Displaying publications 1 - 20 of 26 in total

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  1. Mohd Nor NA, Chadwick BL, Farnell DJ, Chestnutt IG
    Rev Environ Health, 2020 Nov 18;35(4):419-426.
    PMID: 32598322 DOI: 10.1515/reveh-2019-0059
    OBJECTIVE: The increased availability of fluoride and concern over the impact of fluorosis, have led to guidance suggesting a decrease or cease in the optimal concentration of fluoride in water fluoridation schemes. To date there have been no systematic reviews looking at both impact of fluoride reduction and total cessation. This review aimed to examine the impact of stopping or reducing the level of fluoride in public water supplies on dental fluorosis.

    CONTENT: Multiple databases were searched (MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Web of Science). Two reviewers independently screened sources, extracted data and assessed study quality. Results were synthesised qualitatively and quantitatively. The main outcome measure was the prevalence of dental fluorosis.

    SUMMARY: Six studies of cross-sectional design were included. Two studies were scored as evidence level B (moderate) and the remaining four publications were evidence level C (poor). Meta-analysis indicated fluorosis prevalence was significantly decreased following either a reduction in the concentration of fluoride or cessation of adding fluoride to the water supply (OR:6.68; 95% CI:2.48 to 18.00).

    OUTLOOK: The evidence suggests a significant decrease in the prevalence of fluorosis post cessation or reduction in the concentration of fluoride added to the water supply. However, this work demonstrates that when studies are subject to current expectations of methodological and experimental rigour, there is limited evidence with low methodological quality to determine the effect of stopping or reducing the concentration of fluoride in the water supply on dental fluorosis.

    Matched MeSH terms: Fluorosis, Dental/etiology; Fluorosis, Dental/epidemiology*
  2. Mohd Desa, S. N. F., Muhamad, N. A., Mohd Nor, N. A., Abdul Razak, F., Abdul Manan, N. S., Abdul Manan, N. S., et al.
    MyJurnal
    The window of maximum susceptibility for the development of dental fluorosis for anterior
    teeth is during the first two to three years of life. The primary source of fluoride intake for
    infants at this age is mainly from the diet including infant formula. Thus, the present work
    aimed to investigate the fluoride concentration in commercially available Malaysian infant
    formulas that required reconstitution before consumption. A total of 29 infant formulas available in the Malaysian market were reconstituted with deionised water, fluoridated tap water,
    and filtered tap water. The fluoride concentration of the infant formulas was analysed directly
    using a fluoride ion selective electrode. The daily fluoride intake estimation from the infant
    formulas was calculated using the median infant body weight and recommended volumes for
    formula consumption from newborn to > 12 months of age. Results showed that the fluoride
    concentration of the infant formulas when reconstituted with deionised water ranged between
    0.009 to 0.197 mg/L that contributed to the estimated daily fluoride intake ranging from 0.005
    to 0.100 mg (total intake per day) or 0.001 to 0.025 mg/kg (total intake per body weight/day).
    The fluoride concentration in the selected infant formulas was low, but after reconstitution
    with fluoridated tap water, the overall fluoride concentration in infant formulas sample significantly increased (p < 0.001). Nevertheless, the estimated daily fluoride intake from infant
    formulas alone did not exceed the lowest-observed-adverse-effect level (LOAEL) of fluoride
    at 0.10 mg/kg/day.
    Matched MeSH terms: Fluorosis, Dental
  3. Yadav KK, Kumar S, Pham QB, Gupta N, Rezania S, Kamyab H, et al.
    Ecotoxicol Environ Saf, 2019 Oct 30;182:109362.
    PMID: 31254856 DOI: 10.1016/j.ecoenv.2019.06.045
    In low concentration, fluoride is considered a necessary compound for human health. Exposure to high concentrations of fluoride is the reason for a serious disease called fluorosis. Fluorosis is categorized as Skeletal and Dental fluorosis. Several Asian countries, such as India, face contamination of water resources with fluoride. In this study, a comprehensive overview on fluoride contamination in Asian water resources has been presented. Since water contamination with fluoride in India is higher than other Asian countries, a separate section was dedicated to review published articles on fluoride contamination in this country. The status of health effects in Asian countries was another topic that was reviewed in this study. The effects of fluoride on human organs/systems such as urinary, renal, endocrine, gastrointestinal, cardiovascular, brain, and reproductive systems were another topic that was reviewed in this study. Different methods to remove fluoride from water such as reverse osmosis, electrocoagulation, nanofiltration, adsorption, ion-exchange and precipitation/coagulation were introduced in this study. Although several studies have been carried out on contamination of water resources with fluoride, the situation of water contamination with fluoride and newly developed technology to remove fluoride from water in Asian countries has not been reviewed. Therefore, this review is focused on these issues: 1) The status of fluoride contamination in Asian countries, 2) health effects of fluoride contamination in drinking water in Asia, and 3) the existing current technologies for defluoridation in Asia.
    Matched MeSH terms: Fluorosis, Dental/epidemiology
  4. Mohd Nor NA, Chadwick BL, Farnell DJJ, Chestnutt IG
    Community Dent Oral Epidemiol, 2018 10;46(5):492-499.
    PMID: 30019792 DOI: 10.1111/cdoe.12407
    OBJECTIVE: To assess the prevalence and severity of dental fluorosis and caries among Malaysian children following the reduction in fluoride concentration from 0.7 to 0.5 parts per million (ppm) in the public water supply.

    METHODS: This study involved lifelong residents aged 9- and 12-year-olds in fluoridated and nonfluoridated areas in Malaysia (n = 1155). In the fluoridated area, children aged 12 years and 9 years were exposed to 0.7 and 0.5 ppm, respectively, at the times when maxillary central incisors developed. Standardized photographs of maxillary central incisors were blind scored for fluorosis using Dean's criteria. Dental caries was examined using ICDAS-II criteria.

    RESULTS: The prevalence of fluorosis (Dean's score ≥ 2) among children in the fluoridated area (35.7%, 95% CI: 31.9%-39.6%) was significantly higher (P 

    Matched MeSH terms: Fluorosis, Dental/etiology; Fluorosis, Dental/epidemiology*
  5. Bhoopathi PH, Voruganti S, Suma NS, Samudrala T, Kamath BV, Jahagirdar A
    J Contemp Dent Pract, 2018 May 01;19(5):546-553.
    PMID: 29807965
    AIM: To evaluate caries spectrum among 12- and 15-year-old Indian children using the Caries Assessment Spectrum and Treatment (CAST) index.

    MATERIALS AND METHODS: An epidemiological survey of the schoolchildren was carried out in a district in India. A stratified cluster random sampling method was used to select the sample. The caries prevalence of the surveyed population was obtained by using this CAST tool. Chi-square test was used to verify the association between dental fluorosis, socioeconomic status, and age and caries experience. Mann-Whitney U-test was used to compare the caries experience between the two age groups.

    RESULTS: A total of 2,610 children were examined. The majority of the schoolchildren (12 years: 74.2%, 15 years: 75.5%) were healthy concerning their caries experience and the prevalence of the other codes was minimal. The prevalence of dentin carious lesions and the percent of restorable teeth was greater among the 15-year-olds. The mean decayed, missing, and filled teeth (DMFT) of 12- and 15-year-old subjects was calculated to be 0.22 and 0.29 respectively.

    CONCLUSION: The currently surveyed population showed a low caries prevalence and the use of the tool highlighted the caries spectrum in an impressive way.

    CLINICAL SIGNIFICANCE: A well-designed tool to assess the carious spectrum of an individual or a community, thus enabling the responsible stakeholders to plan an appropriate care that is necessary.

    Matched MeSH terms: Fluorosis, Dental/epidemiology
  6. Ramesh M, Malathi N, Ramesh K, Aruna RM, Kuruvilla S
    J Pharm Bioallied Sci, 2017 Nov;9(Suppl 1):S88-S91.
    PMID: 29284943 DOI: 10.4103/jpbs.JPBS_77_17
    Background: High levels of fluoride in the drinking water, especially ground water, results in skeletal fluorosis which involves the bone and major joints. This study was conducted to assess the prevalence of skeletal fluorosis to compare with dental fluorosis in an endemically fluorosed population in the District of Salem, Tamil Nadu.

    Materials and Methods: Institutional ethical clearance was obtained. A total of 206 patients who reported to the Department of Hematology for blood investigations were the participants in this study. Age, sex, place, weight, height, dental fluorosis, and skeletal complaints were noted down. Body mass index was calculated, and statistical analysis was performed.

    Results: Dental fluorosis was present in 63.1% and absent in 36.9% of the samples reported. Skeletal fluorosis was present in 24.8% and was absent in 75.2%. A large number of the patients had knee pain and difficulty in bending. Chi-square test was used for statistical analysis. Skeletal fluorosis and age were compared and P value was 0.00 and was significant. Dental fluorosis and skeletal fluorosis were compared and P value was found to be 0.000 and significant.

    Discussion and Conclusion: There is a need to take measures to prevent dental and skeletal fluorosis among the residents of Salem district. Calcium balance should be maintained, and fluoride intake should be minimized to reduce the symptoms. The government should provide water with low fluoride level for drinking and cooking. Once the symptoms develop, treatment largely remains symptomatic, using analgesics and physiotherapy.

    Matched MeSH terms: Fluorosis, Dental
  7. Ramesh M, Narasimhan M, Krishnan R, Aruna RM, Kuruvilla S
    J Oral Maxillofac Pathol, 2017 Sep-Dec;21(3):345-350.
    PMID: 29391706 DOI: 10.4103/jomfp.JOMFP_247_16
    Background: Fluoride is needed for the normal development of bone and teeth; in high levels, it affects developing teeth and bone. Dental fluorosis (DF) is caused by ingestion of excess fluoride mainly through drinking water.

    Aim: The present study aims to observe and understand the histological changes of fluorosed teeth under light microscope (LM).

    Materials and Methods: Teeth which were indicated for extractions for orthodontic or periodontal problems were selected. Thirty extracted teeth were selected with varying degrees of DF based on modified Dean's fluorosis index. Ground sections of these teeth were prepared and the sections were studied under binocular LM. Photomicrographs were taken under high power objective using 15 megapixels Nikon camera.

    Results and Conclusion: Qualitative histologic changes in different grades of fluorosed teeth were evaluated in enamel, dentin, cementum and between their junctions. Fluoride interacts with enamel in both mineral phases and organic macromolecules by strong ionic and hydrogen bonds resulting in incomplete crystal growth at prism peripheries. This presents as hypomineralization of enamel and dentin, increased interglobular dentin, increased secondary curvatures and changes in cementum such as diffuse cementodentinal junction and increased thickness of Tomes' granular layer. Changes in the structure of the teeth with Dean's index below 2 and teeth with Dean's index of 2 and above were compared using Chi-square test. P value was found to be highly significant being 0.00047. Many of the features of dental fluorosis seen in the present study under light microscope are comparable to those results studied under specialized microscopes.
    Matched MeSH terms: Fluorosis, Dental
  8. Ramesh M, Narasimhan M, Krishnan R, Chalakkal P, Aruna RM, Kuruvilah S
    Contemp Clin Dent, 2016 6 17;7(2):203-8.
    PMID: 27307668 DOI: 10.4103/0976-237X.183061
    CONTEXT: There are various regions in India that have high levels of fluoride in drinking water sources. Many people residing in such places suffer from dental fluorosis (DF).

    AIMS: To evaluate the prevalence of DF in children residing in Salem and also to find any correlation between DF and other related factors.

    MATERIALS AND METHODS: One school from each block of Salem (total 21 blocks) was selected for the study. A single examiner had evaluated untreated caries, lesions, and DF (for permanent anterior teeth and molars) using the Dean's fluorosis index, in all children. Water fluoride level determination at each school was done using the Tamil Nadu Water Fluoridation and Drainage Board field kit. Other factors that may have contributed to DF were assessed using a questionnaire, which was provided to each student. The data obtained were statistically analyzed using the SPSS software version 11.5.

    STATISTICAL ANALYSIS: Chi-square test was used for statistical analysis.

    RESULTS: DF was present in 56.9% of the children examined. It was mostly seen in 9 years old (72%) and male (59%) children. A positive correlation was found between the occurrence of DF and the duration of residence in a place with high water fluoride content, consumption of borewell water (64%), the parts per million of fluoride in drinking water, consumption of black tea (59%). However, no correlation was found between DF, dental caries, consumption of milk, or consumption of foods cooked in aluminum vessels.

    CONCLUSION: There was a correlation between DF and factors such as male gender, bore well water consumption, black tea consumption and the duration of residence in a place with high water fluoride content.

    Matched MeSH terms: Fluorosis, Dental
  9. Jhajharia K, Shah HH, Paliwal A, Parikh V, Patel S
    J Clin Diagn Res, 2015 Jun;9(6):ZD28-30.
    PMID: 26266231 DOI: 10.7860/JCDR/2015/12542.6108
    Tooth discolouration is a common problem and affects people of all ages. Apart from the conventional treatment modalities for the same, newer options are available today with better techniques and materials. The present case report describes a 17-year-old girl who had stained and pitted teeth, attributable to dental fluorosis and she desired aesthetic treatment for the same. The pros and cons of all treatment options were carefully weighed and a multistep treatment process involving ceramic veneers and direct bonding were planned. The execution of the planned treatment yielded a good aesthetic and functional outcome.
    Matched MeSH terms: Fluorosis, Dental
  10. Siti Mariam Ab Ghani, Ahmad Syahir Ahmad Zu Saifudin, Muhammad Aliff Ikram Noor Zari, Teh Adilla Mustaza
    Compendium of Oral Science, 2015;2(1):47-51.
    MyJurnal
    Dental fluorosis incidence had been reported to be affecting children widely, especially in water-fluoridated ar-ea. As these children grow into young adults, perceived aesthetic problems arise mainly due to their concern with generalized mottled and stained teeth appearance. Fixed prosthodontics treatment involving single anterior tooth in patients with generalized fluorosis condition had been found challenging due to aesthetic restorability to blend with fluorosis condition. Clinical considerations: A simplified procedural direct chair-side technique of mimicking fluorosis condition onto anterior all-ceramic crowns are discussed in this paper. The mimicked fluoro-sis is reversible and has the opportunity to be adjusted according to the patient’s fluorosis condition thus hinder-ing the need to redo the crown in the future. Conclusions: The appearance of anterior all-ceramic crowns with direct chair-side staining technique provided blended and harmonized well with the dental fluorosis condition in both patients thus, giving natural looking smile.
    Matched MeSH terms: Fluorosis, Dental
  11. Ha Rahim Z, M Bakri M, Hm Z, Ia A, Na Z
    Pak J Med Sci, 2014 Mar;30(2):404-8.
    PMID: 24772152
    In children, excessive ingestion of fluoride from different sources including bottled drinking water and flavoured beverages or soft drinks can lead to the development of dental fluorosis. In addition, the pH level of beverages is important. Low pH can cause dental erosion. In this study we explore the fluoride content and pH level of certain popular beverages available in Malaysian supermarkets and hawkers' stalls.
    Matched MeSH terms: Fluorosis, Dental
  12. Kadir RA, Al-Maqtari RA
    Int Dent J, 2010 Dec;60(6):407-10.
    PMID: 21302739
    To assess the extent of fluorosis in a representative sample of 14-year-old Yemeni adolescents.
    Matched MeSH terms: Fluorosis, Dental/etiology; Fluorosis, Dental/epidemiology*
  13. Tay HL, Zainudin IS, Jaafar N
    Community Dent Health, 2009 Dec;26(4):211-5.
    PMID: 20088218
    Very mild fluorosis is quite prevalent in children and one of the sources may be attributed to poor fluoride toothpaste utilization habits.
    Matched MeSH terms: Fluorosis, Dental/etiology*; Fluorosis, Dental/prevention & control
  14. Mani, Shani Ann
    MyJurnal
    The use of fluoride as a preventive measure for dental caries has been established more than 50 years ago. The recommendations for fluoride use has been modified over the years due to factors like decreased prevalence of caries, increased prevalence of dental fluorosis and the widespread availability of fluoride in various forms to the community. In recent years, the role of evidence-based recommendations has come to the forefront, in an attempt to ensure the most favorable treatment for the individual. This review has attempted to appraise the most recent evidence- based recommendations for different fluoride modalities put forth by various organizations worldwide, in order to appreciate the current status of fluoride in the early 21st century.
    Matched MeSH terms: Fluorosis, Dental
  15. Tay HL, Jaafar N
    Malaysian Dental Journal, 2008;29(2):140-148.
    MyJurnal
    Background: Mothers play an important role in preventing fluorosis due to inadvertent swallowing of fluoridated toothpaste and enhancing the effectiveness of toothbrushing amongst preschool children through proper supervision.
    Aim: To investigate the knowledge of mothers with regards to the benefits and risks of fluoride toothpaste usage among preschool children and to assess the level of parental supervision during toothbrushing. In additional, we wish to investigate the toothpaste purchasing behaviour of mothers in relation to brand, price, flavour, fluoride content and the influence of advertisement.
    Methodology: Cross-sectional study of a representative random sample of 373 mothers of 5-6 year old preschool children through self-administered questionnaires.
    Result: The response rate was 90.3% (337). The majority (61.7%) of the mothers reported that the amount of toothpaste their children used was half-length. Most mothers (70.6%) claimed they usually apply toothpaste for their child. About one-half (50.4%) reported the children applied the toothpaste themselves. Only 41.2% of the respondents supervised their children every time during toothbrushing. The mean age at which the child started brushing and using toothpaste was about 34 months (S.D. 14.9) and 37 months (S.D.14.8) respectively. Almost all (95.8%) reported that their children rinsed their mouth after toothbrushing. The mothers’ choice of toothpaste for their child was influence by brand (91.4%), flavour (91.4%) and fluoride content (84.6%) with price being the least of the factors. The majority of the respondents (82.7%) had average to good overall knowledge scores. There was significant association (P=0.034) between the level of education of the mothers and their level of knowledge on fluoride toothpaste usage.
    Conclusion: Future oral health messages for preschool children and mothers in Perlis should target areas found lacking in terms of knowledge and practices with regards to fluoride toothpaste usage. This includes regular supervision of preschool children during toothbrushing by parents and using only a small amount of toothpaste for young children.
    Matched MeSH terms: Fluorosis, Dental
  16. Mohd Nor, M., Sheiham, A., Tsakos, G.
    Malaysian Dental Journal, 2008;29(1):20-24.
    MyJurnal
    The objectives were to assess the prevalence, severity, the psychological and social impacts of fluorosis among school children and their parents in the Kuala Pilah area, Negeri Sembilan, Malaysia. Methods: A convenience sample of 431 students aged 16-17 years old from 3 secondary schools in Kuala Pilah, Negeri Sembilan were selected. The students were assessed for presence of dental fluorosis using Dean’s Index and to assess impacts. Questionnaires were administered to all the dental fluorosis students and selected matched students with no fluorosis. They constituted a control group for the case control study. Questionnaires were sent to the parents of dental fluorosis and control non fluorosis cases. Results: The prevalence of dental fluorosis was 27.8%; 82% of the fluorosis cases were questionable to mild and 18% moderate to severe fluorosis. 16.1% of students with dental fluorosis and 8.5% of non-fluorosis students had psychological impacts. 12.8% of the parents of children with fluorosis reported that their child had an impact. More girls with fluorosis (35.7%) had psychological impacts compared than boys (25.0%). In the 16.1% of fluorosis cases who had psychological impacts, difficulty smiling and showing teeth, affected 35.7% of girls and 25 % of boys. The percentage of students with dental fluorosis who had psychological impacts on carrying out school work was 2.7%, and 3.6% had impacts related to going out with friends. Conclusions: There were considerable psychological impacts on smiling and showing teeth among Malaysian teenagers with dental fluorosis and some of their parents were concerned about the fluorosis. But the impacts were mild and do not have a major impact on students’ lives. Dental fluorosis is not aesthetically displeasing to most subjects but does have psychological and social impacts on a small percentage with fluorosis.
    Matched MeSH terms: Fluorosis, Dental
  17. Siew Tan B, Razak IA
    Community Dent Oral Epidemiol, 2005 Oct;33(5):317-25.
    PMID: 16128790
    The aim of this study was to assess (by direct determination) the fluoride (F) exposure from ingested toothpaste among 4-5-year-old Malaysian children.
    Matched MeSH terms: Fluorosis, Dental/epidemiology; Fluorosis, Dental/prevention & control
  18. Tan BS, Razak IA, Foo LC
    Community Dent Health, 2005 Mar;22(1):35-9.
    PMID: 15819114
    This study aims to assess the magnitude of the problem of fluorosis among 10-11 year old schoolchildren in a fluoridated area in Malaysia.
    Matched MeSH terms: Fluorosis, Dental/epidemiology*
  19. Sujak SL, Abdul Kadir R, Dom TN
    J Oral Sci, 2004 Dec;46(4):221-6.
    PMID: 15901066
    The aim of this study was to investigate the prevalence and psychosocial impact of enamel defects among 16-year-old school children on the island of Penang. The data were collected through a self-administered questionnaire survey and an oral examination, using the Modified Developmental Defects of Enamel Index (FDI, 1992). In all, 1024 subjects were selected using a multistage random sampling technique. About two-thirds of the sample (67.1%) had at least one tooth affected by enamel defects. Enamel opacities accounted for 85.6% of the total condition. Diffuse-type opacity predominated (63.5%). Among subjects who expressed dissatisfaction, 18.8% reported covering their mouths when smiling, 8.7% avoided going out with friends and 39.1% had consulted their dentists. About 17% of the subjects reported that their parents had complained about the color of their front teeth but only 5.7% had experienced being teased by their friends about the problem. Two-thirds of the subjects were affected by enamel defects involving at least one tooth; however, the esthetic perception and psychosocial impact of those affected were minor.
    Matched MeSH terms: Fluorosis, Dental/diagnosis; Fluorosis, Dental/epidemiology; Fluorosis, Dental/psychology*
  20. Tan, B.S., Razak, I.A., Foo, L.C.
    Ann Dent, 2004;11(1):-.
    MyJurnal
    The aim of the study was to assess the association between past fluoride exposures from ingested toothpaste and current fluorosis manifestations in 10- 11 year old index subjects. Fluorosis was assessed with the Dean’s Index in 1343 10-11 year old index subjects. Two hundred index subjects who had younger 4-5 year old siblings were sub sampled and fluoride exposures from ingested toothpaste in their younger siblings (proxy subjects) were determined. The values for the fluoride ingested per brushing of the proxy subjects were utilised together with past frequency of toothbrushing of index subjects to extrapolate on the past exposure of index subjects. The mean extrapolated past fluoride exposure from ingestion of toothpaste was highly variable; 671.7 ug ± 739.3 ug (sem= 56.9). It was higher in the subjects with fluorosis (697.3 ug) than in those without fluorosis (646.89 ug) but differences were not of statistical significance. This approach of extrapolation has not been reported elsewhere and need to be validated. The implications of the present methodology to estimate past fluoride exposure is discussed.
    Matched MeSH terms: Fluorosis, Dental
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