Preventive Dentistry Lec. 2

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Questions and Answers

Which age group is primarily affected by excess fluoride intake from tap water used for infant formula?

Birth to 3 years (correct)

3 to 6 years

6 to 12 years

0 to 6 years

What is the clinical appearance of dental fluorosis in its early stages?

Dark brown spots

White opaque appearance (correct)

Transparent enamel

Yellow staining

Which teeth are most affected by excess fluoride intake in children aged 3 to 6 years?

Incisors and first molars

All baby teeth

Premolars and canines (correct)

Wisdom teeth

What factor does NOT influence the severity of dental fluorosis?

Dietary calcium intake Signup and view all the answers

What is a common early sign of dental fluorosis?

Horizontal white lines Signup and view all the answers

What occurs to the enamel at higher levels of fluoride exposure?

Increased subsurface porosity Signup and view all the answers

Which of the following affects all teeth in children aged 0 to 6 years?

Fluoride supplements Signup and view all the answers

How does dental fluorosis lead to enamel damage?

By causing pits and discoloration Signup and view all the answers

What staining is typically observed in individuals with moderate dental fluorosis?

Yellow to light brown staining Signup and view all the answers

What happens to severely fluorosed enamel during normal mechanical use?

It can chip easily Signup and view all the answers

According to Dean's classification, what characterizes very mild dental fluorosis?

Small, opaque white areas not involving more than 25% of the tooth Signup and view all the answers

Which classification has a characteristic of all enamel surfaces being affected with brown stains in dental fluorosis?

Moderate Signup and view all the answers

What feature distinguishes severe dental fluorosis from other classifications?

Marked hypoplasia affecting form Signup and view all the answers

What can influence the susceptibility of teeth to decay in those with dental fluorosis?

Porous enamel structure Signup and view all the answers

Which characteristic describes normal enamel in Dean's classification of dental fluorosis?

Translucent and creamy white Signup and view all the answers

What is a common misconception about teeth with mild dental fluorosis?

They might be more resistant to decay. Signup and view all the answers

What is the recommended treatment for mild dental fluorosis?

Bleaching to make the tooth surface color uniform Signup and view all the answers

Which symptom is NOT associated with the early stages of bone fluorosis?

Heavy bleeding gums Signup and view all the answers

How can dental fluorosis be visually differentiated from an incipient carious lesion?

Carious lesions are not affected by wetting while fluorosis remains Signup and view all the answers

What is the primary distinguishing feature of hypocalcifications from dental fluorosis?

They remain visible regardless of wet or dry conditions Signup and view all the answers

Which treatment method is suitable for moderate dental fluorosis?

Composite restorations combined with micro abrasion Signup and view all the answers

What can be a consequence of untreated advanced bone fluorosis?

Osteoporosis in long bones Signup and view all the answers

What does generalized dental fluorosis indicate about fluoride levels?

Fluoride may be coming from the bones Signup and view all the answers

What may happen to the vertebrae in advanced stages of bone fluorosis?

Vertebrae may fuse together Signup and view all the answers

What is the primary cause of dental fluorosis?

Excessive exposure to high concentrations of fluoride during tooth development Signup and view all the answers

What is the primary effect of fluoride on the enzymes responsible for the removal of enamel proteins?

Fluoride inhibits the activity of these enzymes. Signup and view all the answers

At what age are children most sensitive to the effects of fluoride regarding dental fluorosis?

During the first 3 years of life Signup and view all the answers

What developmental disturbance does dental fluorosis cause in teeth?

Lower mineral content and increased porosity of enamel Signup and view all the answers

How does rapid bone growth affect the risk of dental fluorosis in children?

It decreases fluoride levels in the bloodstream. Signup and view all the answers

Which factor can enhance fluoride uptake in the body?

Deficiency in calcium, magnesium, and aluminum. Signup and view all the answers

Which group is at higher risk for developing dental fluorosis?

Infants fed formula made with fluoridated water Signup and view all the answers

What skeletal problems can result from the long-term ingestion of large amounts of fluoride?

Skeletal fluorosis Signup and view all the answers

What is a visible sign of dental fluorosis in enamel?

Opaque white lines or spots. Signup and view all the answers

What role does pH regulation play in ameloblast cell function concerning fluoride?

It is crucial for continued crystal growth. Signup and view all the answers

How does dental fluorosis typically present on the teeth?

It shows generalized enamel changes over the entire tooth surface Signup and view all the answers

Which dental effect develops earlier than skeletal effects in high fluoride exposure cases?

Dental fluorosis Signup and view all the answers

How does fluoride affect the crystallization of enamel during mineralization?

It disrupts proper crystal formation. Signup and view all the answers

Which of the following ions can reduce the bioavailability of fluoride?

Calcium. Signup and view all the answers

Which statement about fluoride is correct?

Low levels of fluoride help to prevent dental caries. Signup and view all the answers

What is the consequence of endoplasmic reticulum (ER) stress in ameloblast cells due to fluoride?

Reduction in extracellular enzyme production. Signup and view all the answers

Study Notes

Systemic Fluoride: Introduction

Fluoride ingestion has been linked to dental caries control for over a century.
Excess fluoride can cause dental fluorosis, affecting teeth and bones.
Low fluoride levels prevent caries, while excessive intake can lead to severe skeletal issues.
Dental fluorosis symptoms appear earlier than skeletal issues in fluoride overdose.

Dental Fluorosis

A developmental enamel disturbance caused by high fluoride exposure during tooth development.
Characterized by enamel with reduced mineral content and increased porosity.
Fluorosis presents generalized defects easily distinguishable from other enamel irregularities.
Infants (0-3 years) are particularly susceptible as their anterior teeth are most vulnerable.

Risk Factors and Timing

Fluoride accumulation occurs during tooth maturation; the entire tooth surface can be affected.
Infants fed formula with fluoridated water are at a higher risk for fluorosis.
Specific age-related risks:
- Birth to 3 years: Excess fluoride from tap water, primarily affects incisors and first molars.
- 3 to 6 years: Excess fluoride from toothpaste use, primarily affects premolars, canines, and second molars.
- 0 to 6 years: Fluoride supplements and water (with >4 ppm) can affect all teeth.

Severity and Classification of Dental Fluorosis

Severity of fluorosis correlates with fluoride intake levels.
Factors influencing severity:
- Stage of tooth development
- Duration and concentration of fluoride exposure
Clinical classification according to Dean's system:
- Normal: Translucent, smooth enamel.
- Questionable: Slight discoloration.
- Very mild: Small opaque areas.
- Mild: Extensive white opaque areas (<50% enamel).
- Moderate: All surfaces affected, potential for attrition.
- Severe: Marked hypoplasia, extensive discoloration, and surface damage.

Clinical Appearance of Dental Fluorosis

Characterized by white opaque enamel and potential yellow or brown staining.
Initial signs include white horizontal lines along perikymata.
Severe fluorosis results in chalky white enamel and vulnerability to decay, while mild forms may offer some resistance.

Pathogenesis of Dental Fluorosis

Physiological factors include body weight, skeletal growth, and nutritional status.
Fluoride disrupts enamel mineralization processes, leading to porous enamel.
Interferes with enzymes responsible for enamel protein degradation.
Rapid bone growth in children may reduce fluoride levels in the bloodstream, potentially minimizing risks.

Treatment Options for Dental Fluorosis

Mild Fluorosis: Bleaching to even out tooth color.
Moderate Fluorosis: Use of composite restorations, micro abrasion, or aesthetic veneers.
Severe Fluorosis: Use of prosthetic crowns.

Differentiating Incipient Caries from Fluorosis

Dental fluorosis remains constant in appearance regardless of moisture.
Incipient carious lesions diminish when wet, unlike hypocalcifications associated with fluorosis.
White spot lesions typically occur at gingival margins where plaque accumulates.

Bone Fluorosis

Affects both children and adults; may not show symptoms until advanced stages.
Early symptoms of bone fluorosis include pain, stiffness, and muscle weakness.
Advanced stages may lead to osteoporosis and bony growths; fused vertebrae can result in disability.
Generalized dental fluorosis indicates potential fluoride accumulation in skeletal systems.

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Description

Explore the impact of systemic fluoride in controlling dental caries in this Preventive Dentistry lecture. Learn about its benefits and the potential risks of excess fluoride ingestion. This session delves into the history and ongoing discussion surrounding fluoride's role in dental health.