What is Dental Fluorosis?

Dental fluorosis is a cosmetic condition that results when a child under eight consumes too much fluoride while the teeth are forming. The fluoride interferes with the proper crystalline development of tooth enamel, causing hypomineralization. Spotted, discolored teeth are common into adulthood, even when dental hygiene rules are followed. The condition is not reversible, and treatment is limited to cosmetic dental procedures.

Seemingly beneficial actions can cause dental fluorosis to develop. Exposure to excess fluoride can begin in infancy if parents often give fluoride drops to the baby. Small children may swallow toothpaste containing fluoride, causing irreversible damage to the enamel of the developing teeth. Drinking water containing fluoride may cause elevated fluoride levels over time, resulting in cosmetic changes to the teeth.

Mild dental fluorosis causes minor tooth defects. Small white spots or streaks are easily visible on the enamel of the tooth. Less than 25 percent of the tooth’s surface area is marked by the white spots.

Moderate dental fluorosis affects more of the surface area of the tooth. Up to half the tooth may be covered in white spots or streaks. Little changes may occur to the surface of the tooth, causing the tooth to have a rough appearance.

Severe dental fluorosis causes very noticeable color and surface changes to the teeth. The teeth may become pitted and brown. Mottling may cause the teeth to be misshapen and look like they are decaying.

Treatment of dental fluorosis can only disguise the cosmetic defects the condition causes. Simple dental abrasion of the tooth enamel may remove minor spots and streaks. Porcelain veneers can be applied to the surface of the tooth, completely covering any pitting or spotting. Another option is composite bonding, in which the surface of the tooth is scratched to provide an optimum bonding surface, and then a composite material is applied to the tooth to cover the damaged area.

Preventing dental fluorosis is accomplished by monitoring a child’s daily fluoride intake. Taking care to apply a small amount of fluoride toothpaste to a child’s toothbrush can minimize the fluoride accidentally ingested by the child. Some parents may decide to buy toothpaste that does not contain fluoride until the child is past the age of eight. Parents in areas that have fluoridated water may find it necessary to buy bottled water until the risk for developing dental fluorosis has past. Discontinuing infant fluoride drops may prevent future damage to the enamel of some children.