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Wisdom Wednesday – Fluorosis

Today; at Wisdom Wednesday, I would like to talk about a subject that is close to my heart. FLUOROSIS. Why does it hit close to the heart?? Am born and brought up in Nakuru. So are my husband and children. You may be wondering what that has to do with our topic of discussion today, but as you keep reading you will understand it. The water in Nakuru and its environs consists of lots of fluoride. Not only Nakuru, but many parts of the country have high fluoride levels leading to fluorosed teeth.

So what do I mean when I say fluorosed teeth? Many of you know it. It is the brownish discoloration that occurs on the teeth. Sometimes even a snowcapped appearance on the edges of the teeth is an indication of the same. Permanent (adult teeth) form in the jawbone during early childhood, except the 3rd molars (wisdom teeth) up to the age of 8 years. While primary teeth formation happens during 2years of age. The tooth buds for these teeth form in vitro. Dental fluorosis occurs when too much fluoride is ingested while teeth are forming both invitro and during the periods suggested above. The excess fluoride ingested affects formation of the enamel (the white layer of tooth seen) and result in the browning. In most cases this happens when a child is exposed to toothpaste with excess fluoride, fluoride supplements or when the water sources have a natural abundance of fluoride like in our case.

You may be wondering if this is the case, why does toothpastes have fluoride. Anything in excess is bad. Normal fluoride levels are good as they prevent our teeth from getting decay. There are varying degrees of fluorosis ranging from minor discoloration to surface irregularities of teeth to severe staining and deformities of the same. Once the teeth erupt in the mouth, they are not susceptible to fluorosis, so our period of watch is the early 8 years of childhood. While fluorosis is very distressing, it is considered as a cosmetic condition and not a disease.

A dentist will be able to identify fluorosis with a clinical examination. Dental fluorosis is a permanent condition, and the discoloration may darken over time. It can be prevented by closely monitoring your child’s brushing habits and the amount of toothpaste used. Pea-sized toothpaste on brush is effective and it is important to teach the child to spit rather than swallow. Always keep toothpastes and mouth rinses out of reach from children. It is also suggested to get water filters that will defluoride the water. The Catholic Diocese of KITI does wonderful filters for the same. Also avoid borehole and well waters with direct consumption.

Fluorosis does not usually require restorative treatment unless it is causing sensitivity or involving the pulpal tissues (where the pain nerves are, or unaesthetically unpleasing. More often than not, cosmetic treatment will be postponed until the child is between 16-18years of age when they are more mature. Treatment may consist of bleaching, masking, veneers or crown depending on the severity of the situation. Other than dental fluorosis, high fluoride levels result in skeletal fluorosis, thyroid dysfunction, neurological problems, acne and other skin problems, reproductive issues and fluoride poisoning.

If you feel any of the above, be sure to visit a physician and for children within 8years of age visit the dentist to avoid bigger problems in the future.

The Dentist!

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