Key Points
This paper:
-
Improves the understanding of the disadvantages of water fluoridation.
-
Demonstrates public perceptions of dental discolouration typical of dental fluorosis.
-
Shows in one step the application of public participation and involvement in health service research by gathering the public's views on a health issue.
-
Provides findings that will assist policy makers to settle the issue of water fluoridation in the United Kingdom.
Abstract
Objectives A cross-sectional national survey to explore perceptions of dental fluorosis and to determine the proportion of people regarding fluorosis as aesthetically objectionable at differing levels of defect.
Methods A survey using a multistage stratified random probability sample of 6,000 UK adult households. Face-to-face interviews were carried out using a structured questionnaire and photographs of different levels of dental fluorosis. Respondents were interviewed about the parameters of satisfaction, attractiveness and need for treatment for dental fluorosis.
Results The proportion of respondents perceiving teeth as unattractive, unsatisfactory and requiring treatment increased with increasing severity of dental fluorosis. Using agreement between the three negative perceptions as a measure, 14% of the sample perceived mild dental fluorosis as aesthetically objectionable, 45% at moderate level and 91% at severe levels.
Conclusion Negative perceptions of dental fluorosis were lower than reported previously. Three parameters were included in the approach to estimate aesthetically objectionable fluorosis which may provide a more realistic measure than those used previously. The nature of the index and the sample included suggest that findings of this survey provide a reasonable indicator of the likely impact of water fluoridation. Findings may have important implications for fluoridation policies in the United Kingdom and elsewhere.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Mandel I . The image of dentistry in contemporary culture. J Am Dent Assoc 1998; 129: 607–613.
Welie J . Do you have a healthy smile? Med Health Care Philos 1999; 2: 169–180.
NHS CRD. A systematic review of public water fluoridation. York:NHS Centre for Reviews and Dissemination. University of York, 2000.
Van Palenstein Helderman WHV, Mksasabuni E . Impact of dental fluorosis on the perception on the perception of well-being in an endemic fluorosis area in Tanzania. Community Dent Oral Epidemiol 1993; 21: 243–244.
Rozier RG . The prevalence and severity of enamel fluorosis in North American children. J Public Health Dent 1999; 59: 239–246.
Riordan PJ . Perceptions of dental fluorosis. J Dent Res 1993; 72: 1268–1274.
Riordan PJ . Specialist clinicians' perceptions of dental fluorosis. J Dent Child 1993; 60: 315–20.
Ellwood R, O'Mullane D . Enamel opacities and dental esthetics. J Public Health Dent 1995; 55: 101–106.
Hawley GM, Ellwood R, Davies R . Dental caries, fluorosis and cosmetic implications of different TF scores in 14-year-old adolescents. Comm Dent Health 1996; 13: 189–192.
Clark DC, Hann HJ, Williamson MF, Berkowitz J . Aesthetic concerns of children and parents in relation to different classifications of the Tooth Surface Index of Fluorosis. Community Dent Oral Epidemiol 1993; 21: 360–364.
Thylstrup A, Fejerskov O . Clinical appearance of dental fluorosis in permanent teeth in relation to histologic changes. Community Dent Oral Epidemiol 1978; 6: 315–328.
Woodward GL, Main PA, Leake JL . Clinical determinants of a parent's satisfaction with the appearance of a child's teeth. Community Dent Oral Epidemiol 1996; 24: 416–418.
Lalumandier JA, Rozier RG . Parents' satisfaction with children's tooth color: fluorosis as a contributing factor. J Am Dent Assoc 1998; 129: 1000–1006.
Author information
Authors and Affiliations
Corresponding author
Additional information
Refereed Paper
Rights and permissions
About this article
Cite this article
Alkhatib, M., Holt, R. & Bedi, R. Aesthetically objectionable fluorosis in the United Kingdom. Br Dent J 197, 325–328 (2004). https://doi.org/10.1038/sj.bdj.4811651
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.bdj.4811651
This article is cited by
-
Are there good reasons for fluoride labelling of food and drink?
British Dental Journal (2018)
-
Should food and drink have fluoride labels?
BDJ Team (2018)
-
Investigation of the value of a photographic tool to measure self-perception of enamel opacities
BMC Oral Health (2012)
