Excessive intake of fluoride during the period of dental development may result in permanent discoloration of the teeth. This is not associated with any functional disability but may be a cosmetic problem.
Excessive intake may occur:
(1) in areas with increased fluoride in the ground water (as occurs in the Southwest US)
(2) with excessive intake through fluoridated water and dental care products
The fluoride affects enamel formation and calcification from the third month of gestation to 8 years of age.
Appearance
Degree of Fluorosis
few barely noticeable chalk-like, lacy markings across a tooth's enamel surface
minimal
more extensive chalk-like, lacy markings across a tooth's enamel surface
mild
> 50% of the enamel surface is opaque white; may develop a brown color
moderate
pitted and brittle enamel; may develop a brown color
severe
The brittle enamel in severe fluorosis may result in:
(1) excessive wearing
(2) tooth fracture
Management:
(1) If the child is younger than 8 years of age, reduction of fluoride intake can prevent progression of the process.
(2) If mild, an acid/abrasive bleaching technique may be used.
(3) If the teeth are pitted or discolored, then application of veneer is usually required.
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