Dental Fluorosis – Fact vs Fiction


Medically reviewed by  Dr. Vidhi Bhanushali Kabade BDS, TCC

Last updated Apr 8, 2024

Medically reviewed by  Dr. Vidhi Bhanushali Kabade BDS, TCC

Last updated Apr 8, 2024

You may have seen while travelling in rural India, little children with white spots on their teeth. In some cases, these are yellow stains, lines or pits on the teeth. You probably wondered- why are their teeth like that? Then forgot about it- and focused on your journey that lay ahead. In this post, we see the journey of these little ones and why their mouths look like that.

What is Dental Fluorosis?


Dental fluorosis is a disease that occurs in children below 8 years. If kids below 8 ingest a large amount of fluoride per day- more than 3-8 grams a day- they develop dental fluorosis. Fluoride affects the enamel of the teeth, causing white spots on the teeth. In severe cases, it causes pits, lines and stains on the teeth.

Dental fluorosis does not occur once permanent teeth are formed, i.e., after around 8 years of age.

Cause of Fluorosis

When your child’s milk teeth have erupted, permanent teeth are still being formed inside the gums. Fluoride affects the formation of these teeth, causes white spots, and roughness like lines of pits on the surfaces of the teeth. It also makes tooth enamel brittle. All these are features of dental fluorosis.

The Controversy


Depending on geographic location, places need fluoride added to the water. Fluoride, in small doses, is good for preventing dental decay and is a mainstay in dentistry. Even a 0.5 unit (ppm) difference in a child’s intake of fluoride can markedly decrease the incidence of decay.
Districts like Beed in Maharashtra have too much fluoride in their water that causes fluoride toxicity- dental fluorosis and skeletal fluorosis. In districts like Sonbhadra in Uttar Pradesh, there is very less fluoride in the water, and tooth decay is rampant.

The issue at hand is whether or not one should use fluoride products, such as toothpaste that has been fluoridated and fluoride drops. Many people dislike fluoride as one of the main products in dentistry.

Dental Fluorosis- Fiction


Will using fluoride products cause dental fluorosis?

Absolutely not. The fluoride in fluoridated toothpaste and mouthwashes is a safe amount decided by the authorities. A certain amount of fluoride is beneficial for you and your kids- fluoride helps prevent dental decay. There is no risk of dental fluorosis by just using fluoridated products.

Why, then, do fluoride-free products exist?

Fluoride-free products are largely marketed towards people who have- or are at risk of developing dental fluorosis or skeletal fluorosis. People in certain districts of the country suffer from too much fluoride in their water and don’t need any more in their products! A simple online check can show you fluoride content in water in your area, and then you can decide which products you want to use.

Dental Fluorosis- Facts

When should I be worried about fluorosis?

If you know that the fluoride content in your area is high, stay away from local wells. Use water provided to you by the government that is safe to drink. Simple fluoride testing kits are available that can tell you the fluoride content in your water. Eat calcium-rich foods, these slow down absorption of fluoride in the body. Dental fluorosis can be embarrassing for your child as they grow up, so make sure you know about fluoride water content.

Are fluoride drops and tablets safe?

Yes! Fluoride drops and tablets are meant to give your child the fluoride they need. They markedly reduce the chance of dental decay. However, only give your child dental drops or tablets if you know the water in your area has less fluoride. Otherwise, you risk your child developing fluorosis.

What about fluoride treatments in dentistry?

Fluoride treatments like fluoride sealants are very useful for your child, and also very safe. Fluoride sealants seal the grooves in your teeth that are most at risk of developing decay, and your child doesn’t ingest any product. Treatments are usually done at the age of 6-8 years when the permanent molars have erupted. These treatments include applying fluoride gels that make your child’s teeth even more strong and resistant to acid attack.

Treatment of Dental Fluorosis

The effects of dental fluorosis on the teeth are not reversible. Your dentist will decide the course of treatment depending on the type of fluorosis you have. In mild cases, where there are only a few your dentist can carefully remove the outer layer of enamel that is affected, or suggest fillings of composite. You can also get veneers on your teeth, or caps.

Dental fluorosis is really nothing to be worried about. All you have to do is make sure you know about the fluoride content in your water. Visit your dentist if you are worried about your child developing fluorosis.


  • Dental fluorosis occurs if kids ingest more than a 3-8 grams of fluoride per day
  • Dental fluorosis does not occur once permanent teeth are formed, i.e., after around 8 years of age.
  • Fluoridated products are safe to use- as long as you know how much fluoride your water has.
  • Dental fluorosis may not be reversible, but the mark it leaves is treatable by dentists.
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