Treating Fluorosis with Porcelain Veneers and Dental Crowns

Fluorosis is a side effect of exposure to too much fluoride. Fluoride in municipal water is usually not enough to cause more than minor cosmetic problems–fluorosis is more often related to swallowing toothpaste or overuse of other fluoride products. The most serious cases of fluorosis are usually related to the use of natural water sources (such as wells) that contain high levels of fluoride.

The best treatment for your fluorosis depends on the severity of the condition, but porcelain veneers are often the best treatment for cosmetic improvement. Porcelain crowns may be favored if there is structural damage to the tooth.

Fluorosis Causes and Grades

Getting too much fluoride causes fluorosis. Fluoride is a catalyst for tooth enamel formation, so it’s valuable for tooth formation and protecting teeth from decay. But too much fluoride can cause the mineral part of tooth enamel to form at a faster rate, faster than the other components of enamel, leading to defects.

Veneers and crowns can treat fluorosis

Actual patient of Dr. Scott Young

There are two different commonly used scales for fluorosis. The scales overlap in their setup, but Dean’s index, published in 1942 is the simpler version:

  • Grade 0: Teeth look normal
  • Grade 1: Small white flecks on the teeth that lead to suspicion of fluorosis
  • Grade 2: Less than 25% of the tooth is covered by small opaque areas, and these areas don’t involve the tooth cusps
  • Grade 3: Less than 50% of tooth area is affected by opaque white areas
  • Grade 4: The surface of the tooth is fully covered by whiteness and/or brown discoloration. The tooth is beginning to show accelerated wear.
  • Grade 5: Darkly stained teeth that are deeply pitted with wear and decay.

The other scale is the TF index, which expands the grades to a 0-9 scale, but is substantially similar.

Grade 1 and 2 Fluorosis May Respond to Whitening

With minor cosmetic fluorosis, we may recommend teeth whitening. Teeth whitening can help the white regions blend in better with the rest of the tooth. This is a bit uncertain, because the fluorotic regions will whiten, too, which may even make them stand out more. But they will fade faster than your healthy enamel, and the net effect is that the white lesions will blend in most of the time. When attempting to treat fluorosis, we want to make sure your teeth get as white as possible, so we’ll use deep tooth bleaching.

Other times, it might be better to buff out some of these lesions. They are often very superficial, so they can be removed without significant damage to the teeth.

Grade 2, 3, and 4 Fluorosis: Veneers Work Great

With more serious fluorosis, whitening and buffing the lesions may not be enough to blend them with your healthy tooth enamel. Porcelain veneers can be used to cover the fronts of teeth to give them a more cosmetic appearance. Your teeth will look beautiful and healthy with no sign of fluorosis.

Grade 4 and 5 Fluorosis May Require Crowns

With very serious fluorosis, the problem is more than cosmetic. The enamel is so structurally weakened that it is highly vulnerable to decay or erosion. In that case, we’ll need to protect your teeth from damage using porcelain dental crowns. This will also improve the appearance of your smile

You Can Have a Beautiful Smile

If you are unhappy with the effects of fluorosis on your smile, we can help. Please call (281) 367-5559 today for an appointment with Woodlands cosmetic dentist Dr. Scott Young, Purveyor of Fine Dentistry.