We examined 102 children born and reared in an area of rural Kenya with 2 ppm fluoride in the drinking water for dental fluorosis, using the index developed by Thylstrup and Fejerskov (1978). The prevalence of dental fluorosis was 100%, 92% of all teeth exhibited a TFI score of 4 or higher, and 50% of the children had pitting or more severe enamel damage in at least half the teeth present. The fluorotic changes showed a high degree of bilateral symmetry. The intra-oral distribution of the changes corresponded to the pattern of fluoride-induced enamel changes reported by other investigators in high-fluoride areas. The high prevalence and severity of dental fluorosis in a 2-ppm-fluoride area is in accordance with recent observations on dental fluorosis being very prevalent in Kenya, even in low-fluoride areas (less than 1 ppm F). We are presently investigating the possible variables which may explain this unexpected susceptibility of large populations in Eastern Africa to fluorosis from exposure to low levels of fluoride.