White Spots: Is it Fluorosis or Demineralization?

This picture shows two kinds of white spots. Some of these white patches are likely the result of exposure to too much fluoride as the patient’s teeth were developing. Fluorosis, as this is called, is a condition where cells that form enamel, die. Studies show this damage can occur in young children (under the age of 4) who drink liquids with too much fluoride in them. One culprit that creates this mottling is formula milk, which often has varying quantities of fluoride in the powder. When this powder is mixed with fluoridated water, the concentration can be sufficient to result in mottling in the adult teeth (that are forming in the infant’s jaws and the damage will not be known until these teeth erupt around age 7 or 8).

Adults do not develop fluorosis mottling – it only occurs in children before the age of 4 and it is the result of ingesting too much fluoride in these early years. There is little that can be done to take away mottled patterns. Keep teeth white, shiny and healthy is probably the best recommendation.

White patches that develop after teeth have erupted most likely indicates damage or demineralization. This is the loss of minerals from the tooth surface and it should send an urgent warning message. Sometimes these patches are under braces and are noticed when the wires or appliances are removed (leaving scars). These damaged teeth are soft and need therapies to rebuild and repair as quickly as possible. Never try to bleach these marks away with peroxide or other whitening products (which are often acidic and will weaken the tooth more). The color may even out at first but the tooth will be more damaged, often sensitive and may even die. (see “The Dark Side of Whitening” for more info on why whitening is so damaging).

Bleaching may seem like a “quick fix” but your teeth can end up with worse staining in the future, sensitivity and even gum recession. The best approach to stop, prevent or reverse white spots is to use the system of xylitol and rinses that I recommend. As teeth get stronger the mottled color will be less noticeable.

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For more information, please visit all of Dr. Ellie’s web-sites:

Dr. E Oral Health Coaching – articles, resources and videos to help you learn more
Zellies.com – learn more & order your Zellies Xylitol & the Complete Mouth Care System
Dr. Ellie.com – a great resource for learning more about oral health & Dr. Ellie

Join the conversation online on the Zellies Facebook page!

17 thoughts on “White Spots: Is it Fluorosis or Demineralization?

  1. I have been grinding my teeth at night since I was a child (I’m now 28) and have a custom-made mouth guard. But now my bottom teeth are substantially wearing down from rubbing against the mouth guard in the night! So I’ve stopped using it for a few days while I try to strengthen my teeth with your system. But now I have white spots on my front teeth whenever I wake up. Is that because I no longer wear the guard to keep the teeth moist? I do breathe through my mouth a lot at night. Or could it be from the grinding? The spots disappear as the day goes on, but I’m perturbed as to what my plan of action should be. Please let me know what you think. Thank you for your time! 🙂

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    1. I can assure you that a few days using this amazing system is not enough to reverse a lifetime of damage. It sounds as if you have had a lot of acidic damage ( since acidic damage is the reason that teeth wear down). Make sure you keep drinks to mealtimes – even diet drinks and flavored waters are acidic. Mouth breathing has obviously contributed to dental problems – and I’d like to help rescue your teeth! Zellies mints and gum during the day will ensure you balance acidity from meals and snacks etc.

      The system of care we recommend is the perfect start and end to your day ( providing you are using the correct products with the correct method.) If you are doing the Zellies Complete Mouth Care System, mouth breathing will no longer be a problem – because a dry mouth actually enhances the system’s benefits ( with or without your night guard). A little of the final rinse will dry on your teeth and continue to protect them during the night. This way, you get even more help than occurs in a “wet” mouth.

      I’d suggest you carefully check the products you have purchased against the toothpaste ( it’s vital to use the Crest Cavity Protection) and the rinses we show in photographs on our website. Some people order a kit to ensure they get started with the correct products. We have a lot of advice on our blog and websites – and I am personally happy to help you by phone ( a half-hour consultation is available). It sounds as if your damage is reversible – but don’t delay – sometimes deterioration happens quickly.

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    1. Basically if your teeth erupted with white-spots in them, it is probably fluorosis – and these marks will not go away without “surgery” to cut them out of the tooth and replace the spot with a filling or veneer ( if this is your choice). White spots on the other hand develop or “happen” as the result of acidic damage to the tooth surface. As enamel becomes weaker below the surface, light reflects differently off the tooth. The system I recommend – Zellies and the Complete Mouth Care System – will put minerals back into the tooth and the white spots should disappear in 8-12 weeks. If you are not sure which you have, it makes sense to treat them as white spots. Your teeth will end up shinier and cleaner and (if yours were white spots) – they will disappear.
      Here is a link to the blog post about this:

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  2. hello,

    i just realize a very faint white spot on one of my front tooth. i want to reverse this before it gets any ‘whiter’. will the use of zellies reverse this? should i use a high flouride toothpaste?

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    1. Dentists are famous for recommending strong fluoride toothpastes, and some studies show they have benefits over certain toothpastes BUT NOT over the system that I recommend!

      Crest Cavity Protection toothpaste is the only paste that was every properly tested with randomized clinical trials and shown to rebuild teeth. When you additionally rinse with ACT mouth wash after using Crest, you increase the value of the toothpaste 7-12 times. We also know that an acidified, alcohol containing rinse ( like Listerine)used before the ACT can increase the uptake of minerals into the tooth to strengthen and rebuild the enamel.
      So…..what does all this mean? I’d suggest in a couple of weeks that this spot will be gone, but you need to:

      1.) Use the system exactly as described with ALL the correct products
      2.) Limit acidic and sugary foods to mealtimes
      3.) End every meal with Zellies mints or gum!

      You may want to take some photos – so you can compare – maybe a photo each Friday for a month! Please let us know the outcome! Ellie

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  3. Hello dr! My teeth erupted with white spots in them, could it be caries? My dentist told me it isn’t caries but flourosis. What do you think it could be? And what are the possible treatments for me? Btw I’m 14 years old. I think these white spots first appeared when I was 10-11 years old .May God bless you and have a nice day 🙂

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    1. White spots on adult teeth may be demineralized or weak areas ( about to be caries) or they could be fluorosis that developed when your teeth were growing in the first years of life ( fluorosis happens between ages 1-3 but affects the adult teeth that are mineralizing at that time.) In either case, I’d suggest you use a good toothpaste (Crest Cavity Protection) and also a dilute fluoride mouth wash – ( ACT 0.05% fluoride is my suggestion). Zellies gum and mints are also helpful. Try this for a few months and look to see if they are getting better. You may want to keep a photo journal.

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  4. Thank you! Does the white spots(flourosis) become bigger? Is it possible to have carries and fluorosis at the same time? What to do if that’s the case?

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    1. And my dentist also told me that 1/4 of my enamel is already gone,if I use mouthwash will it not harm my teeth? And if I don’t eat sweets will my caries not continue to decay? Thanks for helping me , I’m really scared that I will lose my teeth at a very young age 😦

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  5. Hi Dr Ellie,
    One question I have always had about Fluoride mouthwash is – after I spit, am I supposed to leave it on my teeth for thirty minutes without rinsing out my mouth? Or, can I rinse with water and simply avoid food and drink for thirty minutes? When I leave it without rinsing, it makes my throat feel very dry and uncomfortable and I really don’t like the feeling.

    Thanks,
    James

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    1. Thanks for the question. I guess my first thought is to ensure you have the correct ACT rinse? Avoid the more expensive Total Care version – which contains alcohol – I suggest the plain 18oz version called ACT mouth wash.
      When you rinse with ACT you create a molecular charge on the tooth surface – a charge that attracts minerals from saliva to go into teeth. If you rinse with water (after the ACT)you will remove this. I suggest you have a good spit – but if you really do not like the sensation in your throat – finish with a Zellie’s mint. This Zellie’s mint will stimulate a flow of saliva to “wash” the taste away. Saliva is super-saturated with minerals and these will be an immediate benefit to your teeth- to remineralize them.

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  6. Hi Dr Ellie,
    I have just started to use the Complete Care System as I want to protect my teeth as I get older. I have noticed though that my teeth actually now feel a bit sensitive whereas I’ve never really had any trouble with sensitivity before. Is it a case of things getting worse before they get better?
    Regards,
    Mary

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    1. Sensitivity is usually an indication your mouth is not well balanced. The Complete Mouth Care System is a part of the picture -so you may want to assess 1) how often you are using Zellies 2) how often your mouth is acidic and 3)your diet and the possible need for digestive probiotics (if you have any dietary sensitivities or allergies). My website has details of the basic and more advanced things to consider about the Complete Mouth Care system ( please ensure you have the EXACT toothpaste, the EXACT ACT mouth rinse and do not use water between the steps.) LINK

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  7. Hi, Dr. Ellie. Thank you for all that you do! I’m in my 30s and just got my braces of 4.5 years off today (yay!). Unfortunately my two front teeth have spots that look transparent at the bottom of the teeth, and I also have some white spots that formed on my lower back teeth. I just ordered your system last night. Will it help with the transparency as well?

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    1. Transparency means you have lost minerals from your enamel. Replacing minerals into your enamel requires a few combined strategies. You have to limit acidic damage (so DON’T whiten your teeth or use peroxide). Keep drinking drinks to mealtimes – and ensure you stop sipping anything for several hours, especially after lunch. YOUR saliva is the liquid that contains the minerals needed for your teeth. My system helps prepare teeth to accept these minerals, but it is YOUR SALIVA that does the work. Drinking water will dilute saliva and mid-afternoon is the most mineral dense time for saliva. Ensure you stop drinking or sipping water in the afternoon and lick your teeth to coat them with your saliva, as often as you can. What you eat affects the health of saliva. Eat plenty of veggies at meals and use a tiny bit of butter to help you absorb the fat-soluble vitamins that are so essential for dental health.

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