Dental fluorosis in the paediatric patient

Esthetic Management of Incisors with Diffuse and Demarcated Opacities: 24 Month Follow-up Case Report

CLINICAL RELEVANCE

A minimally invasive esthetic treatment can provide longevity and color stability.

SUMMARY

This clinical case report describes a minimally invasive approach to mask diffuse and demarcated opacities in permanent anterior teeth in an eight-year-old child who was upset with the appearance of her incisors. Clinical examination showed diffuse opacities in teeth 7, 8, 9, and 10, diagnosed as dental fluorosis associated with yellow demarcated opacity in tooth 9 related to molar-incisor hypomineralization. The treatment was based on conservative dentistry using the low-viscosity resin infiltration technique and resin composite restoration in an attempt to mask the lesions. The follow-up time was 24 months.

Aesthetic treatment of dental fluorosis in a 9-year-old girl: Case report

Background/Aim: Dental fluorosis is a specific disturbance of tooth formation caused by excessive intake of fluoride. The discoloration of teeth is the most common reason for parents to seek treatment. The purpose of this paper is to describe the therapeutic management performed in a 9-year-old girl with fluorosis. Case report: A clinical case of a 9-year-old girl diagnosed with fluorosis is reported. The treatment of this clinical case was achieved using microabrasion, which is a minimally invasive method. This technique improves the aesthetics of the teeth without causing significant loss of dental tissue; a characteristic making microabrasion applicable to children as well. Its implementation involved the combined use of 18% hydrochloric acid and pumice on the enamel surface of upper incisors. The improved appearance of the teeth was aesthetically pleasing and, consequently, the patient gained in self-confidence. Conclusions: In the literature, several treatment choices are proposed, depending on the severity of the fluorosis. In our case, microabrasion was applied and the aesthetic outcome satisfied both the patient and the dentist.

Comparison of residual salivary fluoride retention using amine fluoride toothpastes in caries-free and caries-prone children

Aim

This was to compare the salivary fluoride levels following tooth brushing with amine fluoride toothpastes containing three different concentrations of F (250 ppm F, 500 ppm F and 1250 ppm F) and to evaluate the effect of rinsing with water on the oral fluoride levels up to 90 min.

Methods

A double blind randomised six-arm crossover study was conducted with 32 child participants. Patients were divided into two groups depending on their caries experience with caries-free group (n = 17, mean age = 72.9 months) and caries-prone group (n = 15, mean age = 69.6 months, mean dmfs = 12.3). Each participant brushed their teeth with a smear of dentifrice containing (250 ppm, 500 ppm and 1250 ppm F toothpastes) for 60 s. After spitting out the dentifrice/saliva slurry, participants either rinsed with water or did not rinse at all. Samples of whole mixed unstimulated saliva were collected at 0 (baseline), 1, 15, 30, 45, 60 and 90 mins post-brushing/rinsing.

Results

After completing the study on residual fluoride concentration it was found that caries was not a significant variable (p = 0.567) while every other variable was (all p values <0.001). Time, toothpaste F concentration and rinse had significant effects (p < 0.001). In general, higher residual salivary F concentrations were found with increased F concentration in toothpastes and when no rinsing was performed after brushing.

Conclusion

The results of this study support the current recommendation of using toothpastes with >1000 ppm F concentration in children with an increased caries risk in addition to spitting excess toothpaste with no rinsing following brushing.