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October 17, 1936


Author Affiliations

Dental Surgeon, United States Public Health Service WASHINGTON, D. C.

JAMA. 1936;107(16):1269-1273. doi:10.1001/jama.1936.02770420007002

The endemic hypoplasia of the permanent teeth known as chronic endemic dental fluorosis, or mottled enamel, is a water borne disease associated with the ingestion of toxic amounts of fluorides in the water used for cooking and drinking during the period of calcification of the affected teeth. The permanent teeth in particular are affected, although in areas of medium to marked severity the signs of mottled enamel are at times observable on certain of the deciduous teeth.

The causative factor of mottled enamel is operative during the period of tooth development. Hence the affected teeth erupt, showing the characteristic markings of the hypoplasia. Normally calcified teeth erupt showing a smooth, glossy, translucent structure, usually of a pale creamy white color. Teeth affected with mottled enamel, on the contrary, erupt showing a dull, chalky white appearance which in many instances later take on a characteristic brown stain, the frequency of brown