Flyuoroz — the defeat of tooth enamel connected with constant and long hit in an organism of excess amount of fluorine. Flyuoroz can have endemic and professional character. It is shown by emergence on teeth of whitish, and then yellow spots or strips, erosive or destructive changes of enamel in the beginning. In hard cases is followed by damage of a bone tissue of a skeleton. In case of diagnosing of a flyuoroz the patient first of all needs to change the drinking water used by it. Treatment of a flyuoroz consists basically in esthetic and mineral restoration of the affected teeth. Bleaching, remineralization, restoration, installation of crowns is for this purpose carried out.
Cases of a flyuoroz were described in 1890. Long time these changes of teeth carried the name "spotty enamel" and the reasons of their emergence were not known. Only in 1931 connection of a disease with too high content of fluorine in water was established that formed the basis of its name — "" (from Latin "fluorom" – fluorine). Endemic it is widespread in those regions where the content of fluorine in 1 liter of drinking water exceeds 1,5 mg. Meets professional , developing at workers of the aluminum industry and much less often connected with the increased concentration of fluorine in the inhaled air.
Causes of a flyuoroz
Fluorine is a microcell which along with calcium, potassium, magnesium and others participates in the physiological processes happening in a human body. The greatest number of fluorine contains in a bone tissue and in teeth. Its receipt in an organism happens to food and water. However the fluorine which is contained in products is acquired only in a small amount, the main share of the fluorine coming to an organism is the share of the fluorides dissolved in water. Water with the content of fluorine of 1 mg/l is considered optimum. Lower concentration of fluorine in water leads to receipt in an organism of insufficient quantity of this microcell and can become the reason of development of caries of teeth. The increased concentration of fluorine causes .
Most often it is noted at eruption of second teeth at children who up to 3-4 years lived in areas with the increased concentration of fluorine in water. It suggests that development of a flyuoroz is connected with negative impact of excess of fluorine on process of formation of rudiments of second teeth. Damage of milk teeth flyuorozy practically does not meet as their rudiments are formed during pre-natal development when excess of fluorine is late a placenta and is not transferred to a fruit. Flyuoroz of already created teeth at adults can be observed at sharply increased concentration of fluorine in water — from 6 mg/l and above.
On the cause the stomatology allocates endemic and professional . On clinical manifestations distinguish 5 forms of a disease: spotty and shaped, melovidno-speckled, erosive and destructive. The first two forms carry to a flyuoroz of easy degree. Melovidno-krapchataya the form is considered flyuorozy average weight, and erosive and destructive forms — heavy degree of a flyuoroz.
Often at the patient with the expressed degree of a flyuoroz various groups of teeth are surprised different forms of a disease. On observation of some authors, the arisen form of a flyuoroz remains at the patient for the rest of life and is not transformed to other form even at change of concentration of fluorine in the used water.
Manifestations of a flyuoroz
Endemic it is shown by emergence on the shchechny surface of teeth of spots or strips of white color. Within several years there is a change of coloring of spots till yellow and even brown color. Most often defeat of cutters of top meets, is more rare — the lower jaw. At much the increased concentration of fluorine in water damage of other teeth, deleting of tooth enamel, formation of erosion and chips is observed.
The shaped form of a flyuoroz is shown by emergence on a vestibular surface of cutters of cretaceous strokes or strips. In certain cases they are well noticeable, but are expressed to a thicket poorly and become better visible when drying a tooth surface. Merge of strips in spots is possible, but at the same time in structure of a spot it is always possible to distinguish separate strips.
Spotty form of a flyuoroz — on a tooth surface well noticeable multiple whitish spots without strips which at merge can form a spot of big diameter take place. A surface of spots of a flyuoroz brilliant and smooth, borders are expressed not sharply and smoothly pass into healthy enamel.
Melovidno-krapchataya the form of a flyuoroz is characterized by an opaque shade of all enamel of the affected teeth with accurately outlined pigmented spots and points located on it. In some cases enamel has a yellow shade. On it sites of destruction — a speck of 0,1-0,2 mm in depth and with a diameter up to 1,5 mm, having the pigmented bottom can be noted. At this form of a flyuoroz at patients bystry deleting of enamel with an exposure of the dark brown dentine located under it is noted.
The erosive form of a flyuoroz differs in existence of sites of destruction of enamel considerably of the bigger size, than a speck of a melovidno-speckled form of a flyuoroz — erosion. In the field of erosion enamel in general is absent. The expressed deleting of enamel on the chewing surface of teeth is noted.
The destructive form of a flyuoroz is followed by erosive defeats and deleting not only enamels, and and the subject solid tissues of tooth. Tissues of tooth become fragile, are inclined to an oblamyvaniye at the expense of what the form of a tooth crown is broken. However adjournment of replaceable dentine prevents opening of a tooth cavity. The destructive form of a flyuoroz is, as a rule, observed in regions where the content of fluorine in water exceeds 10 mg/l.
Professional it is shown by damage of bones of a skeleton (osteoporosis, an osteosclerosis) with violation of mobility in joints. Spots on teeth can be absent. At a late stage of a professional flyuoroz vegeto-vascular disorders and damage of a liver join. Development of a malignant new growth of bones — osteosarcomas is possible.
Treatment of a flyuoroz
At identification of a flyuoroz it is recommended to patient to hand over the drinking water used by it on the analysis for determination of the content of fluorine in it. At the increased concentration of fluorine it is necessary to change a source of drinking water or to use the water purified of fluorine. Further drink of water with the increased content of fluorine can lead to emergence in the patient of more severe form of a flyuoroz with destruction of the affected teeth. Patients with flyuorozy should refuse use of the toothpastes and other conditioning agents behind an oral cavity containing fluorine.
Removal of affected areas of tooth with the subsequent sealing at a flyuoroza is not applied as it often leads to loss of a seal and further destruction of tooth. The patient with flyuorozy recommended administration of drugs of calcium and phosphorus.
At an easy form of a flyuoroz chemical, LED or laser bleaching of teeth is made. After it the remineralization of tooth consisting in drawing on tooth enamel of compounds of phosphorus and calcium by means of an ultrafonoforez, an electrophoresis or by application is surely carried out. Remineralization of tooth at a flyuoroza demands holding at least 10 procedures, is optimum — 15-20 procedures on a course of treatment.
The procedure of bleaching is inefficient at expressed melovidno-speckled and erosive and destructive forms of a flyuoroz. In these cases restoration of teeth with use of vinir or lyuminir is applied. At a flyuoroza of heavy degree with destructive changes of tissues of tooth treatment at the orthopedist with installation of a ceramic or ceramic-metal crown is shown.
Prevention of a flyuoroz
The main direction of preventive actions in regions with the increased amount of fluorine in water consists in reduction of amount of the fluorine getting to an organism. For this purpose it is necessary to use the purified drinking water or water with the normal content of fluorine brought from other areas; to avoid use of toothpastes and gels with fluorine; to limit the use of fluorinated products (fish, butter, etc.).
In prevention of a flyuoroz at children the balanced diet rich with dairy products and vitamins is of great importance. If necessary in addition apply calcium medicines, vitamins C and D, polyvitaminic complexes.