11/24. A clinical comparison of treatments for endemic dental fluorosis. A case report is presented describing the treatment for endemic dental fluorosis. Six maxillary anterior teeth were treated, three with an acid-bleach combination technique and three with an acid technique. No clinical differences was noted in treatment time or esthetic results. ( info) |
12/24. Fluoride and caries prevention: 2. Clinical rationale. In order to achieve the greatest clinical benefit from the use of fluoride, we must understand its mechanism of action, so that fluoride can be given at the right time, by the best route, at the optimum dosage and in the most suitable form. The first article in this two-part series reviewed the scientific rationale behind the use of fluoride. Part 2 now illustrates fluoride therapy in practical terms, by examining nine clinical cases. ( info) |
13/24. Skeletal and dental fluorosis: two case reports. Two case reports from a high fluoride (10 ppm) rural community. They presented with severe degrees of dental fluorosis, hyper-sensitivity of teeth and skeletal fluorosis all arising from the ingestion of high amount of fluoride in water over a long period of time. Both cases had deformities of the upper and lower limbs. However, the deformities were more pronounced in the lower limbs than in the upper limbs, resulting in knock knee. Radiological finding showed osteosclerosis of the axial bones while the appendicular bones exhibited osteoporosis. There was marked change of bone structure observed as osteomalacia, and course trabecular bone pattern. osteoporosis was also associated with cortical thinning. Periosteal bone apposition was observed in the bones: and genu valgum of the limbs. Biochemical tests revealed normal values for serum calcium and inorganic phosphate. However, the serum alkaline phosphatase was elevated. This may be an indication of a pathological condition where there are possible compensatory mechanisms to maintain normal levels of serum calcium and inorganic phosphate. One case which had undergone corrective surgical intervention of the lower limbs four years earlier, had continued to live in the same environment using drinking water with 10 ppmF after corrective surgery, and showed no improvement. ( info) |
14/24. A report of fluorosis in the united states secondary to drinking well water. A 54-year-old female resident of Wellston, Okla, was found to have osteosclerosis on a routine chest roentgenogram. Subsequent investigation disclosed the cause of her osteosclerosis to be fluorosis secondary to the ingestion of well water containing 429 mumol/L of fluoride (recommended levels, 11 to 58 mumol/L). Water samples were also obtained from the 12 wells on properties adjacent to the index case. In three other wells, all at similar depths as the well of the index case, the fluoride concentration of the water was greater than 212 mumol/L. urine samples from members of the four households who obtain their drinking water from these wells contained elevated urinary fluoride levels. Thus, fluorosis may develop in certain areas of the united states as a result of the natural occurrence of fluoride in the groundwater. Consequently, in known endemic areas, it would appear reasonable to measure the fluoride concentration of the well water at the time of drilling. ( info) |
15/24. Endemic fluorosis presenting as cervical cord compression. Neurological involvement in fluorosis occurs in the advanced stage of the disease and is due to compression of the spinal cord and/or nerve roots. There are only a few reports on the role of surgical management of these cases in the medical literature. Five cases of fluorosis from the endemic areas of Uttar Pradesh, india, had associated cervical cord compression. Their mean age was 43 yr (range 35-50), and all cases were manual laborers. Three patients with blocked cervical subarachnoid space on myelography underwent laminectomy using local anesthesia. All three cases improved significantly after surgery. The usefulness of laminectomy in selected cases of cervical cord compression due to fluorosis is suggested. ( info) |
| The Rieger syndrome is a rare, autosomal dominant disorder. It is characterized by defects of the anterior chamber of the eyes as well as developmental malformations of the dentition. A case is described that shows classic findings with emphasis on dental management. Oral abnormalities in the pedigree may also suggest subtle manifestations of the syndrome. Recognition of the dental anomalies may result in early diagnosis of the syndrome and prevent progressive visual loss. ( info) |
17/24. Posteruptive development of isolated and confluent pits in fluorosed enamel in a 6-year-old girl. A 6-yr-old Danish girl born and reared in a high fluoride area in kenya was examined for a period of 1 1/2 yr during which a permanent maxillary central incisor erupted. Present primary and permanent teeth showed obvious dental fluorosis with isolated pits on primary molars. At the time of eruption the crown of the permanent central incisor had its normal anatomical shape. Isolated and confluent pits began to develop about the time of complete eruption. The observations thus confirm previous theories suggesting that pits in fluorosed enamel are secondarily produced defects of traumatic origin. ( info) |
18/24. Dietary fluoride supplementation for the prevention of caries. Fluoride supplements are effective in preventing dental caries if conscientiously taken on a daily basis from birth until at least 12 to 14 years of age. The optimal dose depends on the child's age and the existing fluoride concentration in the water supply. A dosage schedule is recommended that decreases the dose of fluoride in infancy and that is inversely related to the concentration of fluoride in the drinking water. ( info) |
19/24. Latent fluorides: report of case. This case report examines the effects of a long-term exposure to fluoride on the teeth of two children who started to drink a highly fluoridated mineral water when they were three years and four years of age, respectively. A clinical and SEM study was conducted to supply evidence of the harmful effect of fluoride ingestion at above optimal levels and to ask for an explicit labeling of drinks that contain more than 1 ppm/F. ( info) |
20/24. Dental fluorosis as a complication of hereditary diabetes insipidus: studies of six affected patients. Hereditary diabetes insipidus is a rare endocrine disorder caused by a deficiency of the antidiuretic hormone, vasopressin. The disease is characterized by polyuria, extreme thirst, and polydipsia. In this study of six affected members from two families with hereditary diabetes insipidus, it was found that two children who drank water fluoridated at optimum levels developed moderate to severe fluorosis. By contrast, four other affected patients who did not consume fluoridated water showed normal dentitions. This report indicates that dental fluorosis may be an important complication of diabetes insipidus, and demonstrates the possibility that excessive consumption of optimally fluoridated water can lead to severe developmental enamel defects. ( info) |