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

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