Fluorosis

What is fluorosis?

Fluorosis is a cosmetic dental condition that’s characterized by white or brown spots on your teeth. These spots can range from tiny white flecks that are almost unnoticeable to dark brown patches that are clearly visible.

Who does fluorosis affect?

Dental fluorosis affects people who were overexposed to fluoride during their developmental years, before their permanent (adult) teeth grew in. Children aged 8 or younger are at risk for developing fluorosis. Teeth that have already erupted (grown in) can’t get fluorosis.

How common is fluorosis?

Mild fluorosis is quite common, affecting about 1 in every 4 Americans between the ages of 6 and 49. Moderate to severe fluorosis is far less common in the U.S.

Does fluorosis weaken teeth?

No. Dental fluorosis has no impact on oral health or function. In fact, people with fluorosis are actually more resistant to cavities. This discovery is what prompted health officials to introduce fluoride into public water supplies at a safe level. This means that public water supplies would have enough fluoride to help prevent tooth decay, but not enough to cause fluorosis. (Note: According to the Centers for Disease Control and Prevention (CDC), 0.7 milligrams of fluoride per liter of water is the recommended level.)

What are the symptoms of fluorosis?

Tooth discoloration is the only symptom of fluorosis. Discoloration can vary depending on the severity of your condition. Dentists use the following terms to categorize fluorosis:

• Questionable: A few very light white flecks and white spots.
• Very mild: Light white areas covering less than 25% of your tooth surfaces.
• Mild: Light white areas covering less than 50% of your tooth surfaces.
• Moderate: White or light brown areas covering more than 50% of your tooth surfaces.
• Severe: White, light brown or dark brown spots affecting all surfaces. Your teeth may also have pitting (small depressions in your tooth enamel).

In mild cases, tooth discoloration can be so slight that no one but your dentist would notice. But if fluorosis is having a negative impact on your confidence or self-esteem, cosmetic dental treatments can help.

What are the reasons for fluorosis?

Dental fluorosis happens when a child consistently ingests too much fluoride while their permanent teeth are still forming under their gums. This includes drinking heavily fluoridated water or swallowing fluoride toothpaste.

Dental fluorosis in adults doesn’t occur. It only affects teeth that are still developing under the gums.

How is fluorosis diagnosed?

Your dentist can diagnose fluorosis during a routine dental examination.

Does fluorosis go away?

Fluorosis stains won’t go away with brushing and flossing. The only way to get rid of fluorosis is with cosmetic dental treatments like dental bonding, veneers or crowns. These treatments are further explored in the section below.

How do you get rid of fluorosis?

There are cosmetic dental procedures that can address fluorosis. The treatment that’s best for you depends on several factors, including the severity of fluorosis, your budget and your own personal preferences. Common fluorosis treatments include:

• Teeth whitening. Your dentist applies bleaching gel to your teeth for a predetermined amount of time. The gel lightens your tooth enamel so it blends in with fluorosis. While teeth whitening is an option for mild cases of fluorosis, other treatments may be more suitable for you.
• Dental bonding. During this procedure, your dentist uses tooth-colored composite resin to cover up fluorosis stains. Your teeth are then shaped and polished for natural-looking results.
• Dental veneers. Made from resin or porcelain, veneers are thin shells that adhere to the front surfaces of your teeth. Veneers are custom-made, so you’ll need to have dental impressions to achieve the correct fit and size.
• Dental crowns. Like veneers, crowns are custom-made. However, this type of dental restoration fits over your entire tooth. Your dentist will need to remove some of your natural enamel so the crown fits properly.
• Enamel microabrasion. During this procedure, your dentist removes a small layer of enamel from your teeth. This helps eliminate many fluorosis stains. Often, your dentist will follow enamel microabrasion with teeth whitening to make the color of your teeth even more uniform.

How can I reduce my child’s risk for fluorosis?

To reduce your child’s risk for fluorosis, be aware of how much fluoride they’re exposed to. Find out about water fluoridation laws in your area, or test your well water for fluoride levels. While you don’t want your child exposed to too much fluoride, you also want to make sure they get enough while their teeth are developing. The proper amount of fluoride is important for your child’s oral health.

In addition, you should:

• Make sure your child spits toothpaste out instead of swallowing it.
• Limit your child’s consumption of sugary and acidic foods and beverages.
• Practice good dental hygiene habits with your child.

Visit your dentist at least every six months for routine dental check-ups.

What’s the outlook for people with fluorosis?

Fluorosis isn’t harmful to your dental or overall health. From a medical standpoint, you don’t need to seek treatment. But if fluorosis is causing embarrassment or low self-esteem, cosmetic dentistry can dramatically improve your smile and boost your confidence.

When should I see my healthcare provider?

If you’re embarrassed or self-conscious about fluorosis stains, schedule an appointment with your dentist. They can discuss your treatment options in detail.

A note from Cleveland Clinic

Dental fluorosis is a harmless condition, but it can detract from the appearance of your smile. If tooth discoloration is causing embarrassment or low self-esteem, schedule a visit with your dentist. They’ll talk with you about your cosmetic goals and design a tailored treatment plan that works for you.