What Is Fluorosis?
Your permanent teeth form under your gums in the jawbone during early childhood. They appear in your mouth as the primary or "milk" teeth fall. The crowns of nearly all of the permanent teeth are fully formed by the time you are about 8 years old. The exception is the wisdom teeth, which form in young adulthood. The crown is the part of a tooth you can see in your mouth.
Consuming too much fluoride while the teeth are forming, can lead to fluorosis. This condition causes white or brown discolouration or spots on the enamel, or tooth surface. The effects can range from minor colour changes to surface irregularities of the teeth. Fluorosis does not develop after teeth have erupted.
Fluorosis is a cosmetic condition, not a disease. Often, it is so mild that only a dental professional can detect it. Most cases of fluorosis result from young children taking fluoride supplements or swallowing fluoride toothpaste when the water they drink is already fluoridated.
Teeth affected by mild fluorosis may show no changes or it will be visible only to a dental professional. Mild to moderate fluorosis produces white lines, streaks or spots. In more severe fluorosis, the teeth can become pitted and have brown, grey or black spots. The enamel also may have an unusual shape.
Your dentist will ask about your child's fluoride intake. This will help to determine if the discoloration seen is a result of fluorosis. They also will ask about past and present medical conditions or disabilities that may affect your child's teeth. They will then examine your child's teeth and gums and take X-rays to make sure the teeth have no other defects or cavities.
Other conditions may look like fluorosis. Developmental defects and problems with the skull or bones of the face can disrupt the enamel or dentin of the teeth. In addition, high fevers or trauma (such as a injuries after a fall) in infants or young children may discolour teeth. Young children can get cavities in their primary teeth, so any tooth discoloration should be checked at the dental office.
The spots and stains left by fluorosis are permanent. They may darken over time.
If you have a child under 6, put only a small pea-sized amount of toothpaste on his or her toothbrush. Encourage your child to spit rather than swallow after brushing. Avoid toothpastes with flavours that may encourage swallowing. Keep all fluoride-containing products out of the reach of young children. These include toothpastes and mouthwashes.
Adding fluoride to drinking water is one of the great preventive disease programs of the 20th century. Children should take fluoride supplements only if the water they drink does not contain enough fluoride and they are at high risk for cavities. If your child is taking fluoride supplements now, check the amount of fluoride in your water. If you are on a public water supply, call your supplier to ask about the fluoride level. You can also have your dentist check a sample of your water. Then discuss with your dentist or paediatrician whether your child needs fluoride supplements.
Some foods and drinks contain fluoride. For example, many fruit juices and soft drinks contain fluoride at levels similar to fluoridated water. Now-a-days, even some bottled waters have started adding fluoride and eventually all of these sources can add up. Therefore, it is important to know how much fluoride your child consumes.
Remember that fluorosis affects only the appearance of teeth. It does not result in cavities. As a result, most of the treatment consists of masking the stain.
Many cases are minor enough not to need treatment. Sometimes fluorosis occurs only on the back teeth, where it can't be seen. Severe cases or the ones involving the front teeth can be treated by removing the surface-stained areas through tooth whitening or similar procedures. Extreme cases of fluorosis can be covered with bonding, crowns or veneers.
When to call a Professional
If you notice white streaks or spots on your child's teeth or notice that one or more teeth are discoloured, contact your dental office.
Teeth affected by fluorosis are not diseased. Fluorosis will not result in cavities or other dental problems. Concerns about appearance can be addressed with whitening to remove surface stains and veneers or other procedures to cover the discoloration