Most cases of fluorosis are mild and result from young children taking fluoride supplements or swallowing fluoride toothpaste. Often, it is
so mild that only a dental professional can detect it.
The permanent teeth form under the gums during early childhood. The crowns (the part you see in the mouth) of most of the permanent teeth
are fully formed by the time children are 8 years old. If too much fluoride is swallowed every day while growing up, the extra fluoride can
change how the enamel (outer part) of your permanent teeth forms. This change is called fluorosis, which varies from mild to severe changes
in the color and texture of the tooth enamel. The extra fluoride does not affect other parts of the tooth. Once your teeth have erupted
into your mouth, they are not susceptible to fluorosis.
Powdered infant formula and enamel fluorosis
The possibility of an association between fluoride in infant formula and the risk for enamel fluorosis has been studied for many years.
Until now, most researchers concluded that fluoride intake during a child's first 10 to12 months had little impact on the development of
this condition in permanent teeth. A recent study, however, has raised the possibility that fluoride exposure during the first year of
life may play a more important role on fluorosis development than was previously understood. It now appears that the amount of the fluoride
contained in the water used for mixing infant formula may influence a child's risk for developing mild enamel fluorosis, particularly if
the child's sole source of nutrition is from reconstituted infant formula.
Typically, very mild or mild fluorosis is barely noticeable, if noticed at all.
If you are concerned about children developing enamel fluorosis:
Be sure that children younger than age 8 use no more than a pea-size amount of fluoride toothpaste. Teach children to spit out
the toothpaste.
Be sure that children younger than age two do not use fluoride toothpaste.
Discontinue using fluoride drops or tablets if your family's drinking water contains adequate fluoride to protect teeth.
Consider your child's risk for tooth decay and discontinue fluoride supplements if your child is at low risk for tooth decay even
when your drinking water does not have optimal levels of fluoride.
Consider bottled water that is labeled without fluoride to mix powdered formula.
Consider ready to feed formula.
Breastfeed whenever possible.
Switch from formula to cow's milk at 12 months, or as recommended by your child's health care professional.
Even with regular mixing of formula with fluoridated water, studies have not shown that teeth are likely to develop
noticeable forms of fluorosis.
