Classification
Dean's Index — Very Mild (Score 1)
Small opaque white areas affecting less than 25% of tooth surface.
- • White flecks or streaks parallel to striae of Retzius
- • Affects <25% of tooth surface
- • No staining
- • Normal smooth surface
Dean's Index — Mild (Score 2)
Opaque white areas affecting up to 50% of tooth surface.
- • White chalky areas, may have faint horizontal lines
- • 25-50% of tooth surface affected
- • Surface may be slightly rough
- • Clinically detectable aesthetic issue
Dean's Index — Moderate (Score 3)
All tooth surfaces affected; brown staining common.
- • Entire tooth surface appears chalky white
- • Brown extrinsic staining — 'mottled' appearance
- • Surface may be pitted
- • Significant aesthetic concern
Dean's Index — Severe (Score 4)
Widespread pitting, brown staining, and structural compromise.
- • Discrete or confluent pitting across the surface
- • Dark brown staining throughout
- • Enamel may be chipped or completely lost
- • Severe aesthetic and functional compromise