Fluoride, Tooth Decay, and Enamel Fluorosis

When present in proper dosage, fluoride has been shown to significantly reduce dental decay. It does this by mixing with the enamel of growing teeth. That makes it an important part of ensuring the strength and health of your child’s developing teeth.

Fluoride supplementation
When fluoridated water has less than the ideal amount or is not available, fluoride supplements are recommended. A call to your local water district is all that it takes to determine whether your water contains fluoride or not.

When supplements are needed, they should be introduced shortly after birth and continue through the eruption of your child’s second permanent molars, which generally happens around the age of 12.

Enamel fluorosis and too much fluoride
When a child gets too much fluoride during the years of tooth development, it can result in defects in the tooth enamel – a condition known as enamel fluorosis. Most cases of fluorosis are mild and will appear as tiny white specks or streaks that are often unnoticeable. In more severe cases of enamel fluorosis, the appearance of the teeth is marred by discoloration or brown markings, and the enamel may be pitted, rough, and hard to clean.

Why enamel fluorosis occurs
Fluorosis happens when a child ingests too much fluoride for his or her size and weight during the years of tooth development. This may be a result of taking more of a fluoride supplement than the amount prescribed, or taking a fluoride supplement when there is already an optimal amount of fluoride in the drinking water. Some children simply like the taste of fluoridated toothpaste, and may use too much as well as swallow the toothpaste instead of spitting it out.

Preventing enamel fluorosis
Talk to your child’s dentist as the first step. He or she can tell you how much fluoride is in your drinking water (your local water treatment plant is another source of this information). If you drink well water or bottled water, your dentist can assist you in getting an analysis of its fluoride content. After you know how much fluoride your child is getting, you and your dentist can decide together whether your child needs a fluoride supplement.

Always monitor your child’s use of fluoridated toothpaste. A pea-sized amount on the brush is plenty for fluoride protection. Teach your child to spit out the toothpaste after brushing, and supervise brushing until he or she can be reasonably trusted to do so.  

Treating enamel fluorosis
Once fluoride becomes part of the tooth enamel, it can’t be removed. However, the appearance of teeth affected by fluorosis can be greatly improved by a variety of treatments in esthetic dentistry. Talk to your dentist about the best options for your child.

Regular check-ups, and more children’s dental health information
Remember that regular dental check-ups should begin once your child’s first tooth comes in, and this is a great time to speak with your dentist about fluoride. Read our Mom’s Guide to Infant Dental Health and Parent’s Guide to Children’s Dental Health for more important information on caring for your child’s teeth and gums.