Esthetic Perceptions of Computer-Generated Fluorosis Compared to Other Conditions

Objectives: Dental fluorosis has been thought by some to be a harmless condition, while others view it as a major esthetic problem. The purpose of this study was to assess the perceptions that students had about dental fluorosis as compared to other dental conditions. Methods: A survey was taken by 88 students, ages 18-26, attending four area colleges. Six questions both quantitative and qualitative were asked about five sets of images. The images compared the following: normal versus mild fluorosis; mild fluorosis versus a diastema with no fluorosis; an isolated opacity versus a more involved, mild fluorosis; generalized mild fluorosis versus incisal third only mild fluorosis; and tetracycline staining versus moderate fluorosis. Photos were computer generated to control any extraneous factors. Tests that were conducted were the chi squared test, the t-test, Cochran-Armitage trend test, and the ANOVA test. Frequency distributions, means, and standard deviations were also determined for all of the survey data. Results: Results showed that generalized mild fluorosis, moderate-severe fluorosis, and tetracycline staining seem to be the worst overall rated conditions. For these conditions a majority (>60%) of participants answered that they would seldom or never smile with their teeth, would seek dental treatment, and scored extremely high on the visual analog scale with a high score relating to a very poor perception. Conclusion: It does seem that once dental fluorosis reaches the mild stage and beyond that it is perceived as an esthetic problem by college students. This study shows that the benefits and risks of fluoride need to be balanced and parents need to be educated on keeping ingested fluoride at an optimum level.