What are the best treatment options available for severe dental fluorosis?

Doctor's Answers 1

The areas of white flecks and brown lines are most likely due to microscopic subsurface porosities caused by abnormalities during enamel formation. These abnormalities can be caused by fluorosis, previous trauma (to the baby tooth) or fetal malnutrition. In severe cases, the discolouration is accompanied by abnormal enamel surface texture known as hypoplasia (pitting or small holes, grooves).

There are 3 methods to even out the colour of your teeth that have been affected by fluorosis.

1) Bleaching ($500-1200)

The least invasive method. This will brighten the background colour and can help lighten some of the brown stains. The white flecks will still be present but will not contrast as much when the background colour has been lightened.

Bleaching requires periodic top ups for the effect to be maintained. Enamel hypoplasia is not affected by bleaching.

Bleaching can be used in preparation for resin infiltration or veneers.

2) Resin infiltration (average fee $300-600 per tooth)

Also known as ICON, this infuses a colourless transparent liquid plastic into the porous areas of enamel after surface acid treatment. This fills in the microscopic porosities that are found in the white and brown areas so that light will be able to pass through the enamel surface more evenly. This will make the white flecks disappear into the background of normal enamel.

Some coloured areas may extend deep down below the enamel surface and may not be completely infiltrated. The depth of the lesions can be assessed pre-treatment with transillumination. These deep lesions will not be completely erased with ICON alone.

Sandblasting these resistant lesions after ICON to gently remove the abnormal enamel can be done to remove deeper layers of enamel. This will create a dimple on the tooth surface that can be filled in with a composite (plastic) filling.

Example of a case treated with ICON, sandblasting and composite fillings. L: after treatment, R: before treatment

^ Example of a case treated with ICON, sandblasting and composite fillings. L: after treatment, R: before treatment

Alternatively, you may decide to have these resistant lesions covered up with veneers.

3) Veneers ($1000-2000 per tooth)

A thin plastic/ceramic coating can be applied to the front surface of your teeth to mask discolouration. Most cases require some minor shaving of the enamel surface (less than 0.5mm) to accomodate the veneering material.

This will be suitable for cases that don't respond to bleaching or ICON. The veneers are quite delicate and can chip or break if you bite into hard foods.

Your dentist can help you select the appropriate treatment for your case and give you a good idea of what to expect with the different options. I usually start my patients on the least invasive option before moving up the scale, depending on how their teeth respond.

Similar Questions

Can chewing habits correct an asymmetric jaw?

I fully agree with Dr Lee that chewing on one side will do little to help with the problem. In my experience as an aesthetic physician, it is as Dr Lee said, most of us have mild asymmetries, and almost every case of asymmetry has a mixture of BOTH bony and muscular elements. If the asymmetry is bothering you, I would suggest some botox and fillers first to correct it as a temporary measure. I would refer to my dental or orthodontic colleagues to correct teeth alignment and jaw surgery for better functional outcomes and long-lasting results.

Which doctor performs excision of trauma irritated fibroma in mouth?

Thank you for your question. Oral fibromas are benign growths (consisting of scar tissue) in the mouth that usually appear following repeated trauma (usually from rubbing of your teeth or dentures/braces against the inner lining of your mouth or from accidental lip biting). The inner cheek area (buccal mucosa) would be most common.

Photo of Dr Eng Cern Gan

Answered By

Dr Eng Cern Gan

ENT Doctor

Ask any health question for free

I’m not so sure about a procedure...

Ask Icon Ask a Question

Join Human

Sign up now for a free Human account to get answers from specialists in Singapore.

Sign Up

Get The Pill

Be healthier with our Bite-sized health news straight in your inbox