Endemic fluorosis: causes, symptoms and treatment
Fluorosis is a disease of the dental tissue that forms with prolonged intake of excessive amounts of fluoride with water.The cases of fluorosis are recorded in a certain area, for which the increased content of fluorine in water is characteristic.Table of contents: Fluorosis: causes of symptoms Symptoms of
Fluorosis: the causes of
The optimal fluoride content in drinking water is 1.0 mg / L fluorine.According to the sanitary norms adopted in the Russian Federation, the upper limit of the permissible content of this trace element is 1.5 mg / l. Exceeding this indicator provokes the development of fluorosis in most people.
Children who live in an endemic area with a high fluoride content in are the first to suffer from an ailment.The disease affects permanent teeth.But the milk teeth do not suffer from the disease at all, because the placenta detains the excess of a trace element and does not allow it to penetrate the fetus.So, at the time of the birth of the baby, the rudiments of the baby teeth are sufficiently mineralized.But if a child lives in an endemic area for several years, excess fluorine gradually accumulates in the body.And then on a place of the dropped out milk teeth constant, but already changed by a fluorosis grow.
Adult people are more resistant to fluorine.However, a significant excess in the drinking water level of this chemical element( over 6 mg / l), can cause the development of fluorosis in an adult.
What happens with fluorosis? Excess fluoride damages ameloblasts - cells responsible for the synthesis of tooth enamel.Change in the functioning of ameloblasts leads to a decrease in the mineralization of enamel.
Symptoms of fluorosis
The clinical picture of the disease depends on the concentration of fluoride in the consumed water and the form of the disease in humans.Thus, with a small excess of this microelement in water, fluorosis lesion is localized only on the incisors, and at a marked excess - on all teeth.
Normally tooth enamel is shiny, smooth.With fluorosis, the enamel on the affected areas fades and turns white, it becomes like chalk .In the future, these areas can accumulate pigment and be painted in yellow, brown.
Dentists distinguish such forms of the disease:
The development of the dashed form is said when small tooth-like strips are detected on the dental enamel in the manner of dashed lines.Strips can be clearly visualized, in other cases the doctor discovers them only after preliminary drying of the tooth surface.The merging bands form a spot with distinguishable strokes.This form of the disease most often occurs on the vestibular( facing the lips and cheeks) surfaces of the incisors.
This form is manifested by distinct continuous melodic spots without a striped pattern on the tooth enamel.The spots are usually a lot and they are scattered all over the tooth surface.Spots can merge into a large spot.Such lesions often acquire a brownish hue.In this case, the enamel in this area is smooth, shiny.The spotted form appears on all teeth, but is clearly expressed on the incisors.
Different manifestations are characteristic for this form of fluorosis.Often enamel on all teeth becomes matte, and on its surface pigmented spots are visualized.In other cases the enamel becomes yellow and covered with dots, spots.Sometimes on the surface of the tooth even speckles are formed with the enamel's loss to the depth.The bottom of such point formations is colored yellow, brown.
Erosive and destructive forms
With erosive form against the changed, colored enamel, its defects are formed, called erosions.Defects can be of absolutely different shapes.During the examination, the dentist determines the erasure of enamel and even dentine.
For the destructive form, a change in the shape of the dental crown is characteristic as a result of the destruction of hard tissues.Teeth, to put it simply, crumble and break.
Degrees of fluorosis
There are many different classifications of fluorosis in the world. According to the most common classification in the CIS countries, there are three degrees of fluorosis:
- The first - on the surface of individual teeth appear small white streaks, spots.
- The second - several teeth are involved in the pathological process, the upper part of the crown suffers.On the teeth appear petiolate, as well as yellow, brown strips and spots.
- Third - a significant part of the crown is damaged.On the teeth it is possible to detect not only the pigmented areas, but also the deformation of the crown, the breaking off of the tooth part.
Prophylaxis of fluorosis
If fluoride is present in the drinking water source in an increased quantity, you need to think about changing the source.If it is impossible to carry out deflatory - purification of water from excess fluorine by means of special filters.
It should be borne in mind that young children are very vulnerable to excess fluorine.Therefore, when preparing infant formula, you should use only benign water.
Adults and children need to enrich their diet with products with a high calcium content.They are milk products, vegetables and fruits.
Treatment of fluorosis
Treatment features are determined taking into account the patient's existing form of fluorosis.If the tooth tissues are preserved, when the disease manifests itself only by staining the enamel, the treatment starts with teeth whitening.
After teeth whitening, proceed to remineralization.This dental procedure restores the mineral composition of the enamel and prevents its further destruction.During the remineralization of tooth enamel saturate with calcium and phosphorus.Minerals penetrate into the tissues of the tooth and thereby strengthen it. Mineral composition of dentists is applied in several ways:
- With the help of appliqués;
- With the help of electrophoresis and ultraphonophoresis.
It is mandatory to sanitize the oral cavity before starting remineralization.The entire mineralization course consists of an average of fifteen procedures.In addition, to saturate the body with minerals, the doctor can prescribe a patient intake of calcium and phosphorus.
With erosive-destructive forms of fluorosis on the tooth enamel, defects are formed, which can not be coped with by bleaching.In this case, resort to methods of restoring the tooth - restoration of tooth enamel with composite filling materials or the use of veneers.When the tooth is broken, the dentist performs the installation of the crowns.
In addition, for successful treatment of fluorosis, you need to follow some recommendations. First of all, you need to replace the existing source of drinking water. In addition, at least slightly reduce the concentration of fluoride in water, you can mix it with water from another source of water supply with a minimum content of fluoride.You can also use the purchased water with a suitable mineral composition in the bottles.
People with fluorosis need to carefully choose toothpaste.Many pastes contain fluoride, such products should be avoided.Preference is given to remineralizing toothpastes.
Grigorova Valeria, medical reviewer