Fluorosis is a developmental phenomenon of the
enamel that presents in both primary and permanent teeth.
The origins of fluorosis are not completely understood;
however, current research suggests that superfluous
amounts of fluoride cause retention of amelogenin proteins
in the developing tooth structure, thereby inhibiting enamel
maturation. This interference results in porosities in the
enamel at the time of tooth eruption. Specifically, recent
animal and human studies indicate that the role of fluoride
is likely due to its interaction with Ca2+ ions; excess F
intake has been shown to indirectly reduce the amount of
available Ca2+ ions, which in turn limits the number of
calcium-dependent proteases available to remove enamel
matrix proteins. This elimination of enamel matrix proteins
is necessary for adequate enamel maturation.
If a child has too much fluoride in their diet as their teeth are developing this can bring about fluorisis which is characterised by discoloured spots of yellow or brown appearing on tooth enamel. Depending on the severity of the fluorosis, this can vary from being only minor colour changes to severe changes in the surface of the enamel. Discolourations may appear as streaks or spots and in more severe case your teeth may develop pits and grey or black spots may develop. After the development period is over and adult teeth are present in the mouth, dental fluorosis no longer develops. Fluorosis is not a disease in itself, only a cosmetic condition and in some cases it may be so mild that only your dentist will notice it. The stains, spots or streaks left by fluorosis are permanent and can become darker as time goes on.
Your dentist should be able to spot early signs of fluorosis developing during a regular dental check up and they may ask if your child has been given fluoride supplements, uses a fluoride toothpaste or drank fluoridated water recently. It's normal to be asked about other medical conditions or disabilities which could affect your child's teeth in order to rule them out. Your dentist will examine your child's gums and teeth and X-rays may be taken to check for any other defects present in the teeth. As several other conditions can produce similar symptoms to fluorosis, such as developmental defects and craniofacial problems it's important that you have any discolouration looked at by your dentist.
The majority of fluorosis cases aren't severe enough to warrant any treatment or alternatively, the signs of fluorosis may occur only on the back of the teeth where they won't be noticed. Serious cases may require the front teeth to be treated using teeth whitening or other cosmetic procedures. In the most severe cases, affected teeth can be covered with dental restorations such as veneers, crowns or bonding.
If your child is under the age of six then put only a pea-sized amount of toothpaste on their brush and make sure they spit rather than swallow following brushing. It's important to avoid toothpastes which may encourage swallowing and to keep products containing fluoride (such as mouthwashes) out of young children's reach. Some food and drinks may contain fluoride, fruit juices and soft drinks for instance, may contain the same amount of fluoride as fluoridated water and some bottled water now contains added fluoride. It's important to limit the amount of these beverages young children should drink.