Fluorosis is a sort of bogeyman that comes up sometimes when talking about oral care. As soon as we know a condition called fluorosis exists, we know it’s something we want to avoid. Unfortunately, most people know relatively little about fluorosis, giving them little chance to take appropriate action and making the actions they do take to prevent it ineffective most of the time. So, just what is this threat to the tooth and what can we do (or not do) about fluorosis?
What is Fluorosis?
Fluorosis is a condition that occurs when a tooth is exposed to excessive amounts of fluoride while it is still developing, before it breaks through the surface (erupts). Note that it’s not a disease. It’s not contagious. Rather, it’s a condition that occurs in a very specific set of conditions.
In mild cases, fluorosis appears as white spots or streaks/lines on the tooth enamel. The white spots are duller than normal tooth enamel, which has a glossy appearance. In fact, in very mild cases, the spots or streaks are so subtle that they are only noticed by a dentist during an exam. In moderate or severe cases, the spots can be brown and the teeth can have a pitted appearance.
The spots, brown or white, on the tooth are a result of areas on the enamel that are missing the minerals that make up normal enamel. They are demineralized. The irony of this is that while appropriate amounts of fluoride help build stronger enamel, too much fluoride can leave the enamel with missing mineral spots.
The ancient Greeks talked about the golden mean—all things in moderation. There’s a lot of wisdom buried in that old concept. Fluoride is a helpful building block and tooth enamel protector. When the acids in your mouth dissolve some of the minerals out of the enamel on your teeth, fluoride helps bind those minerals back to the teeth. That, however, doesn’t mean that any excess amount of fluoride is a great idea.
Fluorosis can only develop in children while the teeth are developing. Adults and older children or teens cannot develop fluorosis. The best way to prevent it is to pay attention to all sources of fluoride in a young child’s diet and habits.
You can check to see if your municipality adds fluoride to drinking water. If you drink well water, you can have the well tested for fluoride levels; some places have high levels of naturally occurring fluoride in the soil.
Young children should be supervised while brushing. If they lack the coordination to spit after brushing, it’s possible to use a fluoride-free toothpaste while learning how to use toothpaste properly. Use only a tiny amount of toothpaste with very young children; children over 3 should use a pea-sized amount.
How Serious is Fluorosis?
The reason to be concerned about mild fluorosis is only the cosmetic concern. A very mild case is only likely to be seen by a dentist during an exam. White spots on the teeth may be a sign of decay, but the white streaks of fluorosis are not. The teeth affected by fluorosis are not weaker and may even be stronger than normal teeth. The primary reasons people seek to prevent fluorosis are cosmetic.
In the United States, nearly all cases of fluorosis are extremely mild or mild. If white streaks are visible or bothersome, a remineralizing toothpaste with nano hydroxyapatite can repair the spots by supplying the missing minerals. Your dentist can help you evaluate your child’s teeth, both to help you avoid fluorosis and to treat any spots if your child has already developed signs of fluorosis.
Remember, fluorosis is not the end of the world, but it can generally be avoided with due care.