Dental fluorosis and its prevention in primary health care

A bibliographical review was carried, aimed describing the epidemiologic and clinical characteristics of dental fluorosis and its prevention by means of the strategy for oral health in primary health care. The criteria of the Dean's Index for the hypomineralization of the tooth enamel were reviewed: very mild, mild, moderate and severe; the index of Thylstrup and Fejerskov, based on the different histopathologic degrees of dental fluorosis and on the adamantine changes that are observed on the tooth surface. The clinical presentation of dental fluorosis is initially given by white spots that cover a minimal part of the tooth surface, up to dark spots looking pitted. It is caused by the excessive accumulation of fluoride on the tooth due to chronic exposure to that mineral at high levels and that may be found in drinkable water, food and other products. The recommendations for prevention are established, channelled basically into avoiding the intake of high concentrations of fluoride since pregnancy until the age of 8, in drinkable water fluoridated naturally or artificially, in foods prepared with it and in fluoridated toothpaste for children, mostly in areas where fluorosis is endemic. A diet rich in calcium, magnesium and antioxidants is advised. Other ways of health damage may occur in children by fluoride intoxication, making dental fluorosis a biomarker.