Fluorosis is caused by the ingestion of a level of fluoride that is above the optimum level during the years when the teeth are developing. Fluorosis generally manifests itself as barely discernable white, opaque spots, and is an esthetic concern. Very high levels of fluoride – levels that are sometimes found in naturally fluoridated water – may produce brown or pitted enamel. Since all water contains some levels of fluoride, the EPA sets certain standards for optimum fluoride content. The levels of fluoride may be increased or decreased to meet with the optimum standards for good dental health.

Left: Enamel fluorosis of moderate severity is seen across much of this patient’s dentition.

Right: Mild-to-moderate enamel fluorosis (the whiter areas) is more localized in this patient.