Dental Fluorosis

Dental Fluorosis

Description, Causes and Risk Factors:

Dental fluorosis is a change in the appearance of the tooth's enamel. These changes can vary from barely noticeable white spots in mild forms to staining and pitting in the more severe forms. Dental fluorosis only occurs when younger children consume too much fluoride, from any source, over long periods when teeth are developing under the gums.

Dental Fluorosis

Only children aged 8 years and younger can develop dental fluorosis because this is when permanent teeth are developing under the gums.

    Once the teeth erupt through the gums and are in the mouth, they can no longer develop fluorosis.

  • The teeth of children older than 8 years, adolescents, and adults cannot develop dental fluorosis.

Dental fluorosis is caused by taking in too much fluoride over a long period when the teeth are forming under the gums. Only children aged 8 years and younger are at risk because this is when permanent teeth are developing under the gums. The severity of the condition depends on the dose (how much), duration (how long), and timing (when consumed) of fluoride intake.

Increases in the occurrence of mostly mild dental fluorosis were recognized as more sources of fluoride became available to prevent tooth decay. These sources include drinking water with fluoride, fluoride toothpaste — especially if swallowed by young children — and dietary prescription supplements in tablets or drops (particularly if prescribed to children already drinking fluoridated water).

The following are the major sources of fluoride intake among children and adults who suffer from dental fluorosis.


  • Drinking water with fluorine.

  • Beverages with fluoridated water.

  • Processed food using fluoridated water.

  • Dietary prescriptions in the form of tablets or drops with fluoride content.

  • Professional dental products like foams, mouth rinses, and gel.

A recent three-year study conducted in Sosnivka, Ukraine investigated the health of children afflicted with dental fluorosis and compared results to children without such enamel defects, the only such study we know of. It was found that children with dental fluorosis had more gastrointestinal diseases (37%), respiratory diseases (29.5%), bone and muscle diseases (13.8), mental disorders (11.3), skin diseases (9.4%), and 8.2% suffered from diseases of the nervous system and sensory dysfunction. As children grew older, there was also in increase in urino-genital diseases. Boys suffered more from mental, bone-muscle, and birth anomalies. The girls had more sight problems and vaginal veneral disease. In all tested groups boys were shorther than the control. In addition children with dental fluorosis had much higher caries occurrence.


Some of the most common signs and symptoms of the condition observed on the teeth of patients include:

    Scattered white flecks.

  • Frosty edges.

  • Fine-chalk lines.

  • Lacy chalk-like lines.

  • White spots (occasional).

These are serious symptoms that should not be disregarded by patients or their family members. If your child begins to exhibit one or more of the aforementioned signs, do not wait for more serious symptoms such as larger white spots or rough pitted teeth surfaces. Seek the advice of your dentist and inquire about the most effective treatment strategy for your child.


The adequate diagnosis of fluorosis requires inspection ofdry and clean dental surfaces, under a good light source.The clinical appearance of mild dental fluorosis is characterized by bilateral, diffuse (not sharply demarcated),opaque, and white striations that run horizontally acrossthe enamel. The opacities may coalesce to form whitepatches. In the more severe forms, enamel may becomediscolored and/or pitted. Upon eruption into the mouth,fluorosed enamel is not discolored, the stains developover time due to the diffusion of exogenous ions (ex, ironand copper) into the abnormally porous enamel.


The damage that dental fluorosis causes to the teeth enamel is permanent and not reversible. Dental fluorosis treatment is targeting in hiding the discoloration of the teeth. Treatment options depend on the severity of dental fluorosis.

  • Tooth whitening - only for mild fluorosis cases. The whitening is achieved by the abrasion of the outer layer of the enamel in order to remove surface stains.

  • In cases of severe dental fluorosis the tooth enamel usually becomes porous, and tooth whitening methods are not recommended as treatment. Dental fluorosis treatment for severe cases of fluorosis requires covering the affected teeth with restorations, such as:

  • Composite bonding. After etching the enamel, a composite resin (with a color matching the other teeth) is "glued" on to the exterior of the tooth.

  • Porcelain veneers. Made out of porcelain, veneers form a ceramic shell over the surface of the tooth, covering the stains and discoloration caused by the dental fluorosis.

  • Tooth bonding and porcelain veneers are relativly expensive dental fluorosis treatments but they can provide excellent cosmetic results.

Controlling the fluoride intake is the best preventive measure for dental fluorosis, however when this is already installed and causing esthetic problems to the patient, some treatment techniques are described in the literature and will depend on the severity of the condition.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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