December 2006

Background: Previous investigations of the public perception of dental fluorosis have focused mainly on aesthetics. Other characteristics which could potentially be ascribed to fluorosis, such as perceived personality traits, have not been examined. Objectives: This study aimed to identify personal characteristics (descriptors) attributed to people with fluorosis of varying degrees of severity, as depicted in standardised photographs viewed from different perspectives. Method: Extra-oral (full face) and intra-oral images of male and female subjects were digitally manipulated to represent normal dental enamel, mild, moderate, and severe fluorosis. The images were then scored by 90 members of the public (45M, 45F), under different experimental conditions, which varied the level of cueing to the teeth. Participants were asked (i) to record their spontaneous descriptors, (ii) select relevant descriptors from a predefined list of 50 descriptors and traits. Results: 170 different word or phrase descriptors were spontaneously attributed to the images. Characteristics used to describe fluorosis varied with the degree of severity. However, endorsements were significantly influenced by whether participants viewed extra or intraoral images and the degree of cueing. Conditions which most accurately mirrored everyday social interactions, that is viewing extraoral images without cueing to pay particular attention to the mouth, were least likely to result in the attribution of characteristics that varied with levels of fluorosis. Conclusions: While characteristics varying with severity of dental fluorosis were ascribed, more sophisticated attitudinal measures are required to ascertain the wider social impact of fluorosis beyond the aesthetic. Key words: Dental Caries, fluoride, fluorosis, perception, psychology, public, risk-benefit.