Dental fluorosis is a metabolic bone disease that comes with warning signs and symptoms. Take a look below.
The mineral fluoride is essential for the normal development of bones and teeth. However, its presence beyond the required limit leads to bone (skeletal) and dental (dental) fluorosis. It is a dominant public health problem in India due to the geographical fluoride belt in many states. Despite the anticarcinogenic potential of fluoride, when present in excessive amounts, it deteriorates aesthetics and cripples the physical, mental and social health of individuals.
We spoke to Dr. Ankit Mashru, Consultant, Department of Dental Services, Sir HN Reliance Foundation Hospital, to find out more about this metabolic bone disease and the symptoms associated with it. Scroll down to find out what the doctor wants you to know.
What causes dental fluorosis?
Drinking water is a major source of fluoride in India. It affects the population of 20 Indian states (level of fluoride in drinking water > 1.5 mg/L) and approximately 62 million people in India suffer from dental, skeletal and non-skeletal fluorosis. Among them, six million are children under the age of 14. Groundwater is considered the main source of drinking water in most places on Earth. Rajasthan and Gujarat in northern India and Andhra Pradesh in southern India are the worst affected states.
Dental fluorosis is caused by absorbing too much fluoride over a long period of time when teeth are forming below the gums. Only children aged 8 and under are at risk, as this is when permanent teeth develop. Children over 8 years old, adolescents and adults cannot develop dental fluorosis. The severity of the disease depends on the dose (how much), duration (how long) and timing (when consumed) of fluoride intake.
Symptoms of dental fluorosis
It is important to understand the signs and symptoms of this serious metabolic bone disease. Symptoms of fluorosis typically range from tiny white spots or streaks that may go unnoticed, to dark brown spots and rough, pitted enamel that is hard to clean. The condition often leads to some change in the color of your teeth. Teeth that are not affected by fluorosis are mostly smooth and shiny. They should also look somewhat pale creamy white.
How to Prevent Dental Fluorosis
- Make sure your child spits out toothpaste instead of swallowing it.
- Limit your child’s intake of sugary and acidic foods and drinks.
- Community diagnosis of fluorosis per village/block/cluster by removing excess fluoride from drinking water (using various defluoridation techniques)
Identify dental fluorosis
Dental fluorosis is a change in the appearance of the enamel surface of the tooth. Mild forms of fluorosis appear as lacy white marks on the tooth enamel. Moderate fluorosis appears mild but covers more of the tooth. In rare cases, fluorosis is described as severe. When fluorosis is severe, the enamel may show pitting and brown spots.
Treat dental fluorosis
Unfortunately, dental fluorosis cannot be reversed once it has developed. Current treatments simply mask the appearance of this condition. The therapeutic approach to dental fluorosis depends on its severity. In mild fluorosis, microabrasion, bleaching, and a combination of the two are also preferable treatment options. In moderate cases resin infiltration is a good option while in severe cases it would warrant more aggressive and invasive options such as full coverage porcelain crowns. Full coverage restoration requires very careful planning as well as execution of the procedure. For more severe fluorosis with dark discoloration and surface pitting, adhesive restorative dentistry may be necessary to meet a patient’s aesthetic requirements and expectations.
In conclusion, increased public awareness regarding the fluoride content of available drinking water, prompt identification of the condition, and early treatment will help reduce the problem and improve the general well-being of our population.
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