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Dentistry · Caries and periodontal disease: pathogenesis of fluorosis
Sample itemChildren in an endemic area have mottled, pitted enamel. At the cellular level, what is the main mechanism?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Fluoride disturbs ameloblast function and matrix protein removal, causing hypomineralisation
Excess fluoride during enamel formation interferes with ameloblast activity and removal of enamel matrix proteins, leaving subsurface porosity and hypomineralised enamel. Only teeth developing during exposure are affected, which is why the effect depends on age at exposure.
Option by option
A. Autoimmune destruction of odontoblasts
Odontoblasts are not the target in fluorosis.
B. Fluoride disturbs ameloblast function and matrix protein removal, causing hypomineralisation (correct)
Correct. Developing ameloblasts and matrix maturation are disrupted.
C. Vitamin A deficiency causing keratinisation of enamel organ
Vitamin A deficiency can cause enamel hypoplasia, but this is not the fluorosis mechanism.
D. Acid dissolution of erupted enamel by plaque
This describes caries, which is not mottling.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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