White Spots on Your Teeth? It May Be Dental Fluorosis

Have you noticed white spots on your teeth or your kids teeth? 

This may be dental fluorosis. A common condition caused by too much fluoride exposure during childhood.  

While these spots do not affect your health, they can impact the look of your smile and your confidence.

In this blog, we explain what dental fluorosis is, why these white spots appear, and what you can do to prevent or treat them.

What Is Dental Fluorosis?

Dental fluorosis is a condition that affects the appearance of your teeth, causing white spots or streaks on the enamel.

It is primarily caused by excessive exposure to fluoride during the early years of a child’s life, usually up to the age of eight, when permanent teeth are still forming beneath the gums.

Fluoride protects the enamel and is very effective at preventing tooth decay. But too much of a good thing is never good! 

Excess fluoride consumption can happen in several ways:

1. Fluoridated drinking water: In many areas, public water systems add fluoride to drinking water to help prevent tooth decay. This level is regulated and cannot exceed 4.0 mg/L. The Environmental Protection Agency (EPA) also set a secondary standard of no more than 2.0 mg/L to help protect young children from excess fluoride consumption. The secondary standard is a guideline, not an enforced regulation. However, public water systems must tell their customers if the fluoride level goes above it. 
2. Fluoride toothpaste: Children who are just learning to brush may accidentally swallow rather than spit out the toothpaste. Regularly swallowing even a small amount can lead to excessive fluoride exposure. Dentists often recommend using only a “pea-sized” or “grain-sized” amount of fluoride toothpaste for young children to minimize this risk.  Also, the amount of fluoride in children’s toothpaste is only ½ the amount put in adult toothpaste.
3. Fluoride supplements: Sometimes, children are given fluoride supplements in areas where water is not fluoridated. It can contribute to excessive fluoride levels, increasing the risk of fluorosis.
4. Other sources of fluoride: Besides toothpaste and tap water, children may also get fluoride from acidic foods and drinks, especially if they are made with fluoridated water. Some bottled waters contain fluoride, though not all do. Fluoride can also be present in some mouth rinses, making it easy to consume accidentally, but this typically is not a problem unless a child gets a hold of the bottle. 

When Dental Fluorosis Develops

Fluorosis only affects teeth that are still forming under the gums.

Therefore, it occurs in children younger than eight years old, typically between birth and around six or seven, when the permanent teeth are developing.

By the time teeth have fully erupted, fluoride can no longer alter the enamel’s formation, which means fluorosis cannot develop after this age.

How to Identify Fluorosis: What Does It Look Like?

Fluorosis has a unique appearance, often presenting as white or chalky spots on your teeth.

You may notice these spots in random areas or throughout the entire tooth, and the discoloration can vary from white to brown.

Common signs include:

• White blotches or streaks on the tooth enamel
• Chalky or cloudy appearance on the tooth surface
• Brown spots in severe cases

The Impact of White Spots on Dental Health and Aesthetics

Fluorosis may not harm your dental health directly, but it can affect the appearance of your teeth, which may impact your self-esteem.

White spots are purely a cosmetic issue, but in severe cases, these spots may indicate areas of weak enamel.

Possible effects on dental health:

• Thinner enamel in spots with severe fluorosis.
• Increased risk of plaque buildup, leading to tooth decay if oral hygiene is poor.
• Potential for tooth sensitivity due to enamel irregularities.

How to Treat Dental Fluorosis

Treatment options for dental fluorosis involve a variety of methods, depending on the severity of the condition and your personal preference.

1. Professional treatments
   • Teeth whitening: Helps lighten the surrounding enamel for a more even appearance.
   • Dental veneers: Thin layers of porcelain veneers or “shells” cover the teeth, ideal for severe discoloration.
   • Tooth bonding: Applies a tooth-colored resin to improve the appearance of the tooth.
2. At-home oral care adjustments
   • For children over 3, use a pea-sized amount of fluoride toothpaste for young children.
   • For children under three, use a smear of toothpaste the size of a grain of rice. 
   • Consider hydroxyapatite toothpaste, a natural alternative to fluoride that may be just as effective at preventing cavities as fluoride toothpaste. 
   • Encourage children to spit rather than swallow toothpaste.
   • Avoid fluoride supplements unless prescribed by a dental professional.

For toothpaste recommendations, read What is the Best Toothpaste? Our Top Picks.

Preventive Measures for White Spots and Fluorosis

Balance is your best friend when it comes to fluoride, especially in young children.

Here are practical steps to protect your child’s teeth:

• Find out how much fluoride is in your tap water.  To do this, you just need to take a sample of your city’s tap water to the Commissioner of Public Works, for testing.  This position typically is a function and office in your city government. If you have young children and the level is over 2.0 mg/L, consider switching to bottled water. 
• Teach your child to spit out toothpaste after brushing to avoid swallowing excessive fluoride.

For adults, focus on maintaining a balanced diet with essential minerals to support strong enamel and prevent other dental issues, like enamel hypoplasia.

A Beautiful Smile Is Within Reach

If you have concerns about white spots on your teeth, dental fluorosis, or other oral health issues, our team at Power Road Dental Care in Mesa, AZ, is here to help.To book an appointment at our dentist office in Mesa, AZ, call (480) 664-1438 or complete the online inquiry form. We are located at 2500 South Power Road, Suite 102, Mesa, AZ.