Dental fluorosis occurs because of the excessive intake of fluoride either through naturally occurring fluoride in the water, water fluoridation, toothpaste, or other sources. The damage in tooth development occurs between the ages of 6 months to 5 years, from the overexposure to fluoride. Teeth are generally composed of hydroxyapatite and carbonated hydroxyapatite; when fluoride is present, fluorapatite is created. Excessive fluoride can cause yellowing of teeth, white spots, and pitting or mottling of enamel. Consequently, the teeth become unsightly. Fluorosis can not occur once the tooth has erupted into the oral cavity. At this point, fluorapatite is beneficial because it is more resistant to dissolution by acids (demineralization).

Although it is usually the permanent teeth which are affected, occasionally the primary teeth may be involved. In mild cases, there may be a few white flecks or small pits on the enamel of the teeth. In more severe cases, there may be brown stains. The differential diagnosis for this condition may include Turner's hypoplasia (although this is usually more localized), some mild forms of amelogenesis imperfecta, and other environmental enamel defects of diffuse and demarcated opacities.

Prevelence of Dental Fluorosis

According to the Centers for Disease Control, 32% of American children now have some form of dental fluorosis, with 2 to 4% of children having the moderate to severe stages (CDC 2005).

The Center of Disease Control found a 9% higher prevalence of dental fluorosisin American children than was found in a similar survey 20 years ago. In addition, the survey provides further evidence that black Americans suffer from higher rates of fluorosis than whites.

The condition is more prevalent in rural areas where drinking water is derived from shallow wells or hand pumps. It is also more likely to occur in areas where the drinking water has a fluoride content of more than 1ppm (part per million), and in children who have a poor intake of calcium.

Dental fluorosis can be prevented by lowering the amount of fluoride intake. Dental fluorosis can be cosmetically treated by a dentist. The cost and success can vary significantly depending on the treatment. Bleaching, microabrasion, and conservative composite restorations or porcelain veneers are commonly used treatment modalities. Generally speaking, bleaching and microabrasion are used for superficial staining, whereas the conservative restorations are used for more unaesthetic situations.

References

• Dental Fluorosis Explained

Oral pathology

fluorose dentaire פלואורוזה | Fluorosis