Fluorosis stains on my son’s teeth

January 30, 2010 – 6:12 pm

I have a question about my 9 year old son’s teeth. He has severe fluorosis stains on his permanent teeth (the central and lateral incisors on both top and bottom), and our dentist doesn’t seem very concerned about this. My son is in braces already, even though his 12 year molars are not in, because he is so self-conscious about his teeth. The braces will straighten his teeth, but we need to figure out what to do about the blotches and stains. They look terrible, like the teeth of an 80 year old chronic smoker. What would be your recommendation?

Thanks,
Alice in Cedar Rapids

Dear Alice,

I think the first thing you must think about is seeking the advice of a different dentist. If you feel that your current dentist is not very concerned about the appearance of your child’s teeth, then he is not the one you want helping you deal with severe fluorosis stains. You need to seek the services of an expert cosmetic dentist.

The stains you describe do indeed sound like fluorosis stains, which indicates that your son consumed too much fluoride while his teeth were still forming. This could have been from the public water supply, or even from habitual swallowing of fluoridated toothpaste. If fluorosis is the source of the staining, then merely bleaching his teeth is not an alternative. The procedure is safe for children, but it will not remove the stains. Mild fluorosis stains can be addressed with direct bonding to cover the blotches and stains, but more severe stains will require porcelain veneers.

This problem is beyond your family dentist, especially if he seems indifferent to the self-esteem issues your son is experiencing with his teeth. You want the services of an experienced and talented cosmetic dentist, one who is sensitive to your son’s embarrassment about his teeth.

In terms of timing, the braces will have to come off first. When your son’s orthodontic treatment is complete, it could be possible that his front teeth may still not have fully erupted, so your cosmetic dentist may advise you to consider a direct bonding procedure as a temporary solution before placing porcelain veneers.