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Spira's syndrome

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A chronic form of hypoplasia of the dental enamel characterized by mottling or brown discoloration of teeth. Other features include nausea, anorexia, vomiting and constipation. In older patient, possibly, stiffness, rheumatalgia. The hair of some of these mottled enamel cases is unusually coarse, almost like horse hair. Affected persons frequently complain that the hair is falling out prematurely. Finger nails are apparently not normal. Onset in late childhood to early adulthood. It is caused by drinking water with a high fluorine content during the time of tooth formation. It now seems that the condition is associated with zinc deficiency and hypothyreosis, as fluorides cause zinc deficiency.

The term "Spira's syndrome" was coined by the German dentist Helmut Schöhl in 1985.

We thank Zoran Bojanic, Serbia, for calling our attention to this syndrome.


  • L. Spira, in:
    Franco British Medical review, London, 1928, 5: 61.
  • H. Schöhl:
    Fluor-Fluorid, Heilmittel oder Gift?
    Gesellschaft für Gesundsheitsberatung (GGB) Krankenhaus Lahnhöhe, Lahnstein, Germany, 1985.

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