Purpose: The aim of present study was to assess the frequency, severity, and distribution of developmental defects of tooth enamel and correlate the etiology with the type of defect in 11–13-year-old Indian children.
Materials and methods: The present study included examination of permanent maxillary incisors in 500 children in the age-group of 11–13 years to examine the occurrence of distribution of developmental defects of tooth enamel.
Materials and methods: Only the buccal surface of four permanent maxillary incisors was examined for enamel defects using modified developmental defects of enamel (DDE) index by Clarkson which recognized three basic types of enamel defects; namely demarcated opacities, diffuse opacities, and hyploplsia. Personnel details, dental history which included dental infection, extraction, trauma, lifetime fluoride, fluoride in water, and medical history were also recorded. Data was coded and analyzed for distribution of developmental defects of tooth enamel by tooth type and gender using Statistical Package for the Social Sciences.
Result: Out of 500, 114 (22.8%) children showed defective enamel in permanent maxillary incisors. Of all enamel defects, diffuse opacities were most prevalent with 48.25% occurrence followed by demarcated opacities 38.5%, hypoplasia 10.52%, and any other defects 1.75%. No significant difference was observed in males and females for the occurrence of developmental enamel defects. The occurrence of dental enamel defect significantly correlated with dental history as well as with medical history (Chi-squared statistical test, p-value = 0.001**).
Conclusion: (1) High fluoride in water accounts for most prevalent diffuse opacity. (2) Demarcated opacities are associated mainly with positive dental history. (3) Hypoplasia of incisors was found to be least prevalent associated with trauma, periapical infections.
Simmer JP, Hu JC. Dental enamel formation and its impact on clinical dentistry. J Dent Educ 2001;65(9):896–905.
Avşar A, Kalayci AG. The presence and distribution of dental enamel defects and caries in children with celiac disease. Turk J Pediatr 2008;50(1):45–50.
Pindborg JJ. Aetiology of developmental enamel defects not related to fluorosis. Int Dent J 1982;32(2):123–134.
Elcock C, Lath DL, Luty JD, et al. The new Enamel Defects Index: testing and expansion. Eur J Oral Sci 2006;114 Suppl 1:35–41, 379. DOI: 10.1111/j.1600-0722.2006.00294.x
Bhagyajyothi CS, Pushpanjali K. Perceptions and concerns about dental fluorosis as assessed by tooth surface index of fluorosis among high school children in an area of endemic fluorosis–Kaiwara. Oral Health Prev Dent 2009;7(1):33–38.
Clarkson J, O'Mullane D. A modified DDE Index for use in epidemiological studies of enamel defects. J Dent Res 1989;68(3): 445–450. DOI: 10.1177/00220345890680030201
Woźniak K, Łagocka R, Lipski M, et al. Changes in developmental defects of dental enamel within the space of centuries. Dur Anthropo J 2005;12:2–3.
Aasenden R, Peebles TC. Effects of fluoride supplementation from birth on human deciduous and permanent teeth. Arch Oral Biol 1974;19(4):321–326. DOI: 10.1016/0003-9969(74)90194-0
Sarnat BG, Schour I. Enamel hypoplasia (chronologic enamel aplasia) in relation to systemic disease: a chronologic, morphologic and etiologic classification. J Am Dent Assoc 1941;28(12):1989–2000. DOI: 10.14219/jada.archive.1941.0307
Aasenden R, Peebles TC. Effects of fluoride supplementation from birth on dental caries and fluorosis in teenaged children. Arch Oral Biol 1978;23(2):111–115. DOI: 10.1016/0003-9969(78)90147-4
Al-Alousi W, Jackson D, Compton G, et al. Enamel mottling in a fluoride and in a non-fluoride community. A study. Br Dent J 1975;138(2):56–60. DOI: 10.1038/sj.bdj.4803373
Jackson D, James PM, Wolfe WB. Fluoridation in Anglesey. A clinical study. Br Dent J 1975;138(5):165–171. DOI: 10.1038/sj.bdj.4803404
Goward PE. Enamel mottling in a non-fluoride community in England. Community Dent Oral Epidemiol 1976;4(3):111–114. DOI: 10.1111/j.1600-0528.1976.tb02109.x
Goward PE. Mottling on deciduous incisor teeth. A study of 5-year-old Yorkshire children from districts with and without fluoridation. Br Dent J 1982;153(10):367–369. DOI: 10.1038/sj.bdj.4804948
Wenzel A, Thylstrup A. Dental fluorosis and localized enamel opacities in fluoride and nonfluoride Danish communities. Caries Res 1982;16(4):340–348. DOI: 10.1159/000260618
JACKSON D. A clinical study of non-endemic mottling of enamel. Arch Oral Biol 1961;5:212–223. DOI: 10.1016/0003-9969(61)90059-0
Wilson RM, Cleaton-Jones P. Enamel mottling and infectious exanthemata in a rural community. J Dent 1978;6(2):161–165. DOI: 10.1016/0300-5712(78)90212-9
Dixon DA. Defects of structure and formation of the teeth in persons with cleft palate and the effect of reparative surgery on the dental tissues. Oral Surg Oral Med Oral Pathol 1968;25(3):435–446. DOI: 10.1016/0030-4220(68)90019-4
Curzon ME, Spector PC. Enamel mottling in a high strontium area of the U.S.A. Community Dent Oral Epidemiol 1977;5(5):243–247. DOI: 10.1111/j.1600-0528.1977.tb01648.x
Schamschula RG, Cooper MH, Adkins BL, et al. Oral conditions in Australian children of Aboriginal and Caucasian descent. Community Dent Oral Epidemiol 1980;8(7):365–369. DOI: 10.1111/j.1600-0528.1980.tb01309.x
Sognnaes RF, Armstrong WD. A condition suggestive of threshold dental fluorosis observed in Tristan da Cunha: II. fluorine content of the teeth. J dent res 1941;20(4):303–313. DOI: 10.1177/00220345410200040201
Hurme VO. Developmental opacities of teeth in a New England community; their relation to fluorine toxicosis. Am J Dis Child (1911) 1949;77(1):61–75. DOI: 10.1001/archpedi.1949.02030040068005
Nevitt GA, Frankel JM, Witter DM. Occurrence of nonfluoride opacities and nonfluoride hypoplasias of enamel in 588 children ages 9 to 14 years. J Am Dent Assoc 1963;66:65–69. DOI: 10.14219/jada.archive.1963.0001
Gray AS. Prevalence of opacities and hypoplasia of non- fluoride origin in permanent teeth. J Canad Dent Assoc 1964;30(3):137–139.
Forrest JR, James PM. A blind study of enamel opacities and dental caries prevalence after eight years of fluoridation of water. Br Dent J 1965;119(7):319–322.
Richards LF, Westmoreland WW, Tashiro M, et al. Nonfluoride enamel hypoplasia in varying fluoride-temperature zones. J Am Dent Assoc 1967;75(6):1412–1418. DOI: 10.14219/jada.archive.1967.0384
Young MA. An epidemiological study of enamel opacities and other dental conditions in children in temperate and sub-topical climates. PhD Thesis, London, 1973.
Moller IJ, Poulsen S. A study of dental mottling in children in Khouribga, Morocco. Arch Oral Biol 1975;20:601–607. doi: 10.1016/0003-9969(75)90081-3
Suckling GW, Pearce EI, Cutress TW. Developmental defects of enamel in New Zealand children. NZ Dent J 1976;72(330):201–210.
Akpata ES, Jackson D. Mottled permanent incisors in 15-year-old Lagos children. Community Dent Oral Epidemiol 1978;6(1):36–39. DOI: 10.1111/j.1600-0528.1978.tb01116.x
Murray JJ, Shaw L. Classification and prevalence of enamel opacities in the human deciduous and permanent dentitions. Arch Oral Biol 1979;24(1):7–13. DOI: 10.1016/0003-9969(79)90168-7
Jälevik B, Szigyarto-Matei A, Robertson A. Difficulties in identifying developmental defects of the enamel: a BITA study. Eur Arch Paediatr Dent 2019;20(5):481–488. DOI: 10.1007/s40368-019-00431-x
Thylstrup A, Fejerskov O. Clinical appearance of dental fluorosis in permanent teeth in relation to histologic changes. Community Dent Oral Epidemiol 1978;6(6):315–328. DOI: 10.1111/j.1600-0528.1978.tb01173.x
King NM. Developmental defects of enamel in Chinese girls and boys in Hong Kong. Adv Dent Res 1989;3(2):120–125. DOI: 10.1177/08959374890030020901
Suckling GW, Brown RH, Herbison GP. The prevalence of developmental defects of enamel in 696 nine-year-old New Zealand children participating in a health and development study. Community Dent Health 1985;2(4):303–313.
de Liefde B, Herbison GP. Prevalence of developmental defects of enamel and dental caries in New Zealand children receiving differing fluoride supplementation. Community Dent Oral Epidemiol 1985;13(3):164–167. DOI: 10.1111/j.1600-0528.1985.tb00435.x
O'Mullane D, Clarkson J, Holland T, et al. Children's dental health in Ireland, 1984. Government Publications Office, Dublin 2.
Thylstrup A, Fejerskov O, Bruun C, et al. Enamel changes and dental caries in 7-year-old children given fluoride tablets from shortly after birth. Caries Res 1979;13(5):265–276. DOI: 10.1159/000260410
Holm AK, Andersson R. Enamel mineralization disturbances in 12-year-old children with known early exposure to fluorides. Community Dent Oral Epidemiol 1982;10(6):335–339. DOI: 10.1111/j.1600-0528.1982.tb00405.x
Ramesh G, Nagarajappa R, Raghunath V, et al. Developmental defects of enamel in children of Davangere district and their relationship to fluoride levels in drinking water. Asia Pac J Public Health 2011;23(3):341–348. DOI: 10.1177/1010539509340912
Suckling GW, Pearce EI. Developmental defects of enamel in a group of New Zealand children: their prevalence and some associated etiological factors. Community Dent Oral Epidemiol 1984;12(3): 177–184. DOI: 10.1111/j.1600-0528.1984.tb01434.x
Wong HM, Wen YF, King NM, et al. Longitudinal changes in developmental defects of enamel. Community Dent Oral Epidemiol 2016;44(3):255–262. DOI: 10.1111/cdoe.12213
Broadbent JM, Thomson WM, Williams SM. Does caries in primary teeth predict enamel defects in permanent teeth? A longitudinal study. J Dent Res 2005;84(3):260–264. DOI: 10.1177/154405910508400310
Chellappah NK, Vignehsa H, Lo GL. Enamel defects in a fluoridated south-east Asian community. Aust Dent J 1990;35(6):530–535. DOI: 10.1111/j.1834-7819.1990.tb04685.x