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Fluorosis is a cosmetic condition affecting the teeth that's caused by overexposure to fluoride, more commonly during the first eight years of life. This is the time when most permanent teeth are beginning to form. After the teeth have come in, the affected teeth may appear mildly discolored. For instance there may be lacy white markings that only dentists are able to detect. In other cases teeth may also suffer side-effects such as stains ranging from yellow to dark brown, highly noticeable pits, or surface irregularities in the teeth. 

Fluorosis Causes 

One of the primary causes of fluorosis is the improper use of dental products such as toothpaste and mouthwash, that contain fluoride. Sometimes, children enjoy the taste of fluoridated dental products so much that they swallow it instead of spitting it out which can lead to major concerns down the line. 

There are other causes of fluorosis though, for example taking a large quantity of fluoride supplements during early childhood can always cause it. Taking a fluoride supplement when fluoridated drinking water and fluoride-fortified dental products are already provided can be over-exposing them. 

Fluorosis Symptoms

There is a blend of symptoms that could lead you to the diagnosis of fluorosis. These include white specks or streaks that may appear incredibly light or clear and can range to dark brown stains and rough, pitted enamel that becomes challenging to clean. Teeth that are unaffected by fluorosis are smooth and glossy and are usually a pale creamy white in color. 

We recommend contacting your dentist if you notice that you or your family member has white streaks or spots on their teeth or if you see that one or more of their teeth is discolored. There are levels of severity for fluorosis that fall into the following categories: 
  • Questionable. The enamel has shown minor changes ranging from a few white flecks to occasional white spots.
  • Very mild. Small off-white or paper-white areas are scattered over less than 25% of the tooth surface.
  • Mild. White opaque areas on the surface are more extensive but still affect less than 50% of the surface.
  • Moderate. White opaque areas affect more than 50% of the enamel surface.
  • Severe. All enamel surfaces are affected. The teeth also have pitting that may be discrete or may run together.

Fluoride Levels In Drinking Water

You may have heard about fluoride occurring naturally in water. Natural fluoride levels that appear above the recommend range for drinking water can increase the risk for fluorosis. In local communities and neighborhoods where natural levels exceed 2 parts per million, the CDC recommends that paren'ts give children water from other sources such as bottled water.

The Health and Human Services Department addressed the concern of overexposure to fluoride through local water sources in 2011 and lowered it's recommend level of fluoride in drinking water. The EPA is also reviewing it's rule on the upper limit of fluoride levels in drinking water. 

Knowledge of Fluorosis and the effects of it first gained recognition in the early 20th century when it was noticed that the teeth of many native-born Colorado Springs residents had brown stains. This was due to the peaking  levels of fluoride that was contained in the local water supply there. People with these stains also had an unusually high resistance to dental cavities. This is the idea that sparked a movement to introduce fluoride into public water supplies at a level that could prevent cavities but without causing fluorosis.

Fluorosis affects nearly one in every four Americans ages 6 to 49. It’s most prevalent in kids ages 12 to 15. The vast majority of cases are mild, and only about 2% are considered “moderate.” Less than 1% are “severe.” But researchers have also observed that since the mid-1980s, the prevalence of fluorosis in children ages 12 to 15 has increased.


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