Fluorosis vs. Teeth Whitening

(What Is it and Can I Get My Teeth White Despite it)

As a parent, we notice the little things in our infant’s development- the first words, the first steps.  As the child grows, we share in the joy of each new milestone and notice new and exciting changes.

So when your child smiles and you start to notice spots or white streaks on your child’s teeth or discoloration, it is time to consult with your dentist.  Your child may be affected by fluorosis!

What is Fluorosis

This is an aesthetic problem as opposed to a disease process caused by an excess intake of fluoride while the teeth are developing (prior to the age of 8).  The effect is one of appearance unlike a condition that promotes cavities or other dental disease.

Too much fluoride introduced into the system typically comes from taking fluoride supplements as young children, fluoridation in the water at excessively high concentrations or ingesting fluoride toothpaste.

Tooth changes range from mild color changes to irregularities of the enamel surface.  White lines, spotting or streaking are found in mild fluorosis while more severe fluorosis produces grayish, brown or black spots on the exterior of the teeth with atypical enamel shapes.  These spots and discolorations may progress and darken with age but the stains are permanent.

Diagnosis

There are several medical conditions that may mimic fluorosis in appearance and must be ruled out.

These include:

  • Craniofacial abnormalities in development  (involving the bones of the skull or face, creating problems with tooth enamel and dentin formation)
  • High fevers in infants or toddlers
  • Trauma in infants or toddlers
  • Genetic abnormalities
  • Hormonal dysfunction
  • Chronic antibiotic usage in early childhood

A thorough history must be taken (with the parents of the child affected by teeth discoloration) to determine fluoride exposure during early childhood.

X-rays are taken to rule out any defects or cavities, which are then attended to.

Therapy

Occasionally fluorosis is limited to back teeth which are not readily visible when the individual smiles.  Should that be the case, no treatment is necessary.

A small number of cases are severe with dental pitting, black and brown spots of the front teeth.  For those individuals, the options are crowns, veneers or bonding.

However, most of the cases that involve the front teeth are mild.  The extrinsic surface stains can be removed with tooth whitening agents or with laser therapy. Techniques vary among whitening gels and trays, strips, whitening pens and toothpastes.

The most effective and quickest way is the bleaching with light therapy performed in the dentist’s office.

While this is not a disease, the sooner the condition is eradicated, the less likely that the child will suffer from a lack of confidence and self-esteem in the future.