What Is Fluorosis?
Dental fluorosis is characterized by tooth discoloration caused by exposure to excessive amounts of fluoride during enamel formation. Fluorosis is seen in people who consumed high levels of fluoride when they were below 8 years old. However, it can also affect children up to 16 years.  
During this period, permanent teeth are still developing. Fluoride is incorporated into the structure of enamel. Little amounts of fluoride are beneficial in preventing caries: it makes the enamel stronger and resistant to tooth decay. 
However, too much fluoride interferes with the mineralization of enamel leading to the discoloration observed in fluorosis. Severe fluorosis can weaken the tooth because of this interference with mineralization. The teeth chip and break easily when exposed to pressure.
Signs and Symptoms of Fluorosis
*  Tooth discoloration. Depending on the severity, the teeth can be chalky white, light brown or dark brown
* The surface of the teeth has pits and grooves
* In severe cases, the teeth are sensitive
* Tooth decay is common in severely affected teeth since the structure of enamel is compromised
* The teeth chip and crack easily especially those with extreme fluorosis 
Sources of Fluoride
We get fluoride from fortified foods, water and fluoridated toothpastes.  
Drinking water that has a fluoride content greater than 1 million per parts increases the risk of getting fluorosis. Water is the most common cause of fluorosis in our country due to the use of borehole water. 
Some rocks in Kenya, especially in the Rift Valley region, have high amounts of fluoride. This makes their underground water more fluoridated. It is advisable to drink water from other sources if you use underground water at your home. Water purification using purifiers is another viable option. 
In rare cases, fluoride dentifrices (pastes and powders used to clean teeth), such as fluoridated toothpaste, cause fluorosis. Some children like the taste of these toothpastes and instead of spitting the toothpaste, they swallow it. Monitor your child as they are brushing their teeth. We recommend that you buy children’s toothpaste which contains just a little amount of fluoride.
Prevention of Dental Fluorosis
The diagnosis of fluorosis occurs after most of the damage has already occured. To prevent dental fluorosis,
* Always ensure that you keep all fluoride containing products out of children’s reach
* Monitor your child as they are brushing their teeth. Make sure they spit the toothpaste instead of swallowing it
* Use children’s toothpaste which contains less amounts of fluoride
* The amount of toothpaste for brushing your child’s teeth should be pea-size
* If you are not certain about the amount of fluoride in your drinking water, you can use water purifiers or defluoridation treatment. Visit us to get advice on this.
Treatment of Fluorosis
Most cases are usually mild and go unnoticed; only a dentist can detect them. 
Severe cases, however, can affect one’s self esteem due to the brown discoloration. There are different treatment options to handle the discoloration:
* Whitening treatment. Bleaching agents can be used in mild cases to make the teeth white. This requires professional help and cannot be done by over the counter whitening product
* Dental crowns. These teeth are like ‘caps’ that are cemented on teeth. Not only do they fix the discoloration problem, but they also support the teeth and prevent chipping and breakage
* Veneers. Veneers are placed on the surface of the teeth and make them appear white. They cover the discoloration. You can select the shade you want on your teeth to make them look as natural as possible
* Enamel microabrasion. This involves removal of small amounts of the affected enamel. The discolorations are less visible and the tooth’s surface becomes smooth.

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