Ann Clark, RDH

                                                                                                      What are those white spots on my teeth?

Dental fluorosis is not a disease but a permanent cosmetic condition affecting the way the teeth look.  It occurs when baby and permanent teeth are forming under the gums.  Once erupted, teeth cannot develop enamel fluorosis.  This condition is caused by overexposure to fluoride during the development stage of the tooth.  After their eruption into the mouth, teeth may appear discolored;  such as: lacy white markings, yellow to brown stains, surface irregularities, or pitting into the enamel.

Causes
A major cause is inappropriate use of fluoride products such as toothpaste and rinses.  Children are offered products with some fun flavors.  They are known to eat and swallow them so remind them to spit out.  Taking a higher than recommended supplement can also cause fluorosis.  The perfect amount is already regulated into the water where it occurs naturally.  Symptoms of fluorosis range from small white specks or streaks to dark brown stains and rough, pitted enamel.  A normal healthy tooth is smooth and glossy and a pale creamy white.

Treatment
Most cases are mild not requiring treatment.  White spots are considered moderate if more than 50% of the surface is affected  and severe if pitting occurs.  The appearance can be improved by various technique options aimed to mask stains.  Such techniques may include:
–Teeth Whitening and other procedures to remove the surface staining.  Initially whitening can temporarily worsen the appearance.
– Bonding: a coating over the enamel bonded with a hard resin.
–Crowns
–Veneers: custom-made facings that cover the front of teeth.
– MI Paste: a calcium phosphate product sometimes combined with a micro abrasion procedure to minimize discolorations.

Prevention
Parental care is the key to preventing fluorosis.  If you drink well water, which is not regulated, or bottled water,your public health department or local laboratory can analyze the fluoride content.
Fluoride is also in some fruit juices and sodas, so knowing the water content will help you decide whether or not a supplement is needed.  Also, keeping fluoride containing products, like toothpaste, rinses and supplements out of children’s reach is recommended.  Ingesting a large amount of fluoride in a short period of time may result in nausea, vomiting, diarrhea or abdominal pain.  Only a small pea-sized amount of toothpaste is needed for each time you brush.
Encourage your child to spit out and not swallow.

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Sources:

webmd.com Fluorosis:Symptoms, causes, and treatments

American Academy of pediatric Dentistry:”Enamel Fluorosis”
Kidshealth.org: “Fluoride in Water”
Reuters Health:”U.S. Lowers Limits for Fluoride in Water”
National Institute of Dental and Craniofacial Research:”The Story of Fuloridation”
SimpleStepsToBetterDentalHealth.com:”Fluorosis”
CDC:”Prevalence and Severity of Dental Fluorosis in the United States, 1999-2004″