Oral Health Training & Calibration Programme Measurement of Dental Fluorosis
Measurement of Dental Fluorosis
Dean’s Fluorosis Index Index Codes Normal: Dean’s 0 Questionable: Dean’s 1 Very Mild: Dean’s 2 Mild: Dean’s 3 Moderate: Dean’s 4 Severe: Dean’s 5 All 4 anterior teeth absent: Code 6
Dean’s Fluorosis Index- Code Definition Dean’s 0 Normal The enamel surface is smooth, glossy and usually a pale creamy-white colour. Dean’s 1 Questionable The enamel shows slight aberrations from the translucency of normal enamel, which may range from a few white flecks to occasional spots. Dean’s 2 Very mild Small opaque, paper-white areas scattered irregularly over the tooth, but involving less than 25% of the labial tooth surface. Dean’s 3 Mild The white opacity of the enamel of the teeth is more extensive than for code 2, but covers less than 50% of labial tooth surface.
Dean’s Fluorosis Index continued Dean’s 4 Moderate The enamel surfaces of the teeth show marked wear and brown stain is frequently a disfiguring feature Dean’s 5 Severe The enamel surfaces are badly affected and hypoplasia is so marked that the general form of the tooth may be affected. There are pitted or worn areas and brown stains are widespread; the teeth often have a corroded appearance. Code 6 All 4 anterior teeth absent
Fluorosis Ages 6-12 Examine the maxillary four anterior teeth* Decide if they are typical of fluorosis bilaterally symmetrical horizontally striated consist of fine white lines or patches, usually near the incisal edges paper-white or frosted in appearance, snow-capped mountain tend to fade into the surrounding enamel *Teeth with brackets or bands should be excluded from the assessment
Fluorosis Assessment Examine the maxillary four anterior teeth Recording is made on the basis of the two teeth that are most affected (they do not need to be a matched “Pair” of teeth, it could be 11 with the 22) Record the score for the less affected of the two teeth If only one of the 4 teeth is available, record based on that tooth Start at the higher end of the index, i.e. “severe”, and eliminate each score If there is doubt, the lower score should be used
General Technique Wipe plaque off teeth Probe to confirm quantitative defects Exclude white spot caries When in doubt score ‘normal’ Wet teeth Examine from front with patient upright Defects > 1mm Natural light (if possible)
Opacities
Opacities
Hypoplasia
Normal Deans 0
Normal Deans 0
Normal Deans 0
Normal Deans 0
Normal Deans 0
Questionable Deans 1
Questionable Deans 1
Questionable Deans 1
Very Mild Deans 2
Very Mild Deans 2
Very Mild Deans 2
Mild Deans 3
Mild Deans 3
Mild Deans 3
Moderate Deans 4
Moderate Deans 4
Moderate Deans 4
Severe Deans 5
Severe Deans 5
Severe Deans 5