The Indian Council of Medical Research (ICMR) has issued the 'Criteria for Dental Fluorosis', developed by the premier research organisation for field workers based on Dean’s classification for ease of application which can be administered with basic level of training.
The ICMR's initiative in this regard is significant as fluorosis is an important public health problem in India which is caused due to excessive ingestion of fluoride, most commonly in drinking-water.
Fluorosis may cause dental fluorosis, skeletal fluorosis, non-skeletal manifestations, or any combination of the above. Earlier, as part of the ICMR’s initiative to address this problem, a task force was formulated to holistically address different aspects of fluorosis. One of the issues taken up was the development of a simplified index for identification and grading of dental fluorosis to be used by the health workers.
Dean’s index is commonly used both nationally and internationally to assess dental fluorosis. However, such indices can be used only by dental specialists. Therefore a simplified index ‘ICMR Criteria for Dental Fluorosis’ was developed for field workers based on Dean’s classification for ease of application which can be administered with basic level of training.
This index is based on the photographs of dental fluorosis in Indian population. At present there is no nationally representative data on prevalence of dental fluorosis in the country. Further whatever little information is available has not been collected using a uniform criteria, thus it is imperative to have a well designed Indian Index for grading dental fluorosis to ensure uniformity among different examiners during field survey.
A task force study was carried out with the aim to validate the ‘ICMR Criteria for Dental Fluorosis’ before its wide scale application. The study was a community based cross sectional study carried out in South Delhi district (New Delhi) and Hissar district (Haryana) in a school setting among children aged 14-17 years.
The index was found to have a good inter examiner reliability and reproducibility and hence has a good potential for recording dental fluorosis at the National level utilising non-dental personnel.
The ICMR has invited comments from the experts and others on the document.