ABSTRACT This study aims to compare the effect of fTCP-contained toothpaste in combination with 950 ppm fluoride on primary dentin caries surface to ordinary 1100 ppm fluoride toothpaste by using estimation statistics. Dental caries with deep lesion and dentin exposure from nine primary teeth were cut into two equal parts and randomly divided into two groups in a before-after study. Each group was brushed with one type of toothpaste two times per day for 28 days and rested in artificial saliva. SEM images of cavity bottom surfaces and energy-dispersive X-ray spectrometry (EDX) were used to determine the percentage of calcium (Ca), phosphorus (P), fluoride (F) and oxygen (O) at six continuous measured areas from the surface of the cavity bottom into 45 µm depth before and after brushing. About 95% confidence interval of the mean difference was calculated by performing bootstrap resampling with 5000 resamples followed by comparison analysis. The percentage of Ca, P, F, O was shifted after treatment. There was no difference between the two groups. The SEM images reflected a similar illustration of EDX data. The combination of fTCP and 950 ppm fluoride in toothpaste showed equivalent effectiveness to the 1100 ppm fluoride toothpaste in primary dentin caries.
Fluorosis, Dental ; Dental Caries

exposure during enamel formation. Increased and decreased in fluorosis prevalence may also reflect to the different ways of measuring the disease. The choice of measuring fluorosis is depends on the objective of the assessment such as assessing public health significant of fluorosis in the population or assessing the detailed of biological effects of fluoride. These differences in requirement have led to the adoption of many indices and assessment methods of enamel fluorosis, which subsequently led to evaluation of examiner agreement between them. Several indices were developed to measure dental fluorosis in the 20th century. These include fluorosis specific indices such as Dean’s Index; the Thylstrup and Fejerskov Index; the Total Tooth Surface Index; and the Fluorosis Risk Index. Non-specific descriptive indices such as the Developmental Defects of Enamel index have also been used to record fluorosis. Fluorosis has most commonly been recorded using clinical examinations and photographs. Recent developments have seen the use of a Visual Analog Scale and automated grading systems such as Quantitative Light Fluorescence emerge as possible enhancements to fluorosis scoring. This article aims to review existing indices and new methods in measuring dental fluorosis, together with examiner reliability across different methods and indices.
Fluorosis, Dental ; Fluorides

OBJECTIVETo explore the attitude of the public to the psychosocial effects of fluorosis through investigating the public in different areas.

METHODSTwenty typical fluorosis photos were selected and evaluated by the public in Xingtai, Beijing and Guangzhou, which included 101 dentists, 118 dental students, 103 college students in non-dental schools, 102 clerks and 92 leaders. Each evaluator was required to answer seven five-point questions according to each photo.

RESULTSThe mean of the public evaluation was going up with the increase of Dean's Index (DI) score, ranging from 2.21 to 4.74, meanwhile, the prevalence of reporting that fluorosis would affect their psychosocial status also ascended. Less than 25% people reported that very mild fluorosis (DI < or = 1) would affect the psychosocial status of patients, and mild fluorosis (DI = 2) would affect 25% - 56%, while the prevalence would increase to 48% - 97% in severe fluorosis group (DI > or = 3). "Bivariate Correlation Analysis" showed that significant correlation existed in the evaluation of the public and the degree of fluorosis. The scores of dentists were significantly lower than those of dental students, college students in non-dental schools and clerks. The evaluation scores of the public in Xingtai were generally higher than those in Beijing and Guangzhou.

CONCLUSIONSMild or less fluorosis could lead to little psychosocial effects.

nformation regarding water fluoridation (WF) in Malaysia has been substantially documented, but is scattered in various government publications and may be lost to the stakeholders. This paper is a review of water fluoridation in Malaysia and its effect on oral health: a history of WF in Malaysia, the current policy, the evidence of its effectiveness, the challenges and the future directions. A search for relevant physical and electronic documents of WF in Malaysia resulted in the identification of 70 documents for review. WF was gazetted as national policy with an optimal fluoride level of 0.7 parts-per-million (ppm) in 1972, with a reduction of the level to 0.5 ppm in 2005. Evidence showed that WF effectively reduced population dental caries while fluorosis was not a prevalent public health concern. Strong collaboration between stakeholders and the extensive network of piped water supplies resulted in 80% of the population receiving WF in 2013. However, the coverage was reduced to 74.1% in 2018, largely due to the cessation of WF in Pahang. The key challenges in WF included a lack of funding, weak legislation, use of reverse osmosis water filtration system, difficulty to maintaining an optimal level of fluoride in the water, and lack of local data on the impact of WF cessation on oral health, and its cost-effectiveness. This review will provide dental health professionals with scientific evidence on WF and oral health in Malaysia and assist them in answering relevant questions about WF raised by the public.
Dental Caries ; Fluorosis, Dental ; Malaysia ; Review [Publication Type] ; Fluoridation

OBJECTIVETo investigate the effect of high levels of fluoride on children's intelligence development by analyzing the literatures systematically.

METHODSThe literatures on the relationship between endemic fluorosis and children's intelligence development published between 1995 and 2007 were retrieved electronically and manually. A total of 13 relevant literatures that met the inclusion criteria were included for Meta analysis. Meta analysis was performed using the Coorporative network software RevMan 4.3.

RESULTSThe subjects of the 13 literatures included 2 508 children from the high fluoride group and 2 330 children from the control group. Meta analysis showed these literatures were inhomogenous (x2=268.05, p<0.01). Therefore a random effect model was used. The average effect scale (OR=-7.14; 95%CI: -9.90, -4.37) suggested a negative correlation between high fluorosis exposure and children's intelligence development.

CONCLUSIONSExposure to high levels of fluoride may adversely influence children's intelligence development.

Enamel microabrasion has become accepted as a conservative, nonrestorative method of removing intrinsic and superficial dysmineralization defects from dental fluorosis, restoring esthetics with minimal loss of enamel. However, it can be difficult to determine if restoration is necessary in dental fluorosis, because the lesion depth is often not easily recognized. This case report presents a method for analysis of enamel hypoplasia that uses quantitative light-induced fluorescence (QLF) followed by a combination of enamel microabrasion with carbamide peroxide home bleaching. We describe the utility of QLF when selecting a conservative treatment plan and confirming treatment efficacy. In this case, the treatment plan was based on QLF analysis, and the selected combination treatment of microabrasion and bleaching had good results.
Dental Enamel Hypoplasia ; Dental Enamel* ; Enamel Microabrasion* ; Esthetics ; Fluorescence* ; Fluorosis, Dental* ; Methods ; Treatment Outcome ; Urea

OBJECTIVES: The purpose of this in vitro study was to evaluate the microleakage and penetration of fissure sealant in permanent molar teeth with fluorosis after pretreatment of the occlusal surface. MATERIALS AND METHODS: A total of 120 third molars with mild dental fluorosis were randomly divided into 6 groups (n = 20). The tooth surfaces were sealed with an unfilled resin fissure sealant (FS) material. The experimental groups included: 1) phosphoric acid etching (AE) + FS (control); 2) AE + One-Step Plus (OS, Bisco) + FS; 3) bur + AE + FS; 4) bur + AE + OS + FS; 5) Er:YAG laser + AE + FS; and 6) Er:YAG laser + AE + OS + FS. After thermocycling, the teeth were immersed in 0.5% fuchsin and sectioned. Proportions of mircoleakage (PM) and unfilled area (PUA) were measured by digital microscope. RESULTS: Overall, there were significant differences among all groups in the PM (p = 0.00). Group 3 showed the greatest PM, and was significantly different from groups 2 to 6 (p < 0.05). Group 6 showed the lowest PM. Pretreatment with Er:YAG with or without adhesive led to less PM than bur pretreatment. There were no significant differences among groups in PUA. CONCLUSIONS: Conventional acid etching provided a similar degree of occlusal seal in teeth with fluorosis compared to those pretreated with a bur or Er:YAG laser. Pretreatment of pits and fissures with Er:YAG in teeth with fluorosis may be an alternative method before fissure sealant application.
Adhesives ; Dental Enamel* ; Fluorosis, Dental ; Molar ; Molar, Third ; Rosaniline Dyes ; Tooth*

This study sought to determine the impact of dental fluorosis severity on demineralization and remineralization of human fluorosed teeth in vitro. Surface enamel microhardness was measured on the enamel blocks before and after demineralization and after remineralization. The results showed that after demineralization, the sequence of % Surface microhardness demineralization (% SMHD) was TFI4 (18.92 +/- 1.31) < TFI3 (20.50 +/- 1.32) < TFI2 (25.08 +/- 1.69) < TFI1 (27.77 +/- 1.79) < TFI0 (30.70 +/- 1.35) (P < 0.05), and there was no statistically significant differences between TFI1 (27.77 +/- 1.79) and the normal group TFI0 (30.70 +/- 1.35). After remineralization, the sequence of % Surface microhardness remineralization (% SMHR) was TFI1 (55.17 +/- 1.23) > TFI0 (53.97 +/- 3.05) > TFI2 (49.17 +/- 1.81) > TFI3 (44.85 +/- 1.89) > TFI4 (36.51 +/- 2.95) (P < 0.05). Moderately fluorosed enamel showed a significatnt resistance to caries, but mildly fluorosed enamel could get better remineralization. These facts and figures deserve clinicians' attention.
Dental Enamel ; chemistry ; pathology ; Fluorosis, Dental ; metabolism ; Humans ; In Vitro Techniques ; Tooth Demineralization ; Tooth Remineralization

OBJECTIVETo determine the feasibility of water fluoridation to prevent caries in Kunming by investigating the epidemiological status of dental caries and dental fluorosis of children, and to provide the longitudinal reference data for the long-term epidemiology survey of dental caries and dental fluorosis in Kunming city.

METHODSThrough stratified cluster sampling method, 212 5-year-old children and 1149 12-year-old children were recruited in the survey. Dental caries condition of each child was clinically examined, dental fluorosis was examined in 12-year-old group.

RESULTSThe prevalence of dental caries of primary teeth in 5-year-old group was 73.6%, mean value was 4.47 +/- 4.39. The values of permanent teeth in 12-year-old group were 53.5% and 1.42 +/- 1.83. The prevalence of dental fluorosis in 12-year-old group was 4.1% and the average community fluorosis index was 0.03.

CONCLUSIONBased on the high prevalence of dental caries and the low prevalence of dental fluorosis, it is suggested that using water fluoridation to prevent caries is feasible and necessary in Kunming city.

OBJECTIVETo find a way to having higher bond strength on mottled enamel.

METHODSSixty mottled enamel first bicuspid teeth extracted from fifteen patients needing orthodontic force were prepared and divided into four groups. Group A was routine acid etched, group B was air abraded, group C was etched by clearfil liner self-etching primer, group D was air abraded and then etched by clearfil liner self-etching primer. Next the bond and resin were used. The shear bond strength was observed and compared. The data were analysed by SPSS 11.5 statistical package.

RESULTSThe shear bonding strength of group A was (2.247 +/- 0.261) MPa, group B was (5.374 +/- 0.469) MPa, group C was (4.345 +/- 0.401) MPa, group D was (5.791 +/- 0.636) MPa. The strengths of four groups were significantly different (P < 0.01). The adhesive remnant index (ARI) scores of the four groups had no significant difference.

CONCLUSIONIn clinic, using air abrasion surface preparation technique is an acceptable way to enhancing the shear bond strength before sticking the orthodontic bonding on dental fluorosis.