Etiology • Excessive dietary levels of fluoride: greater than one part per
million in drinking water (can lead to fluorosis in a dosedependent relationship) • Childhood ingestion of fluoride dentifrice on a chronic basis • Tooth enamel hypomaturation resulting from prolonged
ingestion of abnormally high levels of fluoride during tooth development, usually between 2 and 3 years of age
Clinical Presentation • Enamel alterations ranging from local pitting to white opacity
or deeper brown mottling • Distribution is symmetric and bilateral and occurs in all quad-
million in drinking water (can lead to fluorosis in a dosedependent relationship) • Childhood ingestion of fluoride dentifrice on a chronic basis • Tooth enamel hypomaturation resulting from prolonged
ingestion of abnormally high levels of fluoride during tooth development, usually between 2 and 3 years of age
Clinical Presentation • Enamel alterations ranging from local pitting to white opacity
or deeper brown mottling • Distribution is symmetric and bilateral and occurs in all quad-
rants of the jaws.
Diagnosis • Characteristic appearance and distribution • Data concerning fluoride concentration in drinking water
should be obtained.
Differential Diagnosis • Amelogenesis imperfecta • Tetracycline-associated staining
Treatment • Restorative dental treatment • Cosmetic bleaching
Prognosis • Excellent