{"id":230,"date":"2019-09-23T15:22:23","date_gmt":"2019-09-23T15:22:23","guid":{"rendered":"https:\/\/www.simmonsyoung.com\/PediatricDentalBlog\/?p=230"},"modified":"2019-09-23T15:22:23","modified_gmt":"2019-09-23T15:22:23","slug":"what-is-dental-fluorosis","status":"publish","type":"post","link":"https:\/\/www.simmonsyoung.com\/PediatricDentalBlog\/what-is-dental-fluorosis\/","title":{"rendered":"What is Dental Fluorosis?"},"content":{"rendered":"\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"614\" src=\"https:\/\/www.simmonsyoung.com\/PediatricDentalBlog\/wp-content\/uploads\/2019\/09\/child-with-buckteeth-490670842_3967x2380-1024x614.jpeg\" alt=\"\" class=\"wp-image-231\" srcset=\"https:\/\/www.simmonsyoung.com\/PediatricDentalBlog\/wp-content\/uploads\/2019\/09\/child-with-buckteeth-490670842_3967x2380-1024x614.jpeg 1024w, https:\/\/www.simmonsyoung.com\/PediatricDentalBlog\/wp-content\/uploads\/2019\/09\/child-with-buckteeth-490670842_3967x2380-300x180.jpeg 300w, https:\/\/www.simmonsyoung.com\/PediatricDentalBlog\/wp-content\/uploads\/2019\/09\/child-with-buckteeth-490670842_3967x2380-768x461.jpeg 768w, https:\/\/www.simmonsyoung.com\/PediatricDentalBlog\/wp-content\/uploads\/2019\/09\/child-with-buckteeth-490670842_3967x2380-1536x922.jpeg 1536w, https:\/\/www.simmonsyoung.com\/PediatricDentalBlog\/wp-content\/uploads\/2019\/09\/child-with-buckteeth-490670842_3967x2380-2048x1229.jpeg 2048w, https:\/\/www.simmonsyoung.com\/PediatricDentalBlog\/wp-content\/uploads\/2019\/09\/child-with-buckteeth-490670842_3967x2380-800x480.jpeg 800w, https:\/\/www.simmonsyoung.com\/PediatricDentalBlog\/wp-content\/uploads\/2019\/09\/child-with-buckteeth-490670842_3967x2380-1200x720.jpeg 1200w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cYou\u2019ve got what?!?&nbsp;\nDental fluorosis?&nbsp; That sounds\nserious.&nbsp; I hope it\u2019s not catching.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;Fluorosis is a dental\ncondition that occurs during the years that a tooth is developing.&nbsp; <strong>Excess fluoride is absorbed through the\ngut and can be stored in bones and teeth.&nbsp;\nIt is noted clinically as white striations but can appear brown that may\nbe attributed to dietary staining of the effected enamel.<\/strong>&nbsp; Severe fluorosis can present as pitted\nenamel.&nbsp; Microscopically, the enamel\nlayer is more porous and thus, weaker in nature.&nbsp; <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The age that fluorosis occurs is during the time the\npermanent teeth are forming, but it is not seen clinically until the teeth\nerupt into the mouth.&nbsp; The top front four\nteeth are where fluorosis is the most commonly visible.&nbsp; These teeth are affectionately called the\ncentral and lateral incisors.&nbsp; The\nincisors begin forming early in a child\u2019s first year of life and the visible\nportion of the tooth (crown) completes forming when the child is 4-5 years\nold.&nbsp; Teeth begin forming at the bottom edge\nand form upwards until the root has been completed.&nbsp; As you can see in the picture above, the\nstaining occurs in lines.&nbsp; The fluorosis\nis seen in the tooth layer that was forming at the time the child received\nexcess fluoride.&nbsp; <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For example, in the picture above, the central incisors have\na brown line near the top third of the tooth.&nbsp;\nThe lateral incisors have brown staining in the bottom third of the\ntooth.&nbsp; It is likely that the fluorosis\noccurred at the same time, but the centrals and the laterals were at different\nstages of crown development.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Fluorosis is more common in the southwestern United States\ndue to its higher naturally occurring fluoride levels.&nbsp; Typically, fluorosis occurs from a long-term\ningestion of excess fluoride and is not noticeable if a child has an acute\nfluoride toxicity event from eating a tube of toothpaste.&nbsp; One instance that can cause fluorosis is\nusing fluoridated water to mix infant formula.&nbsp;\nSince this is the basis of the infant\u2019s diet, especially early on,\nfluorosis can occur if fluoridated water is used on a regular basis.&nbsp; <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>How do we treat a tooth with dental fluorosis?&nbsp; <\/strong>Back in the day, the only treatment\noptions were to use a high-speed handpiece to remove the stained tooth\nstructure and place a filling or a crown.&nbsp;\nI\u2019ve said it before and I\u2019ll say it again, I love the day and age we\nlive in because we have more conservative options at our disposal.&nbsp; I will list the options from most\nconservative to most aggressive:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>Tooth whitening \u2013 no tooth structure will be\nremoved, but the discolored tooth may blend with whitening treatments.&nbsp; Follow up treatment is usually required.<\/li><li>Resin infiltration: a treatment option where the\nenamel is opened with an acid to release staining, apply a bleaching agent to\nthe tooth, and apply a sealant to protect the tooth and prevent future\nstaining.<\/li><li>Microabrasion: the top layer of the enamel is\nremoved with an abrasive to reveal a more esthetic layer of the tooth (not\nalways an option for fluorosis, due to it affecting the entire depth of enamel)<\/li><li>Remove the stained portion with a dental handpiece\nand apply a filling<\/li><li>Remove tooth structure to allow for an esthetic\ncrown to be placed<\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>To summarize, causes of fluorosis can be atributed to\nlong-term fluoride ingestion such as, drinking fluoridated water at levels\nhigher than recommended by the CDC or using fluoridated water to mix infant\nformula.&nbsp; Fluoride varnish is the most\ncommonly placed dental fluoride at cleaning appointments.&nbsp; Research studies do not support a correlation\nbetween increased dental fluorosis and fluoride varnish application.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">References:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Dental fluorosis:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pdfs.semanticscholar.org\/0fb5\/28d4b7a7e193e90bd533b5ea54f816b04375.pdf\">https:\/\/pdfs.semanticscholar.org\/0fb5\/28d4b7a7e193e90bd533b5ea54f816b04375.pdf<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Dental Tooth Formation Chart:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.aapd.org\/globalassets\/media\/policies_guidelines\/r_dentalgrowth.pdf\">https:\/\/www.aapd.org\/globalassets\/media\/policies_guidelines\/r_dentalgrowth.pdf<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Correlation of fluorosis and fluoride varnish placement:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.aapd.org\/assets\/1\/7\/Fluoride_varnish.pdf\">https:\/\/www.aapd.org\/assets\/1\/7\/Fluoride_varnish.pdf<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">American Academy of Pediatric Dentistry Fluoride Guidelines:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.aapd.org\/media\/Policies_Guidelines\/P_FluorideUse.pdf\">https:\/\/www.aapd.org\/media\/Policies_Guidelines\/P_FluorideUse.pdf<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u201cYou\u2019ve got what?!?&nbsp; Dental fluorosis?&nbsp; That sounds serious.&nbsp; I hope it\u2019s not catching.\u201d &nbsp;Fluorosis is a dental condition that occurs during the years that a tooth is developing.&nbsp; Excess fluoride is absorbed through the gut and can be stored in&#8230;<\/p>\n<p><a class=\"more-link\" href=\"https:\/\/www.simmonsyoung.com\/PediatricDentalBlog\/what-is-dental-fluorosis\/\">Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-230","post","type-post","status-publish","format-standard","category-uncategorized","entry","has-post-thumbnail"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>What is Dental Fluorosis? - Milling Pediatric Dentistry<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, 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