Children Dentistry (Fluorosis)
What Causes White Spots On My Teeth?
Many things can cause white spots on the teeth. They can be a factor of nutrition, genetics, or an excess of fluoride intake. Sometimes they develop from braces covering areas of the teeth and the natural development of the tooth in children.
White spots on the surface of the tooth can occur due to:
1. Teeth are constantly exposed to plaque. When plaque is left on the tooth for a period of time without proper brushing, bacteria from the plaque will begin to produce an acid. This acid wears away enamel of the tooth causing it to appear white. This commonly found in patients who have worn braces but neglect of oral hygiene.
2. Diet. Acidic drinks that are infused with vitamins and minerals such as sports drinks, vitamin waters, and fruit waters are extremely acidic and remove the minerals from the teeth. Eating many sour candies, lemons, and vinegar based foods eat away at the pointed parts of the teeth. Acidic drinks such as soda and lemonade are also common causes.
3. Excessive fluoride intake can cause white spots to develop. Excessive ingestion of fluoride during the early childhood years may damage the tooth-forming cells, leading to a defect in the enamel known as dental fluorosis.
4. People suffer from acid reflux. Those who suffer from acid reflux often having white spots on the pointed tips of their teeth. This is due to the fact that the acidity in their mouth is regularly higher than the average person.
Dental (Enamel) Fluorosis: What is it?
Dental fluorosis is an irreversible condition caused by excessive ingestion of fluoride during the tooth forming years. Excessive fluoride can damage the enamel-forming cells, called ameloblasts. This results in a mineralization disorder of the teeth, whereby the porosity of the sub-surface enamel is increased.
It is the first visible sign that a child has been overexposed to fluoride. Teeth impacted by fluorosis have visible discoloration, ranging from white spots to brown and black stains. In the milder forms, the porosity is mostly limited to the sub-surface enamel, whereas in the more advanced forms, the porosity impacts the surface enamel as well, resulting in extensive pitting, chipping, fracturing, and decay of the teeth.
“My child has dental fluorosis. How to fix it?”
There is no way to reverse dental fluorosis. However, there are ways to ‘hide the damage’ — to treat the surface of the teeth so as to hide the discoloration.
Treatment options for fluorosis varies and depend on the severity of the fluorosis. Some of the more common treatments include:
- Abrasion. Abrasion involves finely sanding off the outer layer of the enamel. It is a common approach when the fluorosis is mild.
- Composite veneers. Composite bonding first involves lightly roughening the area of the damaged enamel. After etching the enamel, a composite resin (with a color matching your teeth) is “glued” on to the outer surfece of the tooth.
- Porcelain veneers: Made out of porcelain, veneers form a ceramic shell over the surface of the tooth. Veneers may need to be replaced after several years.
- Dental Crown: During a dental crown procedure, part of a tooth will be shaved down and then replace with an aesthetic crown. This is the most invasive treatment that is normally done for the treatment of dental fluorosis.
How veneer look like before cementation.
Before (above): Fluorosis on upper front teeth.
After (below): Treatment with veneers. Smile enhanced.
Should you still have any questions, comments, or concerns about dental fluorosis and its treatment? We’d love to hear them!