Fluorosis, caused by ingestion of excessive amount of fluoride through food or water, is a major public health problem in India. This study was undertaken to quantify the dental fluorosis burden among school going adolescents and to find factors associated with dental fluorosis in Kolar taluka, Karnataka, India.
A total of 1026 high school adolescents (12–17 years) were enrolled from different schools selected by stratified sampling method. Dental examination was done to record Dean’s fluorosis index, and socio-demographic, food consumption and oral hygiene data were recorded using a pre-tested structured questionnaire. Fluoride content was measured using Orion apparatus, and Community Fluorosis Index (CFI) was calculated from drinking water samples from various drinking sources. Multivariable analysis with generalized estimating equation (GEE) regression model was used to explore the factors associated with dental fluorosis.
Among 1026 enrolled students, 64.3% of adolescents were detected with dental fluorosis; more than 50% had either severe or moderate fluorosis according to the Dean’s Fluorosis Index and Community Fluorosis Index (CFI). The majority of affected students were from government schools. The significantly associated factors with dental fluorosis were living in study area for more than 5 years and studying in government school. A strong positive correlation between the amount of fluoride content in drinking water sample collected and CFI was observed (rho = 0.570).
Prevalence of dental fluorosis was considerably high, affecting nearly two-thirds of the students, and mainly in government schools and long-term residents of the area. Health education and community awareness for preventing fluorosis, apart from setting-up defluoridation plants or training for home based defluoridation techniques in study villages, should be considered.
Latha S, Ambika SR, Prasad SJ. Fluoride contamination status of groundwater in Karnataka. Curr Sci. 1999;76(6):730–4. Available from: http://www.iisc.ernet.in/currsci/mar25/articles13.htm.
Sudhir KM, Prashant GM, Subba Reddy VV, Mohandas U, Chandu GN. Prevalence and severity of dental fluorosis among 13- to 15-year-old school children of an area known for endemic fluorosis: Nalgonda district of Andhra Pradesh. J Indian Soc Pedod Prev Dent. 2009;27:190–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19915267. CrossRefPubMed
Peter S. Essentials of preventive and community dentistry. 21st ed. New Delhi: Arya Publishing House; 2012.
Isaac A, Silvia WDCR, Somanna SN, Mysorekar V, Narayana K, Srikantaiah P. Prevalence and manifestations of water-born fluorosis among schoolchildren in Kaiwara village of India: a preliminary study. Asian Biomed. 2009;3:563–6.
Gopalakrishnan P, Vasan RS, Sharma PS, Nair KS, Hankappan KR. Prevalence of dental fluorosis and associated risk factors in Alappuzha district, Kerala. Natl Med J India. 1999;12(3):99–103. PubMed
Mane AB, Revathi S, Savale PG, Paul CN, Hiremath SG. Study of dental fluorosis among primary school children residing in rural area of Raichur District, Karnataka. Int J Biol Med Res. 2011;2(3):716–20.
World Health Organization. Oral Health Surveys: Basic Methods. 5 th ed. Geneva: WHO; 2013.
Dean T. Classification of mottled enamel diagnosis. J Am Dent Assoc. 1934;568:1–12. Available from: http://dx.doi.org/10.14219/jada.archive.1934.0220.
Sarvaiya BU, Bhayya D, Arora R, Mehta DN. Prevalence of dental fluorosis in relation with different fluoride levels in drinking water among school going children in Sarada tehsil of Udaipur district, Rajasthan. J Indian Soc Pedod Prev Dent. 2012;30:317–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23514684. CrossRefPubMed
Bajaj D, Shetty S. Prevalence of dental fluorosis among 12 and 15 year old school going children of Udaipur city, India. Int J Public Health Dent. 2013;4:29–37.
Arvind BA, Isaac A, Murthy NS, Shivaraj NS, Suryanarayana SP, Pruthvish S. Prevalence and severity of dental fluorosis and genu valgum among school children in rural field practice area of a medical college. Asian Pac J Trop Dis Asian Pac Trop Med Press. 2012;2:465–9. CrossRef
Bhat PK, Kumar A. Prevalence and severity of dental fluorosis in an endemically afflicted district of Karnataka, South India. Int J Contemp Dent. 2011;2:96–100.
Vazquez-alvarado P, Prieto-garcía F, Coronel-olivares C, Gordillo-martinez J, Ortiz-espinosa RM, Hernandez-ceruelos A. Fluorides and dental fluorosis in students from Tula de Allende Hidalgo, Mexico. J Toxicol Environ Health Sci. 2010;2:24–31.
- High prevalence of dental fluorosis among adolescents is a growing concern: a school based cross-sectional study from Southern India
Bharatesh K. Shetty
Mehul K. Chourasia
- BioMed Central