Document Type




Format of Original

14 p.

Publication Date



John Wiley & Sons

Source Publication

Community Dentistry and Oral Epidemiology

Source ISSN


Original Item ID

DOI: 10.1111/cdoe.12187


Objective: Very few studies have examined the relationship between timing of fluoride intake and development of dental fluorosis on late-erupting permanent teeth using period-specific fluoride intake information. This study examined this relationship using longitudinal fluoride intake information from the Iowa Fluoride Study.

Methods: Participants’ fluoride exposure and intake (birth to 10 years of age) from water, beverages, selected food products, dietary fluoride supplements, and fluoride toothpaste was collected using questionnaires sent to parents at 3- and 4- month intervals from birth to 48 months of age and every 6 months thereafter. Three trained and calibrated examiners used the Fluorosis Risk Index (FRI) categories to assess 16 late-erupting teeth among 465 study participants. A tooth was defined as having definitive fluorosis if any of the zones on that tooth had an FRI score of 2 or 3. Participants with questionable fluorosis were excluded from analyses. Descriptive and logistic regression analyses were performed to assess the importance of fluoride intake during different time periods.

Results: Most dental fluorosis in the study population was mild, with only four subjects (1%) having severe fluorosis (FRI Score 3). The overall prevalence of dental fluorosis was 27.8%. Logistic regression analyses showed that fluoride intake from each of the individual years from age 2 to 8 plays an important role in determining the risk of dental fluorosis for most late-erupting permanent teeth. The strongest association for fluorosis on the late-erupting permanent teeth was with fluoride intake during the sixth year of life.

Conclusion: Late-erupting teeth may be susceptible to fluorosis for an extended period from about age 2 to 8. Although not as visually prominent as the maxillary central incisors, some of the late-erupting teeth are esthetically important and this should be taken into consideration when making recommendations about dosing of fluoride intake.


Accepted version. Community Dentistry and Oral Epidemiology, Vol. 44, No. 1 (February 2016): 32-45. DOI. © 2016 John Wiley & Sons A/S. Used with permission.

This is the peer reviewed version of the following article: "Timing of Fluoride Intake and Dental Fluorosis On Late-Erupting Permanent Teeth", Community Dentistry and Oral Epidemiology, Vol. 44, No. 1 (February 2016): 32-45, which has been published in final form at DOI. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

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