How does fluorosis develop?
Teeth need fluoride: in the right concentration, it strengthens enamel and protects against caries. But during the formation of teeth, excess fluoride disrupts the functioning of the cells that build enamel, and it becomes less mineralized, with protein inclusions. Since permanent teeth are formed and mineralized in the first years of life, the critical age is considered to be up to about eight years. Once a tooth has erupted, it is no longer threatened by fluorosis: excess fluoride in an adult does not create stains on the formed enamel.
- Fluoride normally strengthens enamel
- Excess disrupts mineralization
- Critical period - up to 8 years
- Symmetrical teeth are affected
- In adults, new fluorosis does not occur
Where does excess fluoride come from?
The main source is drinking water in regions with high natural fluoride content; In such places, fluorosis occurs in many residents. The second source is the ingestion of toothpaste by young children, especially flavored ones and in large quantities: a child under three years old does not know how to fully spit. The third is the unreasonable use of fluoride-containing drugs and supplements without a doctor’s prescription and without taking into account the fluoride content in the water. Foods and drinks made with water containing high levels of fluoride sometimes play a role.
- Drinking water with high fluoride content
- Children swallowing toothpaste
- Unreasonable intake of fluoride preparations
- Fluoridated water products and drinks
- Combination of multiple sources
What it looks like and how it differs from caries
Mild fluorosis manifests itself as thin white stripes and small chalky spots that are noticeable when the tooth dries. In moderate form, the spots merge, yellowish and brown areas appear, and the enamel loses its shine. In severe cases, the surface becomes uneven, with pits and chips. Key differences from caries: fluorosis is symmetrical, affects the teeth of the same name on both sides, is often located on convex, well-cleaned surfaces and does not progress over time. A carious spot is usually single, appears in the area of plaque accumulation and gradually turns into a cavity.
- Chalky stripes and spots
- Brown areas with pronounced forms
- Pits and roughness in severe flow
- Symmetry of the lesion
- No progression
- Caries - a single spot in the plaque area
What can you do
Tactics depend on severity. For mild forms, professional hygiene and a course of remineralization are sufficient: the enamel is saturated with calcium and phosphates, the spots become less noticeable. For more pronounced changes, microabrasion is used - gentle removal of the thinnest damaged layer of enamel, often in combination with bleaching. For persistent brown spots and surface defects, composite restorations are performed or the teeth are covered with veneers. Homemade whitening products for fluorosis often give uneven results, so the dentist selects a regimen.
- Professional oral hygiene
- Remineralization therapy course
- Enamel microabrasion
- Whitening under the supervision of a dentist
- Composite restoration
- Veneers for severe defects
Prevention in children
The main measure is to know the fluoride content in drinking water and, if it is in excess, use bottled or purified water for drinking and preparing food for the child. Children are dosed with toothpaste: up to three years old - the size of a grain of rice, after three - the size of a pea, and they brush their teeth under the supervision of an adult, teaching them to spit. You should not choose pastes with a strong sweet taste that you want to swallow. Any fluoride-containing supplements should only be prescribed by a doctor after evaluating all sources of fluoride. Excess fluoride will not harm teeth that have already erupted.
- Determine the fluoride content in water
- Bottled water with excess fluoride
- Paste dosing according to age
- Brushing teeth under adult supervision
- Avoiding very sweet baby toothpastes
- Fluoride preparations only as prescribed by a doctor