Can Fluorosis Develop on Baby Teeth?

Can Fluorosis Develop on Baby Teeth?

CHICAGO -- Dental fluorosis, or white or brown spots on enamel, can develop on primary (baby) teeth and may be indicative that a child will have the same cosmetic defect on its permanent (adult) teeth, according to an article in the March 1999 issue of the Journal of the American Dental Association (JADA).

Researchers from the University of Iowa's College of Dentistry did a literature review of all the studies published on primary tooth fluorosis during the past 30 years.

Dental fluorosis is a cosmetic developmental defect of enamel that can occur when a higher than optimal amount of fluoride is ingested during the time when the enamel of teeth is developing. Once enamel has formed, fluorosis can no longer occur. Approximately 94 percent of all dental fluorosis are the mild or very mild type. The mildest forms of fluorosis appear as light spots on teeth and can be detected only by a dentist or dental hygienist. Dental fluorosis is a minor cosmetic effect and is not considered to be harmful to health.

In the JADA article, the researchers ask what does fluorosis in the primary teeth mean for permanent teeth? Their answer is it should raise awareness of possible increased risk for fluorosis in the permanent teeth. The researchers state that detection of this cosmetic effect in a one-to-two-year-old child may present the opportunity for the dentist to complete a careful review of the child's overall fluoride exposure. The dentist may also consider recommending a change in the child's source of fluoride to reduce the likelihood of defects developing on the permanent teeth, especially the cosmetically important front teeth.

The studies reviewed in this article indicate that primary tooth fluorosis is most likely to occur in areas with very high levels (up to 21 parts per million) of naturally occurring fluoride levels in the water. These locations are rarely found in the United States, according to researchers, which limits the relevance of some of the studies used in the article. In the United States, the level of fluoride in drinking water recommended for prevention of cavities is 0.7 - 1.2 parts per million.

According to the American Dental Association (ADA), most mild to moderate fluorosis does not occur from the ingestion of optimally fluoridated water. Fluorosis risk increases when label directions are not followed and dental products are used inappropriately. One example would be ingestion of fluoride toothpaste and mouthrinses by young children. The ADA recommends that children under six use only one pea-sized amount of toothpaste at each brushing, and parents should supervise the toothbrushing habits of their children. Supervision should encourage spitting out, rather than swallowing, the toothpaste. In optimally fluoridated areas, fluorosis can also occur from the unnecessary and inappropriate prescribing of fluoride supplement tablets or drops for children The ADA recommends that parents talk to their dentist if they have concerns about how much fluoride their child is ingesting and if their child is at risk of developing fluorosis.

For more information about fluoride, go to the ADA's website: http://www.ada.org

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