Added to many toothpastes and even to community water supplies in certain parts of the world, fluoride is quite helpful in protecting the teeth against decay.

However, while fluoride is generally seen as beneficial for the teeth, too much can can sometimes lead to a condition called fluorosis.

Dental fluorosis typically develops during childhood, when the permanent teeth are still forming beneath the gums. It doesn’t usually affect the function of the teeth, but it can alter their appearance, sometimes causing white streaks, speckling, or in more pronounced cases, brown staining and surface irregularities.

Whether you’re a parent concerned about fluoride exposure in your child, or someone who has noticed changes in the surface of your teeth, understanding fluorosis can help you make informed choices about your dental care.

At Oasis Dental Studio, with practices in the Gold Coast, Brisbane, Melbourne, and Pottsville, our dentists can provide tailored advice and treatments for both children and adults.

What is Fluorosis?

Dental fluorosis is a developmental condition that affects the enamel, the hard outer layer of the teeth.

In children, it commonly occurs when the teeth are exposed to excessive amounts of fluoride while their permanent teeth are still forming, usually up to around the age of eight.

As for adults, once teeth have fully erupted, fluorosis cannot develop – however, the changes that occurred during childhood can still remain visible.

In most cases, fluorosis is mild and may only be noticeable to a dentist. Many people live with mild fluorosis without it causing functional problems.

In more severe cases, however, the enamel can become discoloured, pitted, or mottled, sometimes creating cosmetic concerns or making teeth more vulnerable to staining.

Causes of Dental Fluorosis

Fluorosis is caused by overexposure to fluoride during tooth development. When it comes to fluoride, especially during childhood, balance is key – while fluoride helps strengthen enamel and prevents cavities, an excess during the early years disrupts the normal formation of enamel crystals. This results in changes to the texture and appearance of the teeth.

Some common sources of excess fluoride include:

Fluoridated drinking water

In areas where the natural fluoride levels in water are high, or where children drink large volumes of fluoridated water, exposure can exceed the recommended levels.

Fluoride toothpaste

If children are using adult toothpaste or toothpaste with higher amounts of fluoride, or are using excessive amounts of toothpaste, it can lead to overexposure of fluoride.

Infant formula

When powdered or concentrated infant formula is reconstituted with fluoridated tap water, it may increase fluoride exposure in young children.

Certain foods and drinks

Processed beverages or some imported bottled waters can contain higher levels of fluoride, which can add to the daily exposure of fluoride.

Symptoms of Fluorosis

The symptoms of fluorosis are usually limited to changes in the appearance of the teeth. Unlike cavities or infections, fluorosis does not cause pain. The signs can vary, depending on the severity of the fluoride exposure.

Mild fluorosis

Mild fluorosis can show up in the form of small white spots or streaks on the enamel. Sometimes, subtle changes are only visible to dentists under a specialised bright light.

Moderate fluorosis

Moderate fluorosis can be characterised by more noticeable white patches, which may also be across multiple teeth. The teeth may also have a slight mottling or chalky appearance, and can be more prone to surface staining over time.

Severe fluorosis

More severe fluorosis can appear as brown or darker stains on the teeth, and possibly enamel surface irregularities, such as pits or grooves. Some teeth may also have a rough texture, which can sometimes make them more difficult to clean and more vulnerable to wear.

While fluorosis can be categorised from mild to severe, it’s not a condition that is as significant as decay. It is generally more a condition that presents cosmetically, meaning it affects the appearance of the teeth, as opposed to function. However, in more severe cases, it can sometimes contribute indirectly to oral health challenges by altering the enamel’s surface.

Types and Severity Levels of Fluorosis

Dentists often classify fluorosis according to how noticeable the changes are.

The type of fluorosis can be characterised by:

Very mild: Very faint white flecks or spots that are barely visible, or small opaque white areas that cover less than 25% of the tooth’s surface.
Mild: White streaks or patches covering up less than 50% of the enamel.
Moderate: More extensive mottling, with possible brown stains.
Severe: Widespread pitting, brown or black stains, and pronounced enamel irregularities.

Most cases in Australia are in the mild category, partly due to careful regulation of water fluoridation levels.

Preventing Dental Fluorosis

Preventing fluorosis is all about balancing fluoride exposure. Children need enough fluoride to protect their teeth from decay, but not so much that it interferes with enamel development.

Parents and caregivers can take a few simple steps to help achieve this balance:

Use the right amount of children’s toothpaste

Ensure that children are using children’s toothpaste only.

For children under three: only a smear of fluoride toothpaste (the size of a grain of rice).

For children aged three to six: a pea-sized amount is sufficient.

Check local water fluoride levels

Most Australian tap water is adjusted to suitable fluoride levels, but if you live in an area with naturally high fluoride, your dentist may suggest alternatives like using bottled water for formula preparation.

Be careful with supplements

Only use fluoride supplements if recommended by your dentist. Combining supplements with fluoridated water and toothpaste may increase the risk of fluorosis.

Mixing formula

If using powdered or concentrated formula, alternating between fluoridated tap water and low-fluoride bottled water can help regulate fluoride exposure.

By following these steps, parents can reduce the risk of fluorosis while still protecting children’s teeth against decay.

Treatments for Dental Fluorosis

Treatment for fluorosis depends on how noticeable the condition is, particularly how the symptoms are showing up on the teeth. If the changes are quite noticeable, a patient may choose to have a cosmetic treatment to make aesthetic adjustments. Sometimes, fluorosis may contribute to damaging the teeth, which may require a treatment such as crowns.

Professional teeth whitening

Whitening treatments can help even out colour differences and reduce the visibility of white or brown patches. However, in more significant cases of fluorosis, whitening may accentuate mottling, so it is important to have a thorough dental assessment.

Composite bonding

A tooth-coloured resin (composite bonding) is applied to cover stains or surface irregularities, blending in with the surrounding enamel. Composite bonding can be suitable to cover moderately noticeable signs of fluorosis, depending on the patient’s personal preferences.

Porcelain veneers

If the symptoms of fluorosis are quite noticeable, thin, custom-made porcelain shells (porcelain veneers) can be placed over the front of teeth to mask discolouration and irregularities. Porcelain veneers can provide a longer-lasting solution, but do involve more preparation of the tooth surface. At Oasis, we only use high quality, durable porcelain for our veneer treatments.

Dental crowns

For severely affected teeth with extensive damage or pitting, crowns may be recommended to address both the function and the appearance of the teeth.

Managing the Signs of Fluorosis

Many people with mild fluorosis never require treatment. The teeth remain strong and functional, and the condition is largely cosmetic – meaning that it just becomes about the visual appearance of the teeth as opposed to how well they are functioning.

Often, the signs of fluorosis that remain cosmetic only can just be ignored. However, if an adult wishes to make aesthetic changes to their teeth to manage the signs of fluorosis, there are a variety of treatment options available, such as composite bonding or porcelain veneers.

At Oasis, we offer both restorative and cosmetic dental solutions. If you do need or want to consider undergoing a dental treatment in the future, an assessment of how fluorosis has presented on your teeth can help to find the most suitable treatment option.

When to See a Dentist

If you notice unusual streaks, spots, or stains on your child’s teeth, it’s a good idea to book a dental appointment. Your dentist can determine whether the changes are due to fluorosis, early decay, or another condition.

For adults, if the appearance of fluorosis is causing concern, a dentist can discuss cosmetic treatment options. Early intervention may also help prevent staining from becoming more noticeable over time.

Get in Touch

Dental fluorosis is a condition that develops only during childhood, caused by excess fluoride exposure while the teeth are still forming. It presents as changes in the appearance of enamel, from faint white streaks to brown staining and pitting in more advanced cases.

Prevention is key, and parents can reduce risk by supervising brushing, using the correct amount of toothpaste, and monitoring fluoride sources.

For those who already have fluorosis, treatments such as whitening, composite bonding, porcelain veneers, or crowns can help to improve the appearance of any affected teeth.

At Oasis Dental Studio, with practices across the Gold Coast, Brisbane, Melbourne, and Pottsville, our dentists are here to help with both prevention advice and personalised treatment plans. Whether your concern is for your child’s developing teeth or for your own smile, arranging a consultation is the first step.

Fluorosis: Causes, Symptoms, Prevention and Treatments

What is Fluorosis?

Causes of Dental Fluorosis

Symptoms of Fluorosis

Types and Severity Levels of Fluorosis

Preventing Dental Fluorosis

Treatments for Dental Fluorosis

Managing the Signs of Fluorosis

When to See a Dentist

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More ODS dental symptoms pages

Medical references for tooth erosion

Your local trusted Dentists

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