Summary
Fluoride is often talked about as our ally against tooth decay. But be careful, too much of it can cause a little-known problem: fluorosis . What are the symptoms, the causes, and most importantly, how can we avoid it? Let's explore this together!
⚠️ This article is for informational purposes only and does not replace professional medical or dental advice.
What is fluorosis?
According to a 2019 article published by France info, dental fluorosis affects 2% of children in France, which is fortunately quite rare. Fluorosis is a condition that occurs when we are exposed to an excessive dose of fluoride , this mineral which is essential for the good health of our teeth. When consumed in excessive quantities, especially during the years of tooth development or over the long term in adults, fluoride can cause visible or invisible problems, depending on the tissues affected.
There are two main forms of fluorosis:
👉 Dental fluorosis , which affects the tooth,
👉 And skeletal fluorosis , which affects bones and joints.
To fully understand the differences, there's nothing better than a summary table.👇
| CRITERIA | DENTAL FLUOROSIS | BONE FLUOROSIS |
| Touched fabric | Tooth enamel | Bones and joints |
| Main cause | Excess fluoride during dental training | Prolonged exposure to high doses of fluoride |
| Visible symptoms | White or brown spots, chalky appearance | Joint pain, stiffness, fragility |
| Population at risk | Child < 8 years old | Adults exposed over the long term |
| Gravity | Aesthetic, rarely functional | Functional, sometimes disabling |
Depending on the intensity and duration of exposure to fluoride, there are two other types of fluorosis:
Acute fluorosis : This occurs suddenly after ingesting too much fluoride (such as when a child swallows a lot of toothpaste). Symptoms can include nausea, vomiting, stomach pain, and sometimes neurological problems. This is a condition that requires prompt medical attention .
- Chronic fluorosis : This is the most common form. It develops gradually after repeated exposure to high levels of fluoride, often through drinking water, fluoride supplements, or certain age-inappropriate toothpastes. It can affect teeth or bones, depending on age and duration of exposure.
What are the symptoms of fluorosis?
Signs of fluorosis vary depending on the type (dental or bone), the person's age, and their exposure to fluoride. Some forms go almost unnoticed, while others can seriously impact quality of life.
Dental fluorosis
Dental fluorosis is often noticeable to the naked eye, especially if it is moderate or severe. It is not painful and does not usually affect tooth function, but it can be a minor cosmetic concern. Here are the most common signs:
Irregular white spots on the tooth (a bit like frost or chalk)
Brownish discolorations and/or spots in more advanced cases
Rough or porous enamel , sometimes with a mottled appearance
💡 Note : Fluorosis affects teeth that are still developing, so it doesn't appear on teeth that have already erupted. The most affected teeth are often the upper incisors, which are visible as soon as you smile.
Bone fluorosis
Skeletal fluorosis is relatively rare in Europe, but it can occur in some parts of the world where the water is naturally rich in fluoride, such as India, Africa, or China.
The main symptoms to watch out for are:
Persistent joint pain 🦵
Stiffness in movements
Fragile bones, which increases the risk of fractures
In more serious cases: bone deformities or neurological problems
It can be confused with other diseases such as osteoarthritis or osteoporosis. It is therefore crucial to take into account prolonged exposure to fluoride, particularly through water.
Conclusion : Dental fluorosis is the most common, often benign but visible. Skeletal fluorosis, although rarer, can have more serious impacts on overall health.
What causes fluorosis?
Fluorosis is caused by excessive exposure to fluoride over a long period of time. Don't worry, it's not the fluoride itself that's dangerous for teeth , but rather its overconsumption, especially in children.
It can come from several sources:
Drinking water too rich in fluoride,
Fluoride toothpaste swallowed regularly, especially by children,
Fluoride supplements incorrectly dosed or taken without real need.
As UFSBD indicates , for children under 8 years old, teeth are still forming, and this is when excess fluoride can disrupt enamel mineralization. This can result in white or brown spots on the surface of a tooth, sometimes visible as soon as the permanent teeth appear.
In adults, bone fluorosis may occur, but only in cases of prolonged exposure to high doses of fluoride (contaminated water, professional environment, excessive consumption of black tea, etc.).
👉 The risk usually doesn't come from a single source, but rather from the accumulation of small doses of fluoride on a daily basis .
How is fluorosis diagnosed?
To know if someone has fluorosis, it depends on whether it is dental or bone.
For dental fluorosis , a simple appointment with the dentist is generally sufficient. He or she will observe the appearance of your tooth enamel (looking for white, brown, or chalky spots on the surface of the teeth) and take into account your age, medical history, and exposure to fluoride (such as water, toothpaste, or supplements). The spots present are often symmetrical and not painful, which helps distinguish them from cavities.
For bone fluorosis , it's a little more complicated: you need medical examinations, blood and urine tests (to measure fluoride), and above all, you need to understand the context of exposure (such as where you live, where you work, or what water you consume).
👉 You should therefore consult your dentist:
If you notice suspicious stains on the surface of your child's tooth,
Or if you experience unexplained joint pain in the context of overexposure to fluoride.
What treatments are there for fluorosis?
Treatment varies depending on the type of fluorosis, its severity, and its aesthetic or functional impact. In all cases, the goal is to reduce visible or painful effects and prevent further excessive fluoride exposure.
In case of dental fluorosis
If the fluorosis is mild, don't panic, no medical treatment is necessary: the teeth remain strong, even if their appearance is slightly altered.
But if aesthetics bother you, several options are available to you :
Teeth whitening (only at the dentist, never at home)
Resin infiltration to mask white spots
Veneers or crowns for more severe cases, when the enamel surface is very damaged.
These treatments aim to beautify your smile without compromising the health of your teeth.
In case of bone fluorosis
The first step is to stop exposure to fluoride (water, food, professional environment).
Then, the treatment is mainly medical and symptomatic:
Regular monitoring by a doctor,
Treatment of pain and stiffness (analgesics, physiotherapy if necessary),
In severe cases, specialist care (rheumatologist).
Bone fluorosis requires continuous monitoring, especially if the bones are fragile.
Can fluorosis be prevented?
Yes, absolutely, it can be prevented, especially the dental form in children. You just need to use the right amount of fluoride , neither too much nor too little. Here are some tips to follow.
Choose an age-appropriate toothpaste : Before the age of 6, choose a toothpaste with a low dose of fluoride (500 to 1000 ppm maximum) and teach your child not to swallow it. A very small amount is enough, like a grain of rice before the age of 3, then a pea-sized amount after that.
Check the fluoride content of your water: in some regions or for bottled water, the level may be high. If you have any doubts, don't hesitate to ask your dentist or pediatrician for advice.
Avoid unnecessary fluoride supplements : Unless recommended by a doctor, they are often not necessary if your child already uses fluoride toothpaste.
Visit your dentist regularly : as soon as your first teeth appear, then once or twice a year. Your dentist will be able to detect early signs of fluorosis and adjust your hygiene recommendations.
💡 In summary : fluoride is a great ally against cavities ... provided you use it in the right doses, especially during childhood.
Conclusion
When used correctly, fluoride is a powerful ally for our teeth . But as always in health, it's a question of balance! By knowing the right actions and the signs to watch for, we can easily avoid fluorosis and maintain good oral health. And above all, always remember to consult your dentist if you have any doubts!
Frequently Asked Questions (FAQ)
Is fluorosis reversible?
Unfortunately, no. Once the enamel has formed, fluorosis cannot disappear. But don't worry, you can improve its appearance with cosmetic treatments!
How to remove stains naturally?
There's no miracle home remedy. Some products, like lemon, can even damage enamel. It's best to consult a dentist for appropriate treatment.
What are the side effects of fluoride?
In normal doses, it protects your teeth. But in excess, it can cause stains or long-term bone pain. Take care!
