Fluorosis is a cosmetic side effect of exposure to too much fluoride when teeth are developing. Although fluoride protects teeth from decay, at higher levels it can also alter the formation of tooth enamel, creating an unattractive appearance. Unfortunately, there is little that can be done to alter the structure of the fluoride once it’s set, but porcelain veneers can give your teeth an attractive surface so you’ll always be delighted with your smile.
Fluorosis Causes and Grades
Fluorosis is caused, as we said, by exposure to too much fluoride. Fluoride is a catalyst that influences the speed at which the enamel forms. When there’s too much of it, the enamel forms faster than all the minerals can be put in place, so the enamel is weak and demineralized.
That’s why fluorosis and decay go hand in hand. Low grades of fluorosis is similar to white lesions that signal pre-decay of teeth.
Fluorosis is scored by one of two different grading scales. The oldest is Dean’s index, developed through the 1930s and published in its final form in 1942:
- Grade 0: Normal teeth
- Grade 1: Small white flecks on the tooth
- Grade 2: Small opaque areas, but affecting less than 25% of the surface of the tooth and not too much on the tooth cusps
- Grade 3: Opaque areas affect much of the teeth, but less than 50% of the surface
- Grade 4: Not only are enamel surfaces fully affect, but they’re also beginning to show wear. Brown stains affect the teeth.
- Grade 5: The teeth look pitted and corroded, darkly stained.
The more modern scale is the TF index, which is similar, but is more finely graded, with a scale that runs from 0-9.
Treating Minor Cosmetic Fluorosis
Fluorosis doesn’t have to be severe to be considered a cosmetic problem. Many people with mild fluorosis are unhappy with the appearance of their smile.
In some cases, minor cosmetic fluorosis will respond to teeth whitening, especially deep bleaching, which will whiten the rest of the tooth to match the white lesions. Other times, teeth whitening will cause the white lesions to get even whiter, and they’ll continue to stand out.
When these more serious lesions are still superficial, they can be buffed out of the surface of the tooth. This creates a more uniform appearance for the teeth, and it can be an effective cosmetic solution, though it may expose the tooth to more risk from erosion or decay.
Treating Serious Cosmetic Fluorosis
If your teeth are relatively sound structurally, but they’re not responding to the above treatments, porcelain veneers can be a great solution. Veneers will cover the defects in the enamel, and give your teeth the appearance of natural, healthy enamel. The white lesions will be completely concealed, and no one will be able to see the impacts of fluorosis.
Treating Structural Fluorosis
If your teeth are structurally damaged from fluorosis, we have to worry about protecting them as well as beautifying them. This can be done with porcelain crowns. Porcelain crowns not only give your teeth an attractive appearance–they create a protective covering that prevents decay from penetrating the weak enamel.
Depending on the state of your teeth, it might be necessary to perform a root canal before putting crowns on. In some cases, decay may penetrate and destroy the tooth before we are able to restore it. In this case, though, it’s still possible to replace one or more lost teeth with dental implants.
Find the Best Treatment for You
If you’re looking for a good solution to your fluorosis, whether it’s cosmetic or more serious, we can help. Please call (918) 528-3330 today for an appointment with Tulsa cosmetic dentist Dr. Hodges at élan by Dr. Meghan Hodges.