Assessment of dental fluorosis prevalence in Swiss populations.

In 1996 and 2006, recruits of the Swiss army participated in a dental survey. Similarly in 1995/96 and 2004/05, randomly selected schoolchildren from 16 rural communities of the Canton of Zurich participated in a dental survey. As part of these surveys, color slides were taken of the incisor teeth of all recruits, as well as of third and fourth grade schoolchildren. The slides (N = 2049) were examined for the presence of fluoride-associated enamel opacities (FOP), using the Thyl-strup-Fejerskov (TF) index. Two examiners (A and B) assessed all slides. The examiners were blind as to the year of survey. Examiner A recorded prevalences of FOP between 18% and 27% depending on population; examiner B recorded prevalences between 7% and 12%. The examiners' influence on the estimation of the prevalence was obvious. The prevalences reported should, therefore, be considered as rough estimates. FOP of TF score 2 were only observed in approximately 1% of the participants. One examiner recorded a TF score 3 in a single individual. FOP therefore are not a cosmetic problem and certainly not a public health concern. The prevalence of FOP decreased slightly during observation period I (recruits born 1975-77 vs 1985-87) and period II (school children born 1985-87 vs 1994-96). However, the decline was statistically supported in only one instance (Period I, Examiner B).