Fluorosis
By Dr BN Mua
Aetiology
• Dental flourosis or hypominerisation of tooth
enamel/dentine is produced by chronic
ingestion of excessive amounts of F- during
the period when teeth are developing.
• Takes place during the first 6 years of life
• Both decidous and permanent teeth may be
affected but the effects are more in secondary
dentition than in primary dentition
Environmental existence of fluoride
• Fluorine rarely exists as in nature but exists as
an inorganic fluoride.
• It is naturally found in the following spheres
of earth.
1.Land ( lithopshere)
2.Water(hydrosphere)
3.Biosphere( living things)
4.Atmosphere(air)
Sources of F-
• Different soils contain different
concentrations of F- depending on the
underlying rock
• Different plants contain varying amounts of
fluoride
• Sea animals eg fish a lot of F-
• All water contain varying amount of F- . It is
highest in volcanic areas
Contd….
• Some F- concentrations is found is the
air(atmosphere) particularly in highly
industrialized areas.
Fluoride in Kenya
• Geology of East Africa is characterised by
landscapes formed by faulting and volcanic
activity.
• Volcanic rocks occur both on the surface and
underground
• Volcanic rocks contain large amounts of F-
• F- rich areas Kenya include Mt Kenya Region,
Mt Elgon, Rift Valley etc
Contd…..
• Most rivers and lakes outside Volcanic areas
have low F- levels
• Ground water contains high levels of F-
• Some areas have high concentration of F-
upto 2888ppm
• L. Nakuru has the highest concentration of
volcanic rock
Contd….
• Ground water is consumed to a large extent in
Kenya
• Most people who drink water from boreholes
in Rift Valley, Kiambu, Muranga risk
developing Fluorosis
• Nairobi, Kitui,, Taveta, Limuru, Ngong, South
Coast are are rich in F-
Contd…..
• Western Kenya, Nyanza and N.Eastern has
low F- concentration of less than 0.5ppm
• Nairobi has got high concentration of F-
(>8ppm)
• F- is widely is distributed in Kenya in
underground water, some areas with below
optimal level while others above optimal
levels
Sorces of F- for man
Adults
• Water
• Food
Infants
• Breast milk
• Formula feeds
Dietary sources of F-
• Water
• Food eg maize, banana, milk, fish, beans
• Beverages
NB plants such as tea, coffee, carrots,Spinachs,
plums, cabbage, potatoes etc contain high
amount
F- concentration in the body
• In soft tissue - very low and transient.
• But high in hard tissues eg bone, tooth due to
presence of apatite which binds with F- to
form CaF2 and other forms
Significance of F- in the body
• F- crosses placental barrier and thus causes
flourosis in primary dentition.
• At optimal levels, F- increases teeth
resistance to caries( tooth decay)
• Above the optimal levels of F-, it causes
flourosis of the teeth
Contd…
Measurement of fluorosis
Using indices eg
Dean’s index
FDI index
Community index of fluorosis
Tooth surface index fluorosis
others
Preventive measures
• Create awareness to communities
• Educate communities on preventive measure
• Take recommended F- levels particularly in
water( 0.7 to 1.2 ppm)
• Defluoridate water at community, institutional
and house hold levels. Various methods
available
• Treat where applicable
END
