Fluoride strengthens tooth enamel and reduces cavities, according to the American Dental Association, which is why it's in our toothpaste and our drinking water. If children receive too much fluoride when their teeth are forming below the gums, however, it can cause fluorosis. The American Academy of Pediatric Dentistry says most fluorosis cases are mild, causing nothing more than slight white streaks, but severe cases produce discoloured, pitted enamel. Another, rarer form, skeletal fluorosis, results when our bones absorb a high excess of fluoride. That can cause pain, as well as stiffness as our ligaments calcify and harden.
Ask your dentist about your child's teeth. Fluorosis isn't the only problem that can discolour enamel: Development defects, problems with the bones of the head or face, tooth injuries and fever can also discolour teeth, so learn the real problem before going further.
Figure out the source of the fluorosis with your dentist's help. Common causes are children taking fluoride supplements on top of fluoridated toothpaste and water. Sometimes kids simply like the taste of toothpaste so much they use lots of it and swallow it.
Talk to your doctor if you're worried about skeletal fluorosis, which affects adults, not children. It's rare in America, but can be diagnosed through bone biopsies and X-rays.
Cut back your child's fluoride intake to reduce fluorosis' effect on teeth that haven't grown out yet. Research how much fluoride is in her bottled water, soft drinks and tap water, and reduce the amount she drinks or switch brands if need be. If your child is taking a fluoride supplement, ask the dentist if he really needs it.
Teach your child to only use a pea-sized dollop of toothpaste when brushing and to spit it out as soon as he's finished, without swallowing it. The Colgate company says this may be enough to reduce fluoride intake and protect the later teeth from fluorosis.
Improve the appearance of your child's teeth by standard whitening treatments. Once the teeth have grown out, fluoride can't be removed from the enamel, but whitening---or in severe cases, bonding or other treatments---can cover it up and keep your child's smile attractive.
Ask your doctor about treatments for skeletal fluorosis. Neurologist Dr. Raja Reddy says surgery may be useful in some cases, but not all. Reddy says treatment with fluoride absorbing compounds may help reduce fluorosis, but a lot more research is needed.
Fluoride can't be removed from the enamel, so preventing fluorosis before it starts is the best solution. Talk to your child's dentist about their fluoride intake before it becomes a problem.
Fluoride is important for protecting teeth from cavities. The slight risk of fluorosis does not mean your child should avoid fluoride completely.