Fluorosis
Fluorosis is a discoloration of the teeth due to chronic excessive exposure to fluoride during tooth development. It is a cosmetic issue that does NOT affect systemic health.
Clinical Appearance
- Usually consists of white mottling
Prevalence & Risk Factors
- Prevalence of fluorosis (mostly mild) in the United States is 0.2%–27% and rising.
- The risk of developing fluorosis is greatest at an intake of more than 0.06 milligram per kilogram of body weight per day.
- Varnish is not a major risk factor for fluorosis as it is an irregular source of fluoride rather than a daily one.
Risk Reduction
- Determine the fluoride content of the child's drinking water before prescribing supplements.
- Avoid duplicate fluoride prescriptions.
- Follow current dosage schedules for systemic fluoride supplementation.
- Tell the child's caregiver to place only a smear (under two years) or pea size dab (children over age 3 or when the child can spit effectively) of fluoridated toothpaste on the child's toothbrush.
- Keep fluoride-containing products out of the reach of small children.
Moderate Fluorosis
Severe Fluorosis
References
Pendrys DG. Risk of enamel fluorosis in nonfluoridated and optimally fluoridated populations: considerations for the dental professional. Journal of the American Dental Association. 2000;131(6):746-55.
Skotowski MC, Hunt RJ, Levy SM. Risk factors for dental fluorosis in pediatric dental patients. J Public Health Dent. 1995 Summer;55(3):154-9.
Do LG, Spencer AJ. Risk-benefit balance in the use of fluoride among young children. J Dent Res. 2007 Aug;86(8):723-8.
Chankanka O, Levy SM, Warren JJ, Chalmers JM. A literature review of aesthetic perceptions of dental fluorosis and relationships with psychosocial aspects / oral health-related quality of life. Community Dent Oral Epidemiol 2010.
Wright JT, Hanson N, Ristic H et al. Fluoride toothpaste efficacy and safety in children younger than 6 years: A systematic review. JADA. 2014. 145(2): 182-189.