Dental fluorosis is a cosmetic condition caused by excessive fluoride intake during the first eight years of life when permanent teeth are forming. It is characterized by discoloration of the teeth ranging from white flecks to brown stains. Fluorosis is widespread globally, especially affecting countries in Asia, Africa, and parts of Latin America and Mexico where fluoride levels in water are high. While the enamel defects from fluorosis are permanent, cosmetic treatments like microabrasion, bonding, veneers, and crowns can reduce the appearance of tooth discoloration. Controlling fluoride intake from water below 1.5 mg/L and using only small amounts of fluoridated toothpaste for young children can help prevent dental

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 .

4. • Or fluorosis is a disease caused by deposition of fluorides in
the hard and soft tissues of the body.
• It’s not merely caused by the excess intake of fluoride but
there are many other attributes and variables which
determine the onset of fluorosis in human population.
• It is usually characterised by discoloration of teeth and
crippling disorders.

5. Magnitude Of Fluorosis :
• Worldwide in distribution
• Endemic in 22 countries
• Asia (India and China are the worst affected)
• Mexico in North, Argentina in Latin America, East and North
Africa are also endemic

8. • 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.

9. • 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

10. • Type C: Brown areas less than 2mm
• Type D: Brown areas less than 2mm
• Type E: Horizontal white lines
• Type F: Horizontal brown lines

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

13. Questionable
Ranging from a few
white flecks to
occasional white spots.

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

15. 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.

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

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

18. 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

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

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

21. 3. Crowns

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

23. • To prevents the fluorosis the fluoridation of
drinking water shouldn’t exceed the normal
range (0.7- 1.2) ppm
• When Fluoride in water is more than 1.5
mg/litre, it is toxic to health
• Fluoride supplements should only prescribed for
children living in non fluoridated areas.
• Use only acceptable amount of toothpaste for
children under 6 years

24. 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.

25. 1) http://www.webmd.com/children/fluorosis-symptoms-causes-treatments
2) Fluoride action network/http://fluoridealert.org/issues/fluorosis
3) American dental association
4) http://www.webmd.com/children/fluorosis-symptoms-causes-treatments
5) American dental association/fluoridationfacts 2005/dr.herschel horowitz

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