November 7, 1931


JAMA. 1931;97(19):1389-1390. doi:10.1001/jama.1931.02730190045015

Mottled enamel is a condition in which the enamel of the teeth appears a flat, opaque white, may be stained yellow, brown or black, and in addition may have a corroded surface. Histologically, mottled enamel may be distinguished by the absence of cementing substance between the enamel rods. The condition is of endemic origin, and, curiously enough, dental caries is infrequent in teeth with this defect. The area of prevalence of the disturbance is, in general, in the Mississippi Valley and Rocky Mountain region. Many theories have been put forward to explain the incidence of mottled enamel. Apparently it may be prevented by distillation of the water or a change of water supply. That mottled enamel resulted from some factor associated with the water supply was shown in a report of the United States Public Health Service.1 Kempf and McKay suggested, after a statistical study, that a further study

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