Moderate and Severe Dental Fluorosis in the Rural Population of Anantapur, India: Change in Their Biological Susceptibility?
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2022
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Dental fluorosis affects the quality of life. A cross-sectional, observational study was
conducted in a community affected by endemic fluorosis for several generations with a conserved biological
and social environment. The study included patients from the rural population of Anantapur,
India. The Dean index (DI) and the Thylstrup and Fejerskov Index (TFI) were used for fluorosis classification.
Additionally, water samples were collected for fluoride analysis, taken from the patients’
living areas. The statistical association between the variables was analyzed. In total, 785 patients between
10 and 60 years old were included in the study (58.7% women and 41.3% men). Fluorosis signs
were found in 94.6% of patients examined using the DI and 94.4% using the TFI. Moderate–severe
dental fluorosis was observed in 62.8% by DI and 73.1% by TFI consuming untreated water with up to
2.9 ppm of fluoride. Furthermore, moderate–severe dental fluorosis was observed in 33.2% by DI and
39.9% by TFI consuming water with 1.5 ppm of fluoride. The high prevalence of moderate–severe
dental fluorosis in patients consuming water with a low fluoride concentration suggests that other
factors are involved. Biological susceptibility change could play an essential role in the severity of
dental fluorosis in populations exposed for several generations, affecting its actual and future quality
of life.