THE proper amount of fluoride helps prevent and control tooth decay in children and adults. Fluoride works while the teeth are developing and every day after the teeth have emerged through the gums.

Fluoride consumed during tooth development can also result in a range of visible changes to the enamel surface of the tooth. These changes are known as dental fluorosis.

WHAT IS FLUOROSIS?

Dental fluorosis is a change in the appearance of the tooth’s enamel. These changes can vary from barely noticeable white spots in mild forms to staining and pitting in the more severe forms. Dental fluorosis only occurs when younger children consume too much fluoride, from any source, over long periods when teeth are developing under the gums.

Fluorosis is a cosmetic condition, not a disease.

WHAT ARE THE COMMON SOURCES OF FLUORIDE?

* Toothpaste (if swallowed by young children).

* Drinking water in fluoridated communities.

* Beverages and food processed with fluoridated water.

* Dietary prescription supplements that include fluoride (eg, tablets or drops).

* Other professional dental products (eg, mouth rinses, gels and foams).

SYMPTOMS OF FLUOROSIS

Teeth affected by mild fluorosis may show no visible changes or changes visible to you only to a dental professional. Mild to moderate fluorosis is characterised by white lines, streaks or spots.

In more severe fluorosis, the teeth can become pitted and have brown, gray or black spots, and the enamel can be misshapen.

PREVENTION

If you have a child under six, put only a small smear or pea-sized amount of toothpaste on his or her toothbrush and encourage him or her to spit rather than swallow after brushing. Avoid toothpastes with flavours that may encourage swallowing. Keep all fluoride-containing products (toothpaste, mouthwash, etc) out of the reach of young children.

The addition of fluoride to drinking water is one of the great preventive disease programmes of the 20th century. Children should take fluoride supplements only if the water they drink does not contain enough fluoride. If your child is taking fluoride supplements now, check the amount of fluoride in your water. If you are on a public water supply, call your supplier to ask about the fluoridation level. You can also have your dentist check a sample of your water. Then discuss with your dentist whether your child needs fluoride supplements.

Some foods and beverages contain fluoride. For example, many fruit juices and soft drinks contain fluoride at levels similar to fluoridated water. Some bottled waters now have added fluoride. Young children should drink limited amounts of these beverages.

If you notice white streaks or spots on your child’s teeth or notice that one or more teeth are discoloured, contact your dental professional.

TREATMENT

Many cases of fluorosis are minor enough not to need treatment, or the fluorosis may occur only on the back teeth where it can’t be seen. More serious cases and cases involving the front teeth can be treated by removing the surface-stained areas through tooth whitening or other procedures.

Severe cases of fluorosis can be covered with restorations, such as bonding, crowns or veneers.

Dr Sharon Robinson DDS has offices at the Dental Place Cosmetix Spa located at Shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 630-4710 or visit the website www.dentalplace4u.com