Periodontitis is multifactorial in nature. The effects of fluorosis as an environmental factor are not evaluated and researched to designate it as a risk factor similar to smoking. The primary objectives of this study were to investigate whether there is any association between fluorosis and periodontal disease and to assess salivary oxidative stress in fluorosed and nonfluorosed patients with periodontitis contributing to periodontal disease.
Aim
This is a case—control study with an aim to investigate whether fluorosis acts as a risk factor for periodontal disease and to assess salivary oxidative stress in fluorosed and nonfluorosed patients with periodontitis contributing to periodontal disease.
Materials and methods
About 295 systemically healthy patients were divided into test group (n = 154 fluorosed subjects) and control group (n = 141 nonfluorosed subjects) and assessed for their periodontal status. Clinical parameters recorded were plaque index, gingival bleeding index (GBI), and Jackson's fluorosis index to assess the degree of fluorosis, and community periodontal index was to assess the periodontal status. Biochemical analysis of saliva was done for assessment of malondialdehyde (MDA) levels, superoxide dismutase (SOD) levels, and total antioxidant (TAOC) levels.
Results
The plaque and GBI scores were found similar in fluorosed and nonfluorosed groups. Gingivitis was significantly higher in nonfluorosed than in fluorosed group; in contrast, periodontitis was significantly higher in fluorosed group than in nonfluorosed group. Gingivitis appeared to decline as the fluoride status worsened, while periodontitis showed an increasing gradient from lower fluoride score to higher fluoride score. As the degree of fluorosis increased, periodontitis also increased. The salivary antioxidant levels were found similar in both the groups.
How to cite this article
Dalvi PJ, Vandana KL, Ghosh S, Joshi VM, Bhat K, Prakash VH. Fluorosis: Environmental Risk Factor for Periodontal Disease? J Postgrad Med Edu Res 2017; 51(4):157-161.
Identification of genetic risk factors for periodontitis and possible mechanisms of action. J Clin Periodontol 2005;32(Suppl 6):159-179.
Lipid peroxidation and antioxidant status in patients with periodontitis. Cell Mol Biol Lett 2005;10(2):255-264.
Development in the prevention and treatment of fluorosis caused by coal burning in China (1986–1993). Proceedings of the XXth Conference of ISFR, Beijing, China. 1994. p. 145.
Effect of free radicals on the development of fluorosis and the protective effects by SOD and vit E. Proceedings of the XXth Conference of ISFR, Beijing, China. 1994. p. 145.
Assessment of periodontal status of the patients with dental fluorosis in area with natural high levels of fluoride: a cross-sectional survey. Dent Hypotheses 2013 Dec;4(4):127-130.
Periodontal status of children with dental fluorosis in Juja, Kenya. Am J Med Sci 2015 May;5(1):7-9.
Assessment of periodontal status in dental fluorosis subjects using community periodontal index of treatment needs. Ind J Dent Res 2007;18(2):67-71.
Endemic fluorosis of the skeleton: radiographic features in 127 patients. AJR Am J Roentgenol 1994 Jan;162(1):93-98.
2012.
Gingivitis and gingival recession in adults from high-fluoride and low fluoride areas. Arch Oral Biol 1972 Sep;17(9):1269-1277.
Problems and proposals for recording gingivitis and plaque. Int Dent J 1975 Dec;25(4):229-235.
Prevalence and severity of periodontitis in a high fluoride area in South Africa. Community Dent Oral Epidemiol 1985 Apr;13(2):108-112.
Dental tissue effects of fluoride. Adv Dent Res 1994 Jun;8(1):15-31.
Fluoride in dentistry. 2nd ed. Copenhagen: Munksgaard Publishers; 1996. p. 275-290
Dental fluorosis in cattle. Cornell Vet 1983 Oct;73(4):340-362.
Endemic fluorosis: radiological features of dental fluorosis. J Indian Dent Assoc 1968 Nov;40(11):299-303.
Periodontal changes in fluorosed and nonfluorosed teeth by SEM. Fluoride 2007 Apr-Jun;40(2):128-133.
Structural analysis of proteoglycans synthesized by mineralizing bone cells in vitro in the presence of fluoride. Matrix Biol 1998 Aug;17(4):255-268.
The role of fluoride ions in glycosaminoglycans sulphation in cultured fibroblasts. Fluoride 1998;31(4):193-202.
Biochemical and morphological studies of human diploid and fluoride resistant fibroblasts in vitro. Arch Oral Biol 1986;31(11): 717-722.
Effect of sodium fluoride on growth of human diploid cells in culture. Pharmacol Toxicol 1990 Nov;67(5):411-414.
Selective inhibition of collagen synthesis by fluoride in human pulp fibroblasts in vitro. Calcif Tissue Int 1993 Jul;53(1):38-44.
Measurement of gingivitis among school age children in Braniford, Sarnia, and Stratford using the P-M-A index. Canad J Public Health 1954 Mar;45(3):112-123.
Fluoride in domestic water and periodontal disease. Am J Public Health 1957 Jun;47(6):688-694.
Posteruptive development of isolated and confluent pits in fluorosed enamel in a 6-year-old girl. Scand J Dent Res 1983 Aug;91(4):243-246.
Structural aberrations in fluorosed human teeth: biochemical and scanning electron microscopic studies. Curr Sci 1999 Oct;77:1-6.
Some epidemiological aspects of chronic endemic dental fluorosis. Am J Public Health 1936 Jun;26(6):567-575.
Chronic endemic fluorosis in Northern India. Br Dent J 1940;68:409-424.
Relation of malnutrition, endemic dental fluorosis and oral hygiene to the prevalence and severity of gingivitis. J Periodontol 1951 Oct;22(4):205-211.
Oral aspects of excessive fluoride in a water supply. J Am Dent Assoc 1955 Mar;50(3):272-277.
Periodontal treatment needs in populations of high-and low-fluoride areas of Morocco. J Clin Periodontol 1989 Oct;16(9):596-600.
The effects of natural fluoride on the periodontal health of adults. Am J Public Health Nations Health 1963 Aug;53:1233-1242.
The simplified oral hygiene index. J Am Dent Assoc 1964 Jan;68:7-13.
Fluorosis and periodontium: a report of our institutional studies. J Int Clin Dent Res Organ 2014 Aug;6(1):7-15.
Dental fluorosis and periodontium: a game of shadows? J Oral Biol Craniofac Res 2014 Jan-Apr;4(1):47-48.
Influence of correcting therapy course on salivary components of patients with Fluorosis. Stomatologiia (Mosk) 2007;86(5):24-26.
IuG, Vartichan AI, Lysy. LT. Impact of antioxidative therapy on the activity of salivary glutathione-dependent enzymes in patients with fluorosis. Klin Lab Diagn 2007 Jan;22(1):35-37.
Recent studies an endemic fluorosis in China. Fluoride 1994;27(3):125-128.
Oxidative stress in children with endemic skeletal fluorosis. Fluoride 2001;34(2):103-107.