My 10-year-old daughter has severe fluorosis stains on her teeth. Her upper center and side teeth are blotchy, and one side tooth is jagged. The bottom front and side teeth are her only permanent teeth so far, and they are quite yellow. My daughter sucked her thumb from ages 2 to 7. We want her to feel good about her smile, so she is wearing braces now to correct an open bite instead of waiting until she is a teenager and even more sensitive about her smile. Now I need to think about what we can do, if anything, for the fluorosis stains. I think porcelain veneers might be an option, but I’m not sure if they are good for children. Any recommendations? Thanks. Tisha
Tisha,
Cosmetic dentists conceal severe fluorosis stains with porcelain veneers. Although Dr. Finley would need to examine your daughter’s teeth to recommend a specific treatment, we’ll discuss some possibilities. If a child consumes too much fluoride while teeth are forming, fluorosis stains develop. But this is not the type of work that pediatric dentists do. Neither are family or general dentists qualified. Look for an advanced cosmetic dentist with extensive training and artistic talent. Otherwise, you and your daughter will still be unhappy with her smile.
Although natural drinking water usually has some fluoride, some natural sources don’t have enough fluoride. Lack of fluoride leaves teeth susceptible to decay.
What causes fluorosis stains?
Several factors can cause fluorosis stains, including certain types of water, supplements, and some kinds of toothpaste.
- If community water contains too much fluoride, drinking the water for extended periods causes fluorosis stains in teeth.
- Untreated well water can also cause fluorosis stains.
- Consuming too many fluoride supplements or swallowing too much fluoride toothpaste causes stains.
Types of Fluorosis Stains and Treatment
Depending on how much excess fluoride a child consumes while teeth are developing, teeth can have mild or extensive stains or some discoloration.
Mild
Mild fluorosis creates white or, in severe cases, brown spots on teeth. Often, a dentist can use direct bonding to conceal the spots.
Extensive
If fluorosis stains extensively cover teeth, a cosmetic dentist will use porcelain veneers to conceal the stains. A skilled cosmetic dentist will design veneers that mimic the natural color, shade, and translucency of teeth.
Discoloration
If teeth stains are even and yellow—not blotchy—they might not be fluorosis stains. But a cosmetic dentist can determine the cause of the stains. He or she might try bleaching the teeth before recommending dental bonding or porcelain veneers.
Concealing fluorosis stains is beyond the technical and artistic ability of a family or general dentist. Find a dentist with advanced training in aesthetics.
Orthodontic Treatment and Fluorosis Stains
Can you treat fluorosis while wearing braces? Wait until your daughter completes orthodontic treatment. A cosmetic dentist will want to see how the teeth have erupted. It may be best to use dental bonding or another treatment before porcelain veneers.
Although there is no minimum age for porcelain veneers, teeth bleaching, or dental bonding, an experienced cosmetic dentist must determine which treatment is best depending on tooth eruption and development. A cosmetic dentist who treats children will also consider how your daughter feels about the stains and which treatment will achieve results that make her confident about her smile.
David Finley, DDS, an accredited fellow of cosmetic dentistry in Monroe, LA, sponsors this post.
