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DENTAL
PROBLEMS

Fluorosis

What is fluorosis?
 
Dental fluorosis is a cosmetic condition that is found in the tooth caused due to over exposure of fluoride, beyond the optimal range for that geographic area, during the developmental stages of tooth. It usually affects children between three months and eight years who consume high amount of fluoride rich water, food and drinks.
 
One of the major reasons of fluorosis is high consumption of fluoride during the initial stage of tooth development. Fluoride damages ameloblasts, the enamel cells. Damage caused in these ameloblasts results in a mineralization disorder, i.e. immature enamel, which eventually leads to high-level porosity of the enamel’s sub-surface.
 
The sources of fluoride may include any of the following:
 
  • One of the major sources of fluoride is drinking water, having high levels of fluoride
  • Products like bottled water containing excess fluoride, cookies, and baby foods containing fluoride can lead to fluorosis
  • Another source is toothpastes containing fluoride. Excess usage of fluoride toothpastes during the ages 3 months to 8 yrs (when the milk and permanent teeth are in developmental stages), results in dental fluorosis
  • Parents give medicines to children that contain fluoride in order to increase teeth strength. Excess consumption of these medicines may lead to fluorosis
  • Intake of aerated beverages at the early stage of childhood causes fluorosis
  • Drinking water also contains fluoride, but if the level of fluoride is more than the recommended range then it may lead to severe case of dental as well as skeletal/ bone fluorosis.

Fluorosis

  • In some cases where the severity of dental fluorosis is mild, the changes are unnoticeable with tiny white streaks or flecks on the tooth enamel that can be identified only by a dentist
  • In moderate cases, large white spots/ patches are found on teeth
  • When the condition is severe, the tooth surface becomes rough and pitted with a change of color from white to yellow or brown

Fluorosis

Fluorosis is not a disease, but just a cosmetic condition. Once fluorosis occurs, it is permanent. It cannot be cured completely. Fluorosis affects the appearance of teeth and does not lead to cavity or loss of teeth.  The best treatment that a dentist follows is, to cover the stains by masking. Depending on the severity, patients are advised to undergo tooth whitening (bleaching) and other procedures like covering the tooth with bonding, crowns, micro / macro abrasion and composite restorations. When fluorosis occurs on any of the back teeth, they may require cosmetic fillings or complete crowns covering them (depending upon the severity of the fluorosis level) so as to avoid the eventual eroding and loss of tooth structure.
 
  1. Tooth Whitening:
    Tooth whitening is done in mild cases of fluorosis. In this treatment, the outer stained layer of the enamel is removed by abrasion.
  2. Micro / macro abrasion:
    In micro abrasion, an abrasive grit in a mild acid (mostly HCL) solution is used to polish strains. If the severity is little high, then macro abrasion is used with a composite finishing bur or diamond.
  3. Composite Bonding:
    After eroding the affected part, the dentist covers the tooth with a composite filling using glue. This filling matches the color of the other teeth.
  4. Veneer:
    In this treatment, the affected part of the tooth is removed and the dentist takes an impression of the tooth. A veneer is made up of porcelain that perfectly fits the shaved part. Now, this veneer is fixed on the shaved part to form a complete tooth.
  5. Crown:
    Crowing is the most common treatment for fluorosis. The dentist shaves the affected tooth around and places an artificial crown over the tooth.

Though fluorosis cannot be treated naturally, it can be prevented by proper intake of food. Parents should provide their children with enough amount of food that contains calcium. Calcium is required to keep the teeth healthy and strong.  Vitamin C is commonly found in fruits like kiwi, papaya, orange, guava, fresh herbs, etc. Excess amount of calcium consumption might lead to kidney problems.

Vitamin D is equally important as Vitamin C. Vitamin D helps the body in absorbing calcium. Food products like milk, salmon, cereals, orange juice, eggs, etc. are rich in Vitamin D.

It is better to follow preventive measures than to be affected by fluorosis. Practicing simple home remedies will prevent fluorosis.

  • Avoid using fluoridated and flavored toothpaste on your own
  • Do not let children brush more than twice a day
  • Make sure that children use toothpaste but not more than a pea size amount
  • Keep an eye on children from swallowing toothpaste
  • Avoid using baby food items containing fluoride
  • Check the fluoride level in drinking water before giving your children
  • Do not give fluoride drops or tablets without pediatrician’s advice

Following these simple rules will keep you and your family healthy and fluorosis free.





1) What is fluorosis?

Dental fluorosis is a very common disorder caused due to excess consumption of fluoride. It causes change in the appearance of the teeth’s enamel by leaving white, lacy or light spots or marks to appear on them. Depending on the severity, it can range from normal to serious. The normal version of fluorosis does not affect the function of the teeth or cause any pain in them. Mild or moderate fluorosis leaves light coloured spots on the teeth whereas the severe form of it can result in wear and tear of the enamel of the teeth with brown spots appearing on them.  

2) What are the causes of fluorosis?

The main cause for a person suffering from fluorosis is excess of consumption of fluoride over a period of time. Fluoride consumption can happen in the form of water or fluoride based toothpastes or mouthwash. Children till the age of eight are most vulnerable to it as they tend to swallow toothpaste while brushing their teeth.

3) What are the treatment methods?

Avoid giving children under the age of 6 mouthwash and mouth rinse. Children under the age of 3 must be given only a smear of toothpaste and must brush their teeth in the supervision of an adult to make sure they do not swallow the paste and instead spit it out. Also limiting brushing to only twice a day is recommended as teeth of children as young as 3 are still in the developing stage and excess of brushing can cause wear and tear to the enamel of the teeth leaving them vulnerable to infection and diseases.

4) What is skeletal fluorosis?

Skeletal fluorosis is a bone diseases where the bones start to degenerate and debilitate because of presence of excessive fluorine in the system. The symptoms of skeletal fluorosis are similar to that of any other bone or joint diseases and so mostly goes undetected by doctors. In the early stages of the disease, the person might feel symptoms like joint pain, joint stiffness and gastric distress. However the correct diagnosis of the problem might remain elusive and may look similar to a person having problems like osteoarthritis, spondylosis and rheumatoid arthritis among others.

5) What is dental fluorosis?

Dental fluorosis refers to appearance of white streaks or lines on the surface of the teeth. It usually occurs as a common phenomenon among children under the age of 8 as their teeth are still at a growing stage and forming under the gums.  Also, children tend to consume more fluoride over a long period of time from different resources like swallowing toothpaste or mouthwashes and mouth rinses while brushing their teeth. It is not a very severe diseases and does not affect the health of your teeth but can be detected only by a dentist as its affects are not visible to the naked eye.

6) Best home remedy for fluorosis

Among the most common causes for dental fluorosis are drinking excess of fluoride treated water, using fluoride based toothpaste and eating processed foods made with fluoride. To avoid the problem one must cut down on their caffeine consumption as it may lead to unwanted discolouration of teeth. One must also try and avoid drinking water that is high on fluoride content. Always check for the contents of the packaged water bottle and limit its consumption if it shows high quantities of fluorine in it. Alternatively, using baking soda instead of fluorine based toothpaste is a better option as it keeps the germs away as well as keep teeth sparkling white. Fluorosis is a problem that occurs in the formative years of the teeth which is between 8 & 13 years of age. Maintain good oral hygiene to keep all dental problems away.

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