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World Water Day 2001: Oral health: Previous page | 1,2,3,4,5,6,7

Dental fluorosis

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Dental fluorosis is a specific disturbance of tooth formation caused by excessive fluoride intake during the development of teeth. It is characterized by opaque white patches in the dental enamel. These patches may become stained yellow to a darker colour and in more severe cases normal tooth structure may be destroyed. The degree of fluorosis, and plasma and bone fluoride levels, are directly related to the concentration of fluoride in drinking water.

When mild or more severe dental fluorosis is found to a significant extent in a community, steps should be taken to reduce fluoride ingestion during the ages of tooth development. Excessive levels of fluoride in the drinking water can lead to more serious health problems, notably skeletal fluorosis and other effects on the skeleton. In its extreme form, skeletal fluorosis is a very seriously debilitating disease. Because of excessive total intakes of fluoride in many parts of the world, skeletal fluorosis affects several millions of people.

In drinking water, fluoride is tasteless, odourless, colourless and totally soluble and its detection requires laboratory equipment and specially trained personnel. Methods for removing excess fluoride are well established, although the prevention of fluorosis through the treatment of drinking water requires favourable socio-economic conditions. The provision of a safe low level of fluoride in water from alternative sources should be investigated as a first option. Defluoridation of water may be the only option to prevent fluorosis if alternative supplies are either not available or too expensive. The methods for defluoridation depend on the specific local circumstances in the community and the level of fluoride concentration in the drinking water. In developing countries, WHO's initiative has emphasised the effective and less expensive methods that are suitable for individual households, or community defluoridation of water for drinking and cooking.

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