We are having a lot of problems with my 10 year old daughter’s teeth. The permanent teeth that have come in are extremely yellow, and very blotchy. Our dentist says the blotchiness was caused by too much fluoride. I thought fluoride was good for teeth! She has braces right now, so we have a little time to figure out how we should fix the discoloration and blotchiness. We are trying to address these issues now, because she is very self-conscious about her teeth, and we want to start making positive changes before she hits puberty.

Thanks for your help,
Rochelle in Baton Rouge

Dear Rochelle,

The blotchiness is caused by fluorosis, and it is indeed a symptom of too much fluoride while your daughter’s teeth were forming. Most communities have to add fluoride to their water, but some naturally have too much fluoride, and if it is not detected and removed, extended use can cause fluorosis. This can also happens when people drink untreated well water that is naturally high in fluoride. Fluorosis can even be caused by years of swallowing too much fluoridated toothpaste.

Whatever the root cause, if your daughter’s fluorosis stains are severe, you will probably have to treat them with porcelain veneers. In mild cases of fluorosis, the spots can sometimes be treated with bonding to cover only the affected spots. Severe staining will require more extensive coverage, and that indicates that porcelain veneers would be the treatment of choice.

The good news is that there is no minimum age for porcelain veneers, so you could conceivably get something in place when her braces come off. If you do choose to pursue veneers when she is in her early teens, make very sure you choose a highly skilled cosmetic dentist who has experience doing veneers for teenagers.