Dental fluorosis is a change in tooth enamel caused by taking in too much fluoride while teeth are still forming, mostly before age 8. It's the one side effect of fluoride that health authorities openly acknowledge at Australian exposure levels.
What it looks like
Most cases are faint white lines, flecks or patches that are hard to notice. More severe fluorosis, which is rare in Australia, causes brown staining and pitting of the enamel.
How common is it in Australia?
- The National Child Oral Health Study 2012-14 examined 24,664 children aged 5 to 14. About 1 in 6 had some fluorosis.
- Just under 1% had more noticeable fluorosis.
- The study found no long-term negative effect on children's oral-health quality of life.
- In South Australian studies, fluorosis prevalence fell from 34.7% to 22.1% after children's toothpaste guidance changed.
What causes it
Victoria's health department says the biggest risk factor is young children swallowing toothpaste, not drinking water. Infants fed only formula made with fluoridated water can exceed the recommended upper intake, which FSANZ judged in 2009 was not a health risk. Fluorosis has fallen significantly since 1990, mainly because of low-fluoride children's toothpaste.
How to reduce the risk
- No toothpaste before 18 months unless a dentist advises it.
- From 18 months to 5 years, a pea-sized amount of low-fluoride children's toothpaste.
- Teach kids to spit, not swallow.
- Fluoride mouth rinse only from age 6.
- Australian guidelines do not recommend fluoride tablets or drops.
Can it be fixed?
Fluorosis is permanent but doesn't get worse after teeth have formed. Mild cases often fade from view. Dentists can treat more visible marks with micro-abrasion, whitening or veneers.