Dental fluorosis is a cosmetic condition caused by excessive fluoride intake during the first eight years of life when permanent teeth are forming. It results in changes to the enamel of the teeth ranging from white flecks to brown staining. The severity is classified from questionable to severe based on the extent of opacity and brown staining. While the enamel defects are permanent, cosmetic treatments like microabrasion and veneers can improve the appearance of teeth affected by dental fluorosis. Preventing overexposure to fluoride from water, supplements, and toothpaste is important to avoid this condition.

1. Dental fluorosis

3. Fluorosis : is a cosmetic condition that affects
the teeth. It’s caused by overexposure to fluoride
during the first eight years of life. This is the
time when most permanent teeth are being
formed .

5. • Structurally, an increase in fluoride intake results in
an increase in degree and extent of porosity of the
enamel.
• the enamel changes described may be a result of a
fluoride damage of secretory ameloblasts
• This can either be due to a fluoride-induced change in
composition of enamel matrix, or be a result of a
disturbance of the cellular processes during enamel
maturation.

6. • Mottled enamel is a condition indicates the fluorosis
characterized by minute white flecks, or yellow or brown
spots or areas, scattered irregularly or streaked over the
surface of a tooth
• It is scored according to a method described by Al alousi’
et al as follow:
• Type A:white areas less than 2mm
• Type B:white areas more than 2mm
• Type C:brown areas less than 2mm
• Type D:brown areas less than 2mm
• Type E:horizontal white lines
• Type F:horizontal brown lines

8. Smooth, glossy, pale
creamy-white,
translucent surface
Normal

9. questionable
ranging from a few
white flecks to
occasional white spots

10. Very mild
Small opaque, paper white
areas scattered irregularly over
the tooth but not involving as
much as 25% of the tooth
surface.

11. Mild
The white opaque areas in the
enamel of the teeth are more
extensive but do not involve as
much as 50% of the tooth

12. moderate
All enamel surfaces of the teeth are
affected, and the surfaces subject
to attrition show wear. Brown
stain is frequently a disfiguring
feature

13. Severe
All enamel surfaces are affected ,
discrete or confluent pitting.
Brown stains are widespread and
teeth often present a corroded-like
appearance

14. Although the enamel defect
caused by dental fluorosis is
permanent, the tooth
discoloration that fluorosis causes
can be reduced, and sometimes
eliminated, through cosmetic
treatment

15. 1. microabrasion (conservative removal of
the outer most layer of enamel)
followed by teeth whitening can make
the brown discoloration less apparent.

16. 2. Bonding, which coats the tooth with a
hard resin that bonds to the enamel

17. 3. Crowns

18. 4. Veneers, which are custom-made shells that cover the
front of the teeth to improve their appearance

19. • To prevents the fluorosis the fluoridation of
drinking water shouldn’t exceed the normal
range (0.7- 1.2) ppm
• Fluoride supplements should only prescribed for
children living in non fluoridated areas.
• Use only acceptable amount of toothpaste for
children under 6 years

20. It’s also important to monitor the child’s use of
fluoridated toothpaste. It’s important to teach the
child to spit out the toothpaste after brushing
instead of swallowing it. To encourage spitting, avoid
toothpastes containing flavors that children may be
likely to swallow.

21. 1) http://www.webmd.com/children/fluorosis-symptoms-causes-treatments
2) Fluoride action network/ http://fluoridealert.org/issues/fluorosis
3) Clinical and structural features and possible pathogenic mechanisms of dental
fluorosis, M. JOOST LARSENEuropean Journal of Oral Sciences
4) Wael S Alalousi , B.D.S.,M.D.Sc. /methods for a survey of the oral health of
secondary schools in iraq / the iraqi journal of dental research
5) American dental association
6) http://www.webmd.com/children/fluorosis-symptoms-causes-treatments
7) American dental association/fluoridation facts 2005/dr.herschel horowitz