Presence of Enamel Fluorosis in Libyan Children
Condition: Dental Fluorosis
MeSH terms: Fluorosis, Dental; Fluoride Poisoning
Study type: Observational

Summary: 
      Fluorosis is caused by hypomineralization in the enamel due to increased fluoride ingestion
      during early childhood (Cawson.1, Wong et al. 2, and Sudhir 3). A considerable amount of
      evidence has been reported over the years, which has shown that presence of fluoride ions at
      up to one part per million in public water supply has reduced the prevalence of teeth decayed
      with minimal chance of dental fluorosis. The WHO recognized these facts by its resolution in
      1969 4 and 1975 5, which stated that water fluoridation, where applicable, should be the
      cornerstone of any national policy of caries prevention
    

Detailed description: 
      The optimal concentration is defined as that which gives maximal protection against dental
      caries, with minimal clinically observable dental fluorosis (Dunning 7). This level is
      determined according to the climate and the resultant drinking habits (Newborn 6). Cawson 1
      stated that mottling of enamel is the most frequently seen and most reliable sign of
      excessive quantities of fluoride in the drinking water. Dean 8 concluded that a fluoride
      level of above 1ppm does not significantly reduce caries beyond the optimal effect of 1ppm.

      Different classifications have been introduce to score dental fluorosis. (Dean 9, Al -Alousi
      10, Thylstrup & Fejerskov 11, (Fejerskov, 12). and the DDE index by FDI 1982). Aira Sabokseir
      13, concluded, fluorosis indices, if used alone, could result in misdiagnosis of dental
      fluorosis and information about adverse health-related conditions linked to DDEs
      (Developmental Defects of Enamel) at specific positions on teeth could help to differentiate
      between genuine fluorosis and fluorosis-resembling defects.Various figures for mouth
      prevalence of enamel fluorosis have been reported by different investigators. 39.2% by
      Al-Alousi 10, for Welsh children, 32% by Akpata 14 for Nigerian children. Using the DDE index
      of the FDI (1982), Al alousi 10 defective enamel of 48.9% in children from south Wales. In
      England,Tabari 15 found the prevalence of fluorosis was 54% in the fluoridated area and 23%
      in the fluoride-deficient area. In Iran the prevalence of fluorosis was 61% (Azami-Aghdash et
      al., 16).
    

Observational model: Ecologic or Community
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        This study is part of a cross - sectional investigation of aspects of dental health in
        rural and urban Libyan school children. Total of 2015 Libyan school children aged 7 to 16
        years, from urban (Tobruk) and rural (Kufra) areas were included in the main study. The
        children were of almost equal number of both sexes from each age group (table-I) .The total
        of 1935 children were examined for enamel fluorosis, the remaining, eighty children were
        excluded because they failed to meet inclusive criteria.
      
Keywords: fluoride; mottling; libya; fluorosis