuring the burden of dental. Matrices, in children with dental fluorosis, measured with deans fluorosis index, compared to those without dental fluorosis p fluoride. Prevalence and severity of dental fluorosis in the united. Deans earliest research on fluoride began with investigations into dental fluorosis. Although no numbers were used it was considered to be on ordinal scale. All other teeth were present, no dental caries was found. It is a public health problem caused by excess intake of fluoride through drinking waterfood productsindustrial pollutants over a long period.
Cdcnchs, national health and nutrition examination survey, 19992004. Deans fluorosis index synonyms, deans fluorosis index. Synonyms for dean s fluorosis index in free thesaurus. Prevalence of dental fluorosis due to high levels of fluoride in drinking water is an endemic global. Fluoride exposure, from any source, during the period of tooth development is associated with. The surface is smooth, glossy, and usually of a pale creamy white colour. In contrast deans index of fluorosis records only the appearance of dental fluorosis following a judgement of fluorosis by the examiner. Deans index is scored on the condition of these two teeth. Pdf dental fluorosis prevalence and severity using deans. Pdf dental fluorosis prevalence and severity using dean. Sign up or login to train in dean s index of fluorosis. Fluorine in water and dental fluorosis in a community of. Dental fluorosis is defined as having very mild, mild, moderate, or severe forms and is based on deans fluorosis index. Current issues in the science of community water fluoridation.
Fluorotic lesions are bilaterally symmetrical and tend to show a horizontal striated pattern across the tooth. In 1931 this condition of teeth was found to b correlated to fluoride content of drinking water. Epidemiologic indices for measuring the clinical manifestations of. Fluorosis index department of public health dentistry 10 the fluorosis index set criteria for categorization of dental fluorosis on a 7 point scale. Among 12 year olds, the difference between df28 and df6 was 20. Nonspecific descriptive indices such as the developmental defects of enamel index have also been used to record fluorosis. Dental fluorosis was scored using deans modified index. Ingestion of excess fluoride, most commonly in drinkingwater affects the teeth and bones. Instead of just measuring the overall prevalence of fluorosis i. At the department of childrens dental medicine to the medical university sofia 18 children aged 4 15 were treated for different degrees of fluorosis. The index underwent two changes, appearing in its final form in 1942. The continued use of deans classification system and derived index cfi for more than a half.
Matrices, in children with dental fluorosis, measured with deans fluorosis index, compared to those without dental fluorosis p and dental fluorosis. Deans index in a study of dental fluorosis, and shows the effect on kappa. Prevalence of dental caries and dental fluorosis among 12 and. The community fluorosis index cfi is a way of measuring the burden of dental fluorosis in a population.
Percent distribution of dental fluorosis among persons aged 649. Agreement on the presence or absence of fluorosis using dean s definition of fluorosis ranged from 92 to 97 percent and the respective kappa values ranged from 0. It was also found that a higher percentage of children with dental fluorosis was in the extremely low and low iq categories, whereas a higher percentage of children without dental. Dental fluorosis will be one of the first indicators of fluorosis.
If the two teeth are not equally affected score on the least affected. A comparison of tooth fluorosis scores deans index with the percenta ge of teeth that were sound, decayed, or filled in children from areas with above optimal water fluoride concentrations showed that children with a fluorosis classification of 4 had markedly. Oct 09, 2016 deans fluorosis index modified criteria 1942 combined moderately severe and severe 6 point ordinal scale extensively used today recommended by who in its basic survey manualw. A comparison of subjectlevel severity scores for dean s index resulted in percent agreement ranging from 79.
This would basically equate to about 78% of children having very mild fluorosis, and 23% of children having mild fluorosis. To contrast the sensitivity, specificity, and positivenegative predictive values between dental fluorosis prevalence scored on 28 df28 and on six permanent teeth df6, we undertook a crosssectional study on 1,538 adolescents 12 and 15 years old residing in hidalgo state, mexico, a naturally fluoridated 0. Deans fluorosis index legal definition of deans fluorosis index. Dental caries and dental fluorosis at varying water fluoride concentrations. Among the dean fluorosis index id and dental caries index dmft and dmfs, when the kappa test was applied, congruence was observed in the diagnosis criteria of 87% and 95% for fluorosis caries index re spectively. Criteria for deans fluorosis index 20 score criteria normal the enamel represents the usual translucent semivitriform type of structure. The exam was performed by two qualified and standardized observers accordingly to the who criteria 15. Cdcnchs, national health and nutrition examination survey, 1999 2004 although the effects of the most prevalent forms of dental fluorosis are primarily aesthetic, health professionals should identify all possible sources of fluoride before. Although no numbers were used it was considered to be on an ordinal scale. Data quality evaluation of the dental fluorosis clinical. Pdf dental fluorosis prevalence and severity using deans index. Dean, with others, went on to publish their famous twopart, twentyonecity study in 1942.
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