The Symptoms, Causes, Diagnosis, and Treatment of Fluorosis

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Fluorosis, also called dental fluorosis, is a condition that changes the appearance of tooth enamel in young children as a result of being exposed to too much fluoride. Children are only at risk for fluorosis while their permanent teeth are still forming. Adults and children older than 8 do not get fluorosis. 

A child can develop fluorosis any time during the years when teeth are beginning to form (birth to 8 years) if they are exposed to high levels of fluoride. Excess fluoride may be consumed through toothpaste, drinking water, and fortified foods. Low levels of fluoride have been shown to help prevent cavities and are often recommended as a preventative measure for dental health in children and adults. Excess fluoride can alter the appearance of tooth enamel in children whose permanent teeth haven't come in yet.

preventing fluorosis in kids
Illustration by Brianna Gilmartin, Verywell

Symptoms

The majority of cases are mild and do not permanently damage teeth, and severe cases of fluorosis are not common.

When it's mild, fluorosis is a painless cosmetic condition. It can cause the appearance of the tooth enamel to change, usually becoming stained with white "splotches" or "streaking." 

Severe fluorosis can compromise dental health.

Signs of severe fluorosis include:

  • Brown spots on tooth enamel
  • Pitting of the enamel
  • Permanent damage to the tooth enamel

Causes

Fluorosis is caused by high levels of fluoride. Fluoride is a naturally-occurring mineral that has been shown to help prevent cavities. Fluoride is typically added to toothpaste and mouthwash, and it is added to public drinking water sources in many places around the world. This practice, called water fluoridation, is considered safe and effective by the American Dental Association and the Centers for Disease Control and Prevention.

Children younger than 8, especially toddlers, tend to ingest more fluoride than older children and adults because they are prone to swallowing toothpaste when they brush. Fluoride in toothpaste and mouth rinse is very concentrated.

School-based fluoride treatment programs are common throughout the United States and may contribute to a child's fluoride exposure. 

Over time, swallowing toothpaste or mouth rinse adds to a child's intake of fluoride and can cause fluorosis to develop. 

Diagnosis

The discoloration from fluorosis is usually very mild; parents and caregivers may not notice it until a child's dentist, pediatrician, or another trained healthcare provider (such as a school nurse) mentions it. 

Regular dental checkups, ideally started by the time a child has their first birthday, can help promote good dental health and can help identify conditions like fluorosis or dental caries (cavities) early. 

Treatment

Most cases of fluorosis are mild and do not need treatment. In more severe cases, whitening of the teeth, veneers, or other cosmetic dentistry techniques can be used to correct permanent discoloration.

Once a child reaches the age of 8, they are no longer at risk for developing fluorosis.

Prior to that time, parents and caregivers can help prevent fluorosis by:

  • Using only a small amount of toothpaste on a child's toothbrush
  • Supervising children while they brush to make sure they are spitting out, not swallowing, toothpaste or mouth rinses that have fluoride
  • Keeping toothpaste and mouth rinse out of reach of children
  • Finding out more about the water fluoridation practice in their community 
  • Asking a child's school about fluoride treatment programs

A Word From Verywell

Most cases of fluorosis are mild, not painful, and don't cause any permanent damage to a child's teeth. If severe fluorosis occurs, it can usually be treated through a number of cosmetic dentistry techniques such as whitening or veneers. Parents and caregivers can help prevent fluorosis by supervising children, especially toddlers, while they brush their teeth and making sure children start having regular dental check-ups by the time they're a year old.

Frequently Asked Questions

  • Can you get rid of fluoride stains on your teeth?

    Resin infiltration, a procedure that removes discoloration on teeth, can help mild to moderate fluorosis. Mild cases can also be treated with microabrasion, bleaching, or a combination of both. In some cases, crowns and laminated veneers might be a better option. 

  • Can fluorosis cause cavities?

    No, fluorosis does not cause cavities. Low levels of fluoride may help protect teeth from decay. Too much fluoride before age nine or so can cause problems with the tooth enamel.

  • Should I give my child fluoride supplements?

    Most people in the United States, including infants and young children, get adequate amounts of fluoride through their diet. If you live in an area with fluoridated water, you have the added protection of getting this mineral via tap water. If your dentist has concerns about your child getting enough fluoride, they may discuss supplements with you.

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Fluorosis. Centers for Disease Control and Prevention.

  2. FAQ: Fluoride and Children. Healthy Children.

  3. How can I prevent dental fluorosis in my children? U.S. Department of Health and Human Services.

  4. Shahroom NB, Mani G, Ramakrishnan M. Interventions in management of dental fluorosis, an endemic disease: A systematic review. J Family Med Prim Care. 2019;8(10):3108. doi:10.4103%2Fjfmpc.jfmpc_648_19

  5. Aulestia FJ, Groeling J, Bomfim GHS, et al. Fluoride exposure alters Ca 2+ signaling and mitochondrial function in enamel cells. Sci Signal. 2020;13(619):eaay0086. doi:10.1126/scisignal.aay0086

  6. National Institute for Health Office of Dietary Supplements. Fluoride.

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