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Dental Fluorosis


Dental fluorosis is a defect of tooth development characterized by generalized white spots, brown stains and pitting of the enamel of the permanent teeth (Figure 1). Fluoride, ingested during the formation and maturation of tooth enamel, interferes with a number of cellular events, through its inhibition of various enzyme systems,12 the G-protein complex,13 and the removal and replacement of protein with enamel crystals.14 The severity of the defect appears to be proportional to the total fluoride consumed.15 In the examples of mild to moderate dental fluorosis presented in Figure 1, as affected children age, the defective enamel, which is quite weak, tends to erode with wear and the enamel can take on an appearance of pitting or flaking. The condition nearly always occurs with symmetry, that is, teeth that developed at the same time are similarly affected. When fluoride exposure is early in life (age 1-3 years), only the anterior incisors and first molars are affected. When excess exposure occurs later, while the premolars, canines and second molars are developing, then sometimes these teeth are the only ones affected.16 Excessive fluoride intake from birth results in fluorosis in all the teeth (see Table 1).


Hardy Limeback and Heather Gengerich, Recognition and Management of Fluoride Toxicity.

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