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Saturday, May 15, 2010

Fluorosis Diagnosis


Diagnosis of Dental Fluorosis from Dental Caries.
  • Unlike Dental Fluorosis Dental Caries is a bacterial disorder.
  • Dental Caries also reveal discoloration of teeth; but unlike Dental Fluorosis, the discolouration in Dental Caries may be brown with no pattern.
  • Unlike Dental Fluorosis, Dental Caries shall reveal prominent cavities visible to the naked eye. The acids produced by the bacteria shall chew-up the teeth; only the stub of the teeth shall remain towards later stages.
  • The cavities in Dental Caries shall begin between two teeth or near the base of the crown, closer to the gums where the tooth brush does not reach and food debris collects enabling the bacteria to breed and produce acids. 
Note: Fluoride has very little role to play in rectifying cavities; except it can kill the bacteria so that no acids are formed. The same fluoride does more damage to tissue enzymes and therefore diseases surface. Using fluoride for preventing Dental Caries is an out-dated and unethical concept.

Diagnosis of Dental Fluorosis from dirty teeth.
  • In Dental Fluorosis the discolouration will be on the enamel surface
  • In the child shown below, the teeth of the upper jaw, the two central incisors have discolouration horizontally aligned on the enamel surface, away from the gums. It is due to Dental Fluorosis and is a permanent feature of the teeth.
  • In dirty teeth there will be discolouration of all shades but the discolouration will be along the gums (masuda) and not on the enamel surface.
  • The dirty teeth can be cleaned and polished by a Dentist; but not in Fluorosis.
  • Whereas in the teeth of the lower jaw, there is discolouration along the gums and is due to dirty teeth, which can be cleaned by a Dentist.

Fluorosis Diagnostic Tests: In Adults

Tests :
  • Fluoride to be tested in
    • Drinking Water ( to collect in plastic bottle only )
    • Blood (Serum) [ fasting not required ]
    • Urine (spot urine sample)
  • Radiograph of the fore-arm
  • Hemoglobin
In Children

Tests :
  • Fluoride in drinking water of the child / OR if an infant or new born, the drinking water of the mother.
  • Blood (serum) of the child; if an infant or new born, the blood serum of the mother
  • Urine of the child / infant
Additional tests :
  • Thyroid hormone levels T3 and T4
  • Thyroid Stimulating Hormone (TSH)
  • Iodine in urine
In Industrial workers
Fluoride to be tested in:
  • Drinking water
  • Blood (Serum)
  • Urine & urinary pH
  • Nail clippings
  • Hemoglobin
  • Retrieval of health complaints
  • Retrieval of information related to food habits

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