Fluoride is a trace mineral found in food, tap water and oral health products such as toothpaste and mouthwash. It is used to help reduce the risk of cavities and tooth decay when used at low levels. Fluoride also helps to strengthen the enamel of the teeth.
Too much fluoride, however, can cause discolouration and damage to the enamel which is known as dental fluorosis.
How Fluoride Impacts Tooth Enamel
Fluoride has long been touted as a powerful tool in the fight against cavities and tooth decay. This natural mineral, often found in water and some foods, works by strengthening the enamel on our teeth making them more resistant to harmful bacteria that can cause decay.
Below are some of the most common ways we are exposed to fluoride:
- Natural Water Sources: Across the country, including in Ontario, public drinking water contains a low level of fluoride to protect the teeth’s enamel.
- Fluoride Supplements: These tablets or drops are available in various strengths and are recommended by health professionals for those who lack access to fluoride.
- Fluoridated Toothpaste and Mouth Rinses: To reduce the risk of cavities most toothpastes and mouthwashes contain a variable level of fluoride.
What Is Fluorosis and How Does It Develop?
Fluorosis is a dental condition that causes discolouration and damage to teeth due to overexposure to fluoride. Although fluoride is commonly used to strengthen teeth and prevent cavities, excessive consumption can lead to fluorosis.
This condition typically develops during childhood when teeth are still developing, as excessive fluoride intake can cause white or brown spots to appear on teeth. In severe cases, the surface of the teeth may develop pits, making them susceptible to decay.
While mild cases of fluorosis are considered a cosmetic condition and may not require treatment, severe cases can lead to aesthetic concerns, which may require dental restoration.
The Roots of Dental Fluorosis: The Connection with Fluoride Exposure
Fluorosis can begin when a baby is still in the womb. Expecting mothers who may consume high levels of fluoride can unknowingly pass on the damage to the fetus.
During development, the enamel of a tooth is formed in a process called amelogenesis. Enamel matrix proteins are involved in this process as they are responsible for the mineral deposition and growth of the tooth. Enamel matrix interference occurs when fluoride is introduced. Introducing fluoride during the tooth development stage increases the occurrence of cell apoptosis and enzyme inhibition, leading to fluorosis.
Children have the highest risk of developing fluorosis before the age of eight. This is because, by the age of eight, the permanent teeth have completely developed (except for the wisdom teeth). This is why the Canadian Dental Association advises against the consumption of fluoride products by children under the age of six years.
After this, children are not as susceptible to dental fluorosis regardless of the amount of fluoride consumed in drinking water, toothpaste, mouthwash or food sources.
Other factors that might increase the chances of developing fluorosis include genetics, age, bone growth progress, nutrition, weight, and exposure to fluoride at a young age. A recent Canadian Health Measures Survey revealed that 16% of children may have a mild form of dental fluorosis.
Types of Fluorosis and Identifying the Symptoms
There are five main categories of fluorosis. A dentist will diagnose and grade the severity of the dental fluorosis based on the following scale:
- Questionable: Barely noticeable white flicks or spots on the teeth.
- Very Mild: Minute white areas on less than 25% of the tooth surface.
- Mild: White flecks or spots on less than 50% of the tooth surface.
- Moderate: White or beige spots on more than 50% of the tooth surface.
- Severe: The entire enamel surface is affected with white or brown spots and pitting.
Early signs of fluorosis include:
- White spots
- Streaks or lines
- Mottling or discolouration
- Pits or roughness
These symptoms of dental fluorosis are typically located at the bottom of the teeth. Mild forms of fluorosis can be less noticeable while the moderate to severe forms will typically result in larger markings, pitting, and dark brown spots. In severe cases, the teeth can become disfigured and appear to be rotted causing people to feel self-conscious about their smile.
Dental Fluorosis Treatment Options from Princeview Dental Clinic in Etobicoke
With an early diagnosis of fluorosis, patients at Princeview Dental Group have a wide array of treatment options for dental fluorosis. The affected teeth can be treated with professional cosmetic services, such as:
- Dental Bonding: Dental bonding is a procedure using a composite resin applied in a thin coating directly on the teeth. A special light source is used to “harden” the substance for a brilliant and enhanced smile. The unique composite resin can be matched to the shape, size, position, and colour of the tooth to cover blemishes as seen with dental fluorosis.
- Dental Veneers: Dental veneers are another fluorosis treatment as a ceramic or porcelain shell is placed over the affected tooth to hide stains, flaws, or imperfections caused by the condition. This simple procedure ensures all of your teeth will match in shade and the veneers typically last for years.
Simple Ways to Prevent Dental Fluorosis
It should be noted that Fluorosis is quite uncommon here in Canada and Ontario specifically. The recommended daily intake to prevent fluorosis is between 0.05 to 0.07 mg F/Kg/day. A person’s exposure via tap water, toothpaste, mouthwash, and other fluoride sources determines what steps and measures are needed to maintain a good balance in their consumption. Here are some tips to follow:
- Check the fluoride content of your drinking water. This can narrow down if you need a fluoride supplement or if you need to take steps, such as eliminating certain products and foods, to reduce excessive exposure to fluoride.
- Regulate the amount of toothpaste used by young children to prevent overexposure to fluoride.
- Breastfeed, if possible, for up to six months, and continue when switching to solid foods. This reduces a baby’s fluoride exposure as it can be found in tap water and infant formulas.
- Schedule your child’s first dental visit before the age of one and then continue with regular dental checkups.
Managing Fluoride Intake: Recommendations for Etobicoke Residents
The topic of dental fluorosis is an ongoing conversation through community awareness programs, online support groups, and research panels. Educating the public is one of the best ways to help people understand the risks of too much fluoride exposure.
A recently updated Dental Fluorosis report from the National Center for Biotechnology Information, published by the National Library of Medicine, states how educational initiatives should be at the forefront in preventing fluorosis. They recommend supervised toothbrushing of children, encouraging children not to ingest dentifrices, and limiting the use of additional fluoride supplements in areas served by fluoridated water. In addition, they warn that patients should be informed of potentially less publicized sources of fluoride, including tea, artificially fluoridated milk, and fluoridated salt.
Healthcare providers can also play a role in educating the public.
Safeguard Your Smile's Beauty: Schedule a Consultation Today with Princeview Dental Group
For professional dental care for dental fluorosis in Etobicoke, speak to the team at Princeview Dental Group. We offer personalized dental plans based on your oral health needs including dental crowns, dental veneers, bonding and whitening services for discolouration and/or damage to the teeth.
Don’t let fluorosis affect your confidence and smile! Contact us at (416) 231-4562 or complete our online form to book a consultation with our dental care team. We are located at 3052 Bloor Street West in Etobicoke, now located under The Crooked Cue Pub and Restaurant.