Fluorosis is important to measure because it is a condition that can be used as biomarker for the level
of fluoride exposure during enamel formation. Increased and decreased in fluorosis prevalence may also reflect
to the different ways of measuring the disease. The choice of measuring fluorosis is depends on the objective of
the assessment such as assessing public health significant of fluorosis in the population or assessing the detailed
of biological effects of fluoride. These differences in requirement have led to the adoption of many indices and
assessment methods of enamel fluorosis, which subsequently led to evaluation of examiner agreement between
them. Several indices were developed to measure dental fluorosis in the 20th century. These include fluorosis
specific indices such as Dean’s Index; the Thylstrup and Fejerskov Index; the Total Tooth Surface Index; and the
Fluorosis Risk Index. Non-specific descriptive indices such as the Developmental Defects of Enamel index have
also been used to record fluorosis. Fluorosis has most commonly been recorded using clinical examinations and
photographs. Recent developments have seen the use of a Visual Analog Scale and automated grading systems
such as Quantitative Light Fluorescence emerge as possible enhancements to fluorosis scoring. This article aims
to review existing indices and new methods in measuring dental fluorosis, together with examiner reliability
across different methods and indices.