Validation of fingernail fluoride concentration as a predictor of risk for dental fluorosis

M. A.R. Buzalaf, C. S. Massaro, M. H.C. Rodrigues, R. Fukushima, J. P. Pessan, G. M. Whitford, F. C. Sampaio

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


The aim of this study was to validate the use of fingernail fluoride concentrations at ages 2-7 years as predictors of the risk for developing dental fluorosis in the permanent dentition. Fifty-six children of both genders (10-15 years of age) had their incisors and premolars examined for dental fluorosis using the Thylstrup-Fejerskov index. Fingernail fluoride concentrations were obtained from previous studies when children were 2-7 years of age. Data were analyzed by unpaired t test, ANOVA, and Fisher's exact test when the fingernail fluoride concentrations were dichotomized (≤2 or >2 μg/g). Children with dental fluorosis had significantly higher fingernail fluoride concentrations than those without the condition, and the concentrations tended to increase with the severity of fluorosis (r2 = 0.47, p < 0.0001). Using a fingernail fluoride concentration of 2 μg/g at ages 2-7 years as a threshold, this biomarker had high sensitivity (0.84) and moderate specificity (0.53) as a predictor for dental fluorosis. The high positive predictive value indicates that fingernail fluoride concentrations should be useful in public health research, since it has the potential to identify around 80% of children at risk of developing dental fluorosis.

Original languageEnglish (US)
Pages (from-to)394-400
Number of pages7
JournalCaries Research
Issue number4
StatePublished - Jul 2012
Externally publishedYes


  • Biomarker
  • Dental fluorosis
  • Fingernail
  • Fluoride

ASJC Scopus subject areas

  • Dentistry(all)


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