Fluorosis

What is fluorosis?

Fluorosis is the accumulation of excess fluoride in the bones and teeth. The fluoride is taken in when a child drinks water or eats food that is cooked in water with an excess of 1 part per million of fluoride. It causes permanent discolouration of teeth and when severe, can even cause a change in the tooth structure. The teeth can either be chalky white, light brown or dark brown, sometimes appearing as pits or grooves on the teeth.
Fluorosis is fast becoming a common problem in our country because of increased use of borehole water. Volcanic soil tends to have high levels of fluoride and groundwater which filters through it dissolves the mineral. The level of fluoride in water can be tested by companies like the Water Resource Management Authority. (WRMA)

Who is at risk?

Children below 8 years are the ones most affected by high fluoride levels in water because their bones and teeth are developing, but it can affect bone and teeth formation up to 16 years.
Signs and symptoms
Fluorosis appears as chalky white streaks on the teeth, sometimes affecting the whole tooth and usually affecting multiple teeth. Higher levels of fluoride will cause teeth to appear light brown to dark brown and have a rough surface with pits and grooves.
More severe cases experience sensitivity and due to the rough surface of the teeth they could be more prone to decay.

Diagnosis

Fluorosis can be diagnosed by a dentist using a combination of examination and history taking. There are some common defects of enamel that have a similar appearance to fluorosis and a dentist can help differentiate between them.

Prevention

Unfortunately, diagnosis of fluorosis tends to be once the fluorosis has already affected the forming teeth, and eruption has begun. It is therefore important to start early visits to the dentist from the age of 2 for advice.
Drinking water should be tested for mineral content where possible, especially where the source is borehole water or from an unknown source. Drinking purified rainwater can be a viable option for some. Water defluoridation is also possible with defluoridation filters. Ask your dentist for more information on this.

Treatment

Specific treatment for fluorosis will be determined by your child’s dentist based on their age, the extent of the fluorosis and your preferences.
Since fluorosis affects the tooth structure, the main treatment option is to cover the surface of the tooth. Mild cases can benefit from bleaching, while teeth that are more affected are usually treated by removing a thin layer of surface enamel and replacing it with a white filling for temporary management or a more permanent porcelain veneer.

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