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Fluorosis
Last reviewed: 05.07.2025
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Fluorosis develops due to excessive accumulation of fluorine in the body. There are two types of the disease - endemic and professional.
Endemic fluorosis can be found in regions where the maximum permissible level of fluoride in drinking water is exceeded.
Occupational fluorosis develops in people who work in industries where the level of fluorine in the air exceeds permissible values.
Children are the first to suffer from elevated fluoride levels in water, as their skeletons and molars are actively forming.
Causes of fluorosis
Fluorosis develops from the constant intake of fluorine compounds into the human body.
Normally, fluorine should not exceed 1 mg/l of water; with higher values and regular consumption of such water, a person will inevitably develop this disease over time. Fluorosis initially affects the teeth, and then the skeletal system.
Children under 4 years of age suffer the most from the increased content in water, which causes improper formation of tooth enamel and the appearance of pigment spots on it.
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Symptoms of fluorosis
Fluorosis has several forms and the symptoms differ in each case.
In the case of a line form, only a specialist can determine the signs of fluorosis.
In other forms, a person can understand the development of fluorosis on their own - pigment spots or small erosive lesions appear on the teeth.
A characteristic symptom of the disease is pigmentation of the enamel; over time, tooth enamel becomes brittle and wears down almost to the gums.
Fluorosis in children
Fluorosis in children develops during the growth of permanent teeth. Children aged 6 to 12 years who have a weak immune system and who were bottle-fed are most susceptible to the disease.
The disease can be recognized in a child by the appearance of yellow-brown spots on the teeth. The upper incisors and premolars are most susceptible to fluorosis; the disease usually rarely develops on the lower row of teeth.
Fluorosis of primary teeth
Fluorosis of baby teeth, even with high risk factors, does not develop in all children. The disease is susceptible to children with a weakened immune system, after serious illnesses, as well as children who do not receive breast milk and consume products with a high fluoride content.
Fluorosis usually affects permanent teeth, but in rare cases the disease can also affect baby teeth.
When the first signs of the disease appear, it is necessary to change the source of drinking water, and you should also carefully select complementary foods.
The diet of a child with fluorosis should include foods rich in proteins, vitamins (especially C, D, and B), phosphorus, and calcium.
It is necessary to completely remove strong tea, ghee, fatty meats, sea fish and other products containing fluoride from the children’s menu.
To clean your child's teeth, you need to choose a toothpaste that does not contain fluoride; it is better to use a toothpaste with calcium glycerophosphate.
Forms of fluorosis
Fluorosis comes in several forms:
- stroke (the front teeth are affected, signs of the disease at this stage of the disease development are almost impossible to see on your own)
- spotted (chalky spots of light yellow or white color affect the front teeth, at this stage the signs of the disease can be seen without additional equipment)
- chalky-speckled (all teeth in the oral cavity are affected, the enamel is affected by pigment spots of various shades)
- erosive (the surface of the teeth is affected by erosions, fluorosis in this case develops rapidly)
- destructive (the most dangerous form of the disease, at this stage the destruction and abrasion of tooth enamel occurs).
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Dental fluorosis
Dental fluorosis is a chronic disease in which the accumulation of large amounts of fluoride in the body causes slow destruction of tooth enamel and then bones. The causes of fluorosis remained a mystery to specialists for a long time, but in the mid-19th century it was discovered that "speckled" teeth appear due to high levels of fluoride in drinking water.
Today it is already known that systematic intake of fluoride into the body over a long period of time leads to the development of fluorosis.
Enamel fluorosis
Enamel fluorosis develops as a result of fluoride entering the body over a long period of time (with water or through breathing). A large amount of fluoride in the body disrupts the integrity of tooth enamel and leads to its destruction.
Fluorosis can be mild, when whitish, almost invisible spots appear on the tooth enamel. In more serious forms of the disease, the color of the teeth may change, brown spots may appear on the enamel, it becomes rough, and it becomes difficult to brush your teeth.
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Bone fluorosis
Bone fluorosis is also known as cryolite disease.
The disease develops due to fluoride poisoning, which has been penetrating the body for a long time. The cause of bone fluorosis is the use of water or products with a high level of fluoride, inhalation of air containing high concentrations of fluoride compounds.
Most often, the disease occurs in people who work with fluorides for a long time.
When ingested, fluoride dissolves and enters the bloodstream, followed by the deposition of hydrofluoric acid in the skeletal system and teeth.
As a result, gradual sclerosis of the bones begins.
At the beginning of the disease, a person complains of some stiffness in movements, slight pain in the spine or joints. At the last stage of the disease, movements are given to a person with great difficulty.
At an early stage, changes in tooth enamel can be detected in the form of spots, darkening, and high fluoride content in the urine.
In case of fluorosis, during an X-ray examination, osteosclerosis is detected in the pelvic bones, vertebrae, ribs, and tubular bones.
If the disease is detected, it is necessary to stop any contact with fluorides, stop drinking water or food contaminated with fluoride, and prescribe symptomatic treatment.
Endemic fluorosis
Endemic fluorosis develops due to the constant intake of fluoride into the body with food or water.
Fluorine is one of the most active components of the halogen group and is a part of more than a hundred minerals. The earth's crust contains 0.1% fluorine, mineral fertilizers, fluorine-containing emissions from industrial production significantly increase the natural level of fluorine in the soil.
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Occupational fluorosis
Professional fluorosis develops in workers who are forced to work with fluorides and inhale fluoride vapors. The disease develops gradually, over time fluorine forms chemical bonds with enzymes and inhibits their activity, which ultimately leads to disruption of many organs and systems.
When fluoride is inhaled, the mucous membranes atrophy, resulting in chronic rhinitis and inflammatory processes in the nasopharynx and bronchi.
High concentrations of fluoride in the air can cause bleeding and provoke changes in internal organs.
Fluoride can accumulate in bones, which disrupts their structure, leads to pigmentation of tooth enamel, and makes it brittle.
Spotted form of fluorosis
Fluorosis in the spotted form is characterized by the appearance of whitish spots on the tooth enamel, which are easily visible to the naked eye. The spots have a shiny smooth surface, with unclear borders, several small spots can merge into a large spot.
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Treatment of fluorosis
There is currently no specific treatment plan for this disease. Fluorosis is mainly treated by eliminating cosmetic defects in tooth enamel. Active preventive measures are also taken to prevent further fluoride from entering the body.
If fluorosis is detected, treatment should be started immediately, since over time, as the disease progresses, dental restoration will be required.
At the initial stages of the disease, the doctor may recommend whitening and remineralization of enamel. The doctor may also prescribe additional calcium and phosphorus.
Erosive or destructive fluorosis requires a different approach to treatment; standard bleaching is not enough in this case. After remineralization, the dentist can restore the natural appearance of the tooth with a crown.
Both during and after treatment, it is necessary to reduce the intake of fluoride into the body. The diet should include more dairy products, vegetables, fruits, drink bottled water (if the level of fluoride in drinking water is high), take calcium and a vitamin complex.
Fluorosis is associated with high levels of fluoride in the body, so it is important to choose a toothpaste that does not contain fluoride. It is better to use a special remineralizing toothpaste.
Treatment of fluorosis at home
To prevent further development of fluorosis, it is necessary to limit the intake of fluoride into the body. To do this, you should use filtered water, pay attention to your diet, and also refuse fluoride-containing toothpastes.
You need to exclude walnuts, sea fish, strong tea, fatty meats, spinach from your menu and include in your diet foods that contain calcium and phosphorus salts (legumes, berries, greens, eggs, buckwheat, dairy products, pumpkin seeds, chicken, etc.).
To prevent fluorosis from damaging tooth enamel, you can take calcium, as well as vitamins A, B, C, P.
Whitening for fluorosis
Fluorosis can be prevented by changing your diet, taking additional vitamins and minerals, which you can do yourself at home. Baking soda can help whiten darkening of the enamel.
To do this, before brushing your teeth, dip your toothbrush in a saturated soda solution or mix toothpaste with soda. It is worth noting that you can brush your teeth with soda no more than once a week, otherwise the soda will further destroy the enamel and damage the gums.
Hydrogen peroxide also helps with fluorosis; you can wipe your teeth with it after brushing (afterwards, be sure to rinse your mouth with clean water).
This method also cannot be used too often.
Toothpaste for fluorosis
Fluorosis can be caused by toothpaste that contains increased amounts of fluoride, especially if the body is weakened by disease.
When choosing toothpaste, you should pay attention to its composition. It is better to give preference to pastes that contain calcium glycerophosphate, this is especially worth considering when choosing children's toothpaste.
Prevention of fluorosis
Fluorosis can develop at any age, so it is recommended to follow several recommendations that will help avoid the development of this disease.
First of all, you need to take into account the intake of fluoride into the body and try to reduce it as much as possible.
To do this, you should check the fluoride level in your drinking water (if it is too high, you should stop drinking such water or use filters), and it is also not recommended to cook food with such water.
1-2 times a year you need to take calcium and other microelement supplements (it is better to consult with your dentist about the duration and frequency of intake).
It is also recommended to eat more vegetables and fruits.
Fluorosis prognosis
Fluorosis is a rather dangerous disease, but if treatment is started in the early stages, when the enamel is not very damaged, the prognosis will be favorable.
In advanced stages of the disease, it is difficult to treat, but if you follow all the specialist’s recommendations, you can significantly reduce the negative effects of excessive fluoride accumulation in the body.
Fluorosis usually develops in areas where drinking water contains large amounts of fluoride. The disease affects both men and women, and children, whose immune system is not yet strong enough, are especially susceptible to developing fluorosis.
Cost of fluorosis treatment
Fluorosis, depending on its form, may require bleaching, remineralization or restoration.
At the initial stages, when the enamel has not undergone significant changes, the doctor can use laser, chemical or LED whitening (1500-2500 UAH) with subsequent remineralization.
During remineralization, the dentist applies calcium or phosphorus compounds to the tooth enamel using application, electrophoresis, or ultraphonophoresis (a minimum of 10 procedures are required, one procedure costs an average of 250 UAH).
In case of severe damage to tooth enamel, restoration is required, in which case the doctor may recommend veneers or lumineers (3-5 thousand hryvnia).
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