Dental fluorosis in children attending basic health units.
The purpose of this study was to determine the prevalence and severity of dental fluorosis among patients attending basic health units in Londrina. Five basic health units of the urban area were randomly selected and 434 children attending these units, born between 1986 and 1989 (9 to 12 years of age), were examined. Diagnosis of dental fluorosis was performed by means of the Thylstrup and Fejerskov (TF) Index. Oral examinations were carried out by 5 previously trained dentists with the patients lying in the dental chair, under artificial light, preceded by prophylaxis, isolation with cotton rolls and air-drying of the teeth. Ten percent of the sample was reexamined and an almost perfect agreement on diagnostic criteria was obtained either on the intra-examiner or inter-examiner evaluation (K=1.00, p<0.0001). The observed prevalence of dental fluorosis was 91.0%, and 87.8% of the individuals were classified as TF grade 2 or less. Despite of the low severity, the high prevalence observed shows the need for regular screening of dental fluorosis in Londrina; establishment of procedures to prevent the overutilization of fluoride both by the professionals and the population; sanitary surveillance of fluoride levels in water supply and also in all sources of fluoride available; besides the need for further studies to understand the factors associated to dental fluorosis among children living in Londrina.