Faint white lines or streaks on a child’s teeth can be dental fluorosis. The American Dental Association (ADA) explains it only happens when young children take in too much fluoride, from any source, over long periods while teeth are forming under the gums. Here is what it means and how to get fluoride’s benefits without too much.
Is fluorosis harmful?
The ADA says fluorosis isn’t a disease and doesn’t affect the health of the teeth. In most cases it’s so subtle only a dentist would notice. The type seen in the United States has no effect on tooth function and may make teeth more resistant to decay. Once teeth come through the gums, fluorosis can no longer develop.
What it looks like
MedlinePlus, from the National Library of Medicine, says too much fluoride before teeth come through the gums can change enamel. Faint white lines or streaks may appear, but they are usually hard to see. It adds that too much fluoride in the diet is very rare.
Where fluoride comes from
MedlinePlus lists these sources:
- fluoridated tap water, found in most community water systems (well water often has too little to prevent decay)
- food prepared with fluoridated water
- most seafood, plus tea and gelatin
- for infants, formula. MedlinePlus says breast milk has very little fluoride.
Toothpaste, rinses and supplements add to the total, and young children may swallow them.
Who can get it
The chance exists until about age 8, the ADA says, because teeth are still forming under the gums. The goal is the right amount of fluoride, not too much and not too little. Your dentist, pediatrician or family doctor can help.
How to prevent it
Under age 3
- When teeth come in, brush twice a day with no more than a smear (rice-grain amount) of fluoride toothpaste, and supervise.
- If your baby is mainly formula-fed, ask your doctor about the best type of formula. MedlinePlus also suggests asking which water to mix into concentrated or powdered formula.
Ages 3 to 8
- For ages 3 to 6, use no more than a pea-sized amount of toothpaste.
- Watch brushing to minimize swallowing. The ADA says many cases can be prevented by keeping children from swallowing fluoride products.
- Don’t use fluoride mouth rinses under age 6 unless a dentist or health professional advises it. Many young children may swallow more than they spit out.
Supplements and water
- Use fluoride supplements only as prescribed. The ADA says they are recommended for children 6 months to 16 years who live in non-fluoridated areas and are at high risk of decay.
- The ADA says public water systems must notify customers if natural fluoride exceeds 2.0 mg/L. Families above that level should consider alternative water or home treatment for young children.
- If you use a private well, the ADA suggests testing fluoride yearly, especially with young children, and sharing results with your dentist and doctor.
When to talk to a dentist
- You see white lines, streaks or spots on your child’s teeth.
- You’re unsure how much fluoride your child gets from water, formula, toothpaste and supplements.
- Your family uses well water or lives where natural fluoride is high.
- You have cosmetic concerns about existing marks.
Why fluoride still matters
The ADA explains that fluoride helps rebuild enamel damaged by acid from cavity-causing bacteria, which is why children should use fluoride toothpaste. See our fluoride treatments guide and how to choose a toothpaste.
Frequently asked questions
Can adults get fluorosis?
No. The ADA says it only develops while teeth are forming under the gums, until about age 8.
Can fluorosis spots be treated?
The ADA says fluorosis doesn’t affect tooth health, and MedlinePlus says the marks are usually hard to see. For cosmetic concerns, talk to your dentist. See tooth discoloration causes.
Sources
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Close-up of a toothbrush with toothpaste (49842101773)” by Ivan Radic, via Wikimedia Commons, licensed CC BY 2.0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.