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1994: Nunn J H; Rugg-Gunn A J; Ekanayake L; Saparamadu K D
Prevalence of developmental defects of enamel in areas with differing water fluoride levels and socio-economic groups in Sri Lanka and England.
International dental journal 1994;44(2):165-73.
Defects of dental enamel were recorded in 607 12-year-old children in Sri Lanka and north-east England in 1990/91. In each country, children were included from areas which received drinking water containing 0.1, 0.5 or 1.0 ppm F. In some of these areas, children from both low and high socio-economic groups were examined. The index of Developmental Defects of Enamel (DDE) was recorded clinically for the undried buccal surfaces of 10 permanent teeth (maxillary incisors, canines and first premolars, and mandibular first molars). The results revealed a higher prevalence of enamel defects and more teeth affected per person in children in: the high socio-economic group than in the low socio-economic group in the 1.0 ppm F area in England: in the 1.0 ppm F area than in the 0.1 ppm F area in Sri Lanka (in the low socio-economic groups), and in the 1.0 ppm F area than in the 0.1 ppm F area in England (in the high socio-economic groups but not in the low socio-economic groups): in general in Sri Lanka than in England. The occurrence of diffuse opacities increased greatly with increasing water fluoride level. A high prevalence of hypoplastic lesions was recorded in Sri Lanka.

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