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References

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Severe fluorosis treated by microabrasion and composite veneers

From Volume 44, Issue 2, February 2017 | Pages 93-98

Authors

Philippa Hoyle

BChD(Hons), MJDF RCS(Eng), MPros RCS(Ed)

Specialty Registrar in Restorative Dentistry, Department of Restorative Dentistry, Charles Clifford Dental Hospital, 76 Wellesley Road, Sheffield S10 2SZ, UK (philippahoyle1@hotmail.co.uk)

Articles by Philippa Hoyle

Lyndsey Webb

BDS(Hons), MJDF RCS(Eng)

Specialty Registrar in Restorative Dentistry, Leeds Dental Institute

Articles by Lyndsey Webb

Peter Nixon

BChD(Hons), MFDS RCSEd, MDentSci, FDS(Rest Dent), RCSEd

Consultant, Restorative Department, Leeds Dental Institute, The Leeds Teaching Hospitals NHS Trust, Leeds, UK

Articles by Peter Nixon

Abstract

Dental fluorosis results from excessive intake of fluoride either from water resources or products in early childhood. It results in varying degrees of discoloration and pitting of the teeth. This article aims to highlight the conservative management techniques available for managing the aesthetic impact of fluorosis and highlights what can be achieved conservatively with the use of adhesive dentistry.

CPD/Clinical Relevance: Fluorosis can have a huge impact on dental aesthetics, depending on its extent. This in turn can affect a patient's confidence and daily life immensely. In the past, severe fluorosis may have been managed in a more destructive manner with indirect restorations.

Article

Dental fluorosis results from the excessive consumption of fluoride during tooth development. The free fluoride ions disrupt normal enamel mineralization by decreasing the free calcium ion concentrations in the newly mineralized matrix, therefore interfering with the proteases responsible for degrading the matrix proteins during the maturation phase of amelogenesis.1 The retained matrix proteins inhibit crystal growth and result in enamel that is porous and hypomineralized at the time of eruption.1,2 Fluoride has a cumulative effect on enamel formation and its effect depends upon the total fluoride intake, the timing and duration of exposure.1

As the severity of fluorosis increases so does the porosity and fluoride content of the sub-surface enamel, resulting in increased extrinsic staining. Severely affected teeth are more at risk of mechanical surface breakdown. There is a range of fluorosis severity depending upon the extent of porosity.1

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