Children's Health

Fluorosis Overview

Fluorosis Symptoms continued...

Contact your dentist if you notice that your child’s teeth have white streaks or spots or if you observe one or more discolored teeth.

Since the 1930s, dentists have rated the severity of fluorosis using the following categories:

• Questionable. The enamel shows slight changes ranging from a few white flecks to occasional white spots.
• Very mild. Small opaque paper-white areas are scattered over less than 25% of the tooth surface.
• Mild. White opaque areas on the surface are more extensive but still affect less than 50% of the surface.
• Moderate. White opaque areas affect more than 50% of the enamel surface.
• Severe.All enamel surfaces are affected. The teeth also have pitting that may be discrete or may run together.

Fluorosis Treatments

In many cases, fluorosis is so mild that no treatment is needed. Or it may only affect the back teeth where it can’t be seen.

The appearance of teeth affected by moderate-to-severe fluorosis can be significantly improved by a variety of techniques. Most of them are aimed at masking the stains.

Such techniques may include:

• Tooth whitening and other procedures to remove surface stains
• Bonding, which coats the tooth with a hard resin that bonds to the enamel
• Crowns
• Veneers, which are custom-made shells that cover the front of the teeth to improve their appearance

Fluorosis Prevention

Parental vigilance is the key to preventing fluorosis.

If your water comes from a public system, your doctor or dentist -- as well as your local water authority or public health department -- can tell you how much fluoride is in it. If you rely on well water or bottled water, your public health department or a local laboratory can analyze its fluoride content. Once you know how much fluoride your child is getting from drinking water and other sources such as fruit juices and soft drinks, you can work with your dentist to decide whether or not your child should have a fluoride supplement.

At home, keep all fluoride-containing products such as toothpaste, mouth rinses, and supplements out of the reach of young children. If a child ingests a large amount of fluoride in a short period of time, it may cause symptoms such as:

• Nausea
• Diarrhea
• Vomiting
• Abdominal pain

Although fluoride toxicity usually doesn’t have serious consequences, it sends several hundred children to emergency rooms each year.

It’s also important to monitor your child’s use of fluoridated toothpaste. Only place a pea-sized amount of toothpaste on your child’s toothbrush. That is sufficient for fluoride protection. Also teach your child to spit out the toothpaste after brushing instead of swallowing it. To encourage spitting, avoid toothpastes containing flavors that children may be likely to swallow.