What Is Dental Fluorosis?

Fluoride is an important mineral that helps prevent cavities and reverse early signs of tooth decay in children and adults. It makes the tooth enamel more resistant to acid attacks from sugars and bacteria in the mouth. However, too much fluoride can cause something called dental fluorosis.

Here are the causes, symptoms, treatment, and prevention of fluorosis.

Dental Fluorosis Explained

Dental fluorosis is a condition that causes visible changes to the enamel of the teeth as a result of overexposure to fluoride in the early years of life. It is a cosmetic concern that’s characterized by brown or white spots on the teeth. Children who are eight years old and younger are at risk for fluorosis while their permanent teeth are still forming. Teeth that have already erupted can’t get fluorosis. In the U.S., mild fluorosis affects about 1 in every 4 people aged between 6 and 49.

What Causes Dental Fluorosis?

Dental fluorosis is caused by systemic or internal overexposure to fluoride when a child’s teeth are forming under the gums. Fluoride is usually added to toothpaste and mouthwash. Many children without parental oversight tend to ingest toothpaste when they brush. Fluoride in mouthwash and toothpaste is very concentrated and can lead to dental fluorosis over time.

Fluoride can also be added to public drinking water sources through a process called fluoridation. Drinking water with a higher amount of fluoride than required can increase the risk of dental fluorosis.

What Are the Symptoms?

The only symptom of dental fluorosis is tooth discoloration. This painless cosmetic condition can change the appearance of the tooth enamel, giving it white “streaks” or “splotches.”

The following terms are used to categorize fluorosis:

• Questionable: Characterized by a few light white flecks and occasional white spots on the enamel.
• Very Mild: Small opaque white areas covering less than 25% of the tooth surface.
• Mild: Light white areas affecting less than 50% of the enamel surface.
• Moderate: More than 50% of the tooth surfaces are covered by white or light brown spots
• Severe: All enamel surfaces are covered by larger white, light brown or dark brown spots. The teeth may have rough, pitted surfaces (small depressions in the enamel).

The majority of fluorosis cases are mild and do not cause permanent damage to the teeth. Severe cases are not common.

How is Dental Fluorosis Treated?

Brushing and flossing won’t get rid of fluorosis stains. But if the stains are noticeable and have a negative impact on your self-esteem and confidence, cosmetic dental treatments can help. Common treatments include:

• Teeth whitening
• Veneers
• Crowns
• Dental bonding
• Enamel microabrasion

The most appropriate treatment for you will depend on the severity of fluorosis, your personal preferences, and your budget.

How Can Parents and Caregivers Prevent Fluorosis?

Parental vigilance is the key to reducing a child’s risk for fluorosis. If your water comes from a public system, find out how much fluoride is added to the water in your area. You want to make sure your child isn’t exposed to too much fluoride but still gets enough while their teeth are developing.

For children younger than two years old, you can brush their teeth with a thin layer of toothpaste and a small, soft-bristled toothbrush. For children 2 to 6 years old, use a pea-sized amount of toothpaste. Supervise your child’s tooth brushing to make sure they spit toothpaste out rather than swallow it. Also, keep fluoride-containing products out of reach of young children. It is also important to visit your dentist for routine dental check-ups.

The Bottom Line

Dental fluorosis is a cosmetic condition that causes tooth discoloration. Although it is harmless, it can detract from the appearance of your smile. If fluorosis stains are causing embarrassment or low self-esteem, discuss your treatment options with your dentist.