Dental Fluorosis: Epidemiological Aspects

The use of fluoride for promoting oral health has always involved a balance between the protection against caries and the risk of fluorosis. Dental fluorosis, a developmental condition of enamel, results from excessive intake of fluoride during the tooth development period. Dental fluorosis is the most common adverse effect of fluoride use in prevention of dental caries. The public health importance of dental fluorosis lies in its role as the canary in the coalmine, that is, a population indicator of excessive fluoride exposure. Dental fluorosis is an important aspect of oral health because (a) scientific evidence has recently elevated dental fluorosis to prominence as the adverse outcome associated with fluoride use; (b) public opinion on the safety of fluoride use now routinely includes dental fluorosis as a concern; and (c) recommendations about the use of fluoride should be based on evidence of a risk-benefit trade-off between a preventive benefit against dental caries and a risk of having fluorosis. Research on various aspects of dental fluorosis is important to inform oral health policies.