Prevalence of dental fluorosis among 4- to 14-year-old children from the town of Dimitrovgrad (Bulgaria).

INTRODUCTION: There has been no study on the prevalence of dental fluorosis in Bulgaria of today where people have free access to some fluoride-containing products. AIM: The aim of the study was to investigate the prevalence of dental fluorosis among children 4 to 14 years old from the town of Dimitrovgrad, where due to unsatisfactory qualities of tap water people consume bottled water including such with fluoride levels higher than 1.5 mg/l. PATIENTS AND METHODS: The study included 1504 randomly selected children. We analysed subjects with dental fluorosis according to Dean's modified criteria. The following severity levels were defined: 0 - normal; 0.5 - suspicious; 1 - very mild; 2 - mild; 3 - moderate; 4 - severe. Data were analyzed separately for the different types of dentitions. RESULTS: Results showed that 54.52% of all children included in the study had dental fluorosis in different degrees. Primary teeth were affected by dental fluorosis less frequently than permanent teeth (P < 0.001). In mixed dentition cases 41.41% of the children had fluorosis of permanent teeth only, 1.64% had dental fluorosis of primary teeth only and 12.50% had both their primary and permanent teeth affected. The proportion of individuals with the lowest degree of severity - 0.5, was the greatest both for the primary and permanent teeth. Comparison with the proportions of children with more severe degrees of fluorosis revealed significant differences (P < 0.001). CONCLUSION: The results of the study showed excessive fluoride intake during tooth development and suggested a need for further research of risk factors.