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fluorosis

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pankaj's picture
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is glizer paste or snowdent(a tooth whitener) is effective for removing fluorosis stains..??.. instead of bleaching treatment ...as this treatment contains many side effects..?

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mithilamhapankar's picture
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Re: fluorosis

These whitening toothpastes have very little effect on the shade of the tooth..they wont be of any help in fluorosis stains..

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sushantpatel_doc's picture
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Re: fluorosis-treatment

Fluorosis is a common problem in many parts of the world where a hard enamel of dental tissues is formed because of using an unusually high amount of fluoride during odontogenesis. The enamel formed in fluorosis is a weak, hypocalcified, porous and very unaesthetic collection of tissues.
Some dentists recommend bleaching in order to whiten the fluorosis stains, however, this does not guarantee a 100% result. The procedure to perform dental bleaching can be broken down into four steps:
1.Scrubbing the enamel in order to clean it from all sides.
2.Treating the enamel with Hydrochloric Acid (HCL).
3.Applying Sodium Hypochlorite.
4.Applying dental adhesives.
When a patient suffering from fluorosis stains asks his or her dentist about whitening of his or her teeth, the dentists are happy to convey the good news. Normally, a tooth is either grayish yellow, yellowish white, or grayish white, but very few people actually have such teeth. The reasons for discoloration of our natural teeth are improper brushing, aggressively brushing and extremely strong cleaning techniques. Food and beverages which are acidic in nature also contribute in the process of discoloration. Aging is also a factor that cannot be neglected in this regard, and this is the reason why old people have more yellowish teeth than the younger lot. Even people who have normal teeth are now inclined towards whitening their teeth in order to get the perfect smile. Since bleaching is the easiest, most common and the most cost-effective solution of getting a set of teeth close to perfect, many people are opting for it, and many dentists are conveniently recommending it to their patients to lighten discoloration.
In 1877, Chappel introduced the process of treating discoloration using oxalic acid. Later many variants of this process emerged using chlorine. In 1884, Harlan introduced Hydrogen Peroxide to treat discoloration. Many other bleaching techniques followed till now when modern technology is used to carry out bleaching.
The process of bleaching is relatively simply. Oxidation takes place using a bleaching agent, where this agent reacts with the enamel and take care of the discolored tissues. The intensity of bleaching highly depends upon the nature and depth of stain, and upon the fact that how deep the bleaching agent can penetrate and stay there long enough to remove rigid stains.
There are two types of discoloration – extrinsic and intrinsic. The extrinsic discoloration takes place due to the consumption of tobacco, tea, coffee, silver nitrate, iron tablets, chewing gum and excessive use of mouth washes. Intrinsic stains penetrate through the enamel and are stored within the dental structure. Examples are tetracycline, fluorosis stains, pulp necrosis, dentinogenesis imperfecta, etc.
It is generally observed that premolars and second molars are teeth that are mostly affected by discoloration. Then follow maxillary incisors, canines and the first molars. The mandibular incisors are the least discolored teeth.
The reason why flurosis stains appear may be different for different people. For some it is due to the overdose of fluoride in toothpaste, for others it may be the reason of fluoride contamination in water. The stains on the teeth depend upon the content of fluoride. Therefore, if we keep a check on the water we are drinking, fluorosis stains may never be a problem.

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sushantpatel_doc's picture
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Re: fluorosis

images

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tirath's picture
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Joined: 31 Oct 2009
Re: fluorosis

metal free ceramc crown is the best option

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pankaj's picture
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Joined: 27 Feb 2011
Re: fluorosis

thanku for replying..... really came to know bout many new concepts.. thanku

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docyogeshr@gmail.com's picture
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Re: fluorosis

fluorosis is good topic and is still surrounded by lots of controversy...
well suggests by previous experts, i would like to comment on the suggested t/t options.
first for sushant as u mentioned fluoride tooth paste, they do lead fluorosis once tooth structure forms... it occurs only during tooth developing stage if the drinking water contains more fluoride content..

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docyogeshr@gmail.com's picture
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Re: fluorosis

titath. u have suggested crown.. but my friend its not as conservative...
in 80% of cases u will find mild to moderate stains that is deans fluorosis index 3-4-5, n for every case u cant for full crown if less destructive or rather more conservative options available..

first and foremost is the removal of superficial hypoplastic layer ( 0.5-1mm) through MICROABRASION technique. if u r not removing this layer and proceed for bleaching this porous layer will go on relapsing the whitening procedure as patient will have colored food or drinks..

secondly microabrasion followed by bleaching.

third bleaching followed by composite laminate.

in case of severe fluorosis crown..

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mithilamhapankar's picture
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Re: fluorosis

i agree wid dr.yogesh ....in college we were taught to be as conservative in our teatment plan as posssible

The climax of options given is perfect
Also fluorosis can take place in teeth only in their development stage just as bones are affected

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tirath's picture
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Joined: 31 Oct 2009
Re: fluorosis

thanx for the information.........

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pankaj's picture
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Re: fluorosis

hmmm .... right.... then wat can be best suggested treatment to get rid of this......

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mithilamhapankar's picture
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Re: fluorosis

Refer to the Dean s fluorosis index, once the type of fluorosis is classified one can decide the extensiveness of the treatment..whether bleaching or laminates or crowns

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sushantpatel_doc's picture
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Re: fluorosis

I doubt whether Dean's index helps in determining the treatment of fluorosis..there is no such protocol..i guess one has to determine the treatment according to the need of the patient..

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docyogeshr@gmail.com's picture
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Re: fluorosis

the treatment protocol for management of fluorosis is given in text book of bleaching techniques in restorative dentistry by Linda Greenwall... specially in macro n microabrasion chapter... it also has lots of published articles..
if we are planning best line of treatment, its not difficult to convince the patient for such decisions..

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mithilamhapankar's picture
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Re: fluorosis

The Dean s index helps to classify the fluorosis intensity and hence one can determine how extensive the treatment should be....
It is our duty to place the best options in front of the patient and then they can choose what they want

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