According to the National Institute of Dental Research’s 2002 survey, approximately 40.19% of children suffer from some degree of Dental fluorosis, nearly double the 22.3% of children recorded in 1999. Dental fluorosis is a dental syndrome, in which dental enamel is disturbed by overexposure to high concentrations of fluoride during the years of tooth and enamel development, primarily between the ages of 3 months and 8 years.
Dental fluorosis occurs as discoloration on the surface of teeth. Milder forms of the syndrome will show up as faint white spots, while more severe cases will result in large sections of brown enamel discoloration. If your child shows any signs of these color abnormalities, he/she may be suffering from dental fluorosis.
As previously mentioned, excessive levels of fluoride on developing teeth are the leading causes of dental fluorosis. This occurs when fluoride interacts with the teeth’s hydroxyapatite and carbonated hydroxyapatite, creating fluorapatite. As the teeth mature, they become less susceptible to this kind of demineralization, but permanent teeth are typically affected over primary teeth.
Fortunately, the risks associated with dental fluorosis are primarily aesthetic, but they are also permanent. While this may seem like a small concern, severe dental fluorosis can result in an unattractive smile, which can affect a child’s self-esteem and sociability.
Parents should be especially wary of fluoride ingestion during the ages of 1 and 4 years old, and children are no longer susceptible to the syndrome after age 8. Before the age of 8, parents should limit children’s fluoride exposures, by steering clear of fluoride-containing mouthwashes (which children may accidentally swallow), bottled water that hasn’t been screened for fluoride, excessive fluoride supplements, and imported foods with high fluoride contents. 40% of fluorosis cases can be linked to public water fluoridation, which is typically instituted to prevent tooth decay. Extreme cases of fluorosis are typically traced back to Chinese brick teas and high fluoride coal pollution.
Who’s At Risk
Dental fluorosis occurs more commonly in poorer and more rural areas, where children gather water from wells and hand pumps and have lower calcium levels due to poor nutrition. Water with a fluoride content above 1 part per million is of most concern. According to The U.S. Center of Disease Control, African-American children are more likely to experience dental fluorosis than their Caucasian American counterparts.
Dental fluorosis can be treated with cosmetic dentistry. Many fluorosis sufferers seek out tooth bleaching or microabrasion treatments, which can be costly and not always covered by insurance plans. For extreme cases, restoration can improve the teeth beyond just stains, to revive enamel texture and clean-abilty.The American Dental Association recommends, “Your dentist, pediatrician or family physician can help you determine how to optimize your child’s fluoride intake.” Despite fluoride concerns, the official dental organization believes that fluoride is safe and healthy, but agrees it must be monitored for children in early childhood. The ADA does not discourage the consumption of public drinking water, but suggests parents use ready-to-feed instant formulas or low fluoride waters to prepare liquid concentrate formulas.