Objective: To determine the prevalence, distribution, severity and treatment need of enamel opacities among 11-12 year-old school children in a fluoridated urban community.
Design: A cross-sectional descriptive survey of enamel opacities in 11-12 year-old schoolchildren.
Clinical setting: A questionnaire survey and a clinical examination of erupted teeth using the Modified DDE Index was conducted on schoolchildren in randomly selected schools.
Participants: 957 schoolchildren from government schools in Kuala Lumpur comprising the three major ethnic groups of Malay, Chinese and Indian children.
Main outcome measures: The severity of enamel opacities was assessed by the extent of buccal surface involvement. Normative treatment need was based on severity of opacities.
Results: Enamel opacities were found in 90.7% of subjects and 47.2% of teeth. Malays have the highest prevalence with Chinese the least. Although ethnic differences is statistically significant (p < 0.01), the differences in prevalence between ethnicity is small. The most common type of defect was "diffuse opacities" (88.6% of subjects). Most subjects (70%) showed bilateral distribution of diffuse opacities indicating a systemic disturbance. Posterior teeth were twice more commonly affected (p < 0.05). The majority of opacities in anterior teeth (66.7%) were minor, involving less than 1/3 of the labial surface. Only 0.6% of the whole sample required some form of aesthetic intervention.
Conclusion: Despite the high prevalence of enamel opacities, the degree of severity is very mild with only minimal aesthetic and public health concern.