Dental Fluorosis : Treatment Approaches and Aesthetic Correction

Dental fluorosis is used to describe the one kind of enamel abnormalities due to the over fluoride intake during tooth development. This abnormality displays vary signs from white flecks to severe brown stain and pitting or chipping of enamel. This abnormal toothis appearance seems to be more problem for people especially in recent time that the personality and aesthetics become more important. The answers to solve this problem were developing by the advanced aesthetic dentistry then dentists should learn about the basic knowledge of dental fluorosis and how to manage this properly.

1. Petersen PE, Lennon MA. Effective use of fluorides for the prevention of dental caries in the 21st century: the WHO approach. Commu- nity Dent Oral Epidemiol 2004; 32: 319-321.

2. Fross H, Halme E. Retention of a glass-ionomer and resin-base fissure sealant and effect on carious outcome after 7 years. Community Dent Oral Epidemiol 1998; 26: 21-25.

3. Poulsen S, Beiruti N, Sedat N. A comparison of retention and the effect on caries of fissure sealing with a glass-ionomer and resin-base sealant. Community Dent Oral Epidemiol 2001; 29: 298-301.

4. Aoba T, Fejerskov O. Dental Fluorosis: Chemistry and Biology. Crit Rev Oral Med 2002; 13(2): 155-170.

5. Browne D, Whelton H, OiMullane D. Fluoride metabolism and Fluorosis. J Dent 2005; 33: 177-186.

6. McDonagh M, Whiting P, Bradley M, et al. A systemic review of public water fluoridation. NHS Center for Reviews and Dissemination. University of York; Sep 2000.

7. Levy SM. An update on Fluorides and Fluorosis. J Can Dent Assoc 2003; 69(5): 286- 91.

8. Whelton HP, Ketley CE, McSweeney F,O'Mullane D. A review of Fluorosis in the European Union: prevalence, risk factors and aesthetic issues. Community Dent Oral Epide- miol 2004; 32(Suppl.1): 9-18.

9. Van Palenstein Helderman WH, Mksasabuni E. Impact of dental Fluorosis on the percep- tion of well-being in an endemic Fluorosis area in Tanzania. Community Dent Oral Epidemiol 1993; 21: 243-244.

10. Dean HT. Classification of mottled enamel diagnosis. J Am Dent Assoc 1934; 21: 1421- 1426.

11. Dean HT. The investigation of physiological effects by the epidemiological method. In: Moulton FR, ed. Fluorine and dental health. Washington, DC. Am Assoc. Avd. Sci. 1942; 23-31.

12. Dean HT, Elvovo E. Studies on the minimal threshold of the dental signs of chronic endemic Fluorosis (mottled enamel). Pub Health Rep 1935; 50: 1719-1729.

13. Mandel 1. The image of dentistry in contem- porary culture. J Am Dent Assoc 1998; 129: 607-613.

14. Welie J. Do you have a healthy smile? Med Health Care Philos 1999; 2: 169-180.

15. Edwards M, Macpherson LMD, Simmons DR, et al. An assessment of teenanagers' percep- tions of dental fluorosis using digital simula- tion and web-base testing. Community Dent Oral Epidemiol 2005; 33: 298-306.

16. Albino JE, Cunat JJ, Fox RN, et al. Variables discriminating individuals who seek orthodo- ntic treatment. J Dent Res 1981; 60: 1661-7.

17. Horowitz HS. Appropriate uses of fluoride: Considerations for the '90s. Summary. J Public Health Dent 1991; 51: 60-3.

18. Moller IJ. Fluoride and Dental Fluorosis. Int Dent J 1982; 32: 135-147.

19. Larsen MJ, Richard A, Fejerskov O. Development of dental Fluorosis according to age of fluoride administration. Caries Res 1985; 19: 519-527.

20. Fejerskov O, Yaeger JA, Thylstrup A. Microradiography of the effect of acute and chronic of fluoride on human and rat dentin and enamel. Arch Oral Biol 1979; 24: 123- 130.

21. Vieira A.P.G.F, Hancock R., Limeback H. Is Fluoride Concentration in dentin and enamel a good indicator for dental Fluorosis? J Dent Res 2004; 83: 76-80.

22. Akpata E.S. Occurrence and management of dental fluorosis. Int Dent J 2001; 51: 325-333.

23. ศูนย์ทันตสาธารณสุขระหว่างประเทศ จังหวัด เชียงใหม่. ปัญหาฟลูออไรด์เป็นพิษ สาเหตุและแนว ทางแก้ไข. รายงานการประชุมผู้นำองค์การบริหาร ส่วนท้องถิ่นในพื้นที่เสี่ยงต่อการเกิดปัญหาปริมาณ ฟลูออไรด์เป็นพิษ กรมอนามัย กระทรวงสาธารณสุข หน้า 1-14.

24. สุรัตน์ มงคลชัยอรัญญา, อังศนา ฤทธิ์อยู่ แนวทาง การจัดการฟูลออไรด์สูงในน้ำบริโภค เพื่อป้องกัน ผล กระทบด้านทันตสุขภาพ กองทันตสาธารณสุข กรม อนามัย กระทรวงสาธารณสุข 2548: 22-26.

25. David GP. The differential diagnosis of fluorosis. J Public Health Dent 1999; 59: 235- 238.

26. Black GV, McKay FS. Mottled teeth: an endemic developmental imperfection of the enamel of the teeth heretofore unknown in the literature of dentistry. Dent Cosmos 1916; 58: 129-156.

27. Black GV, McKay FS. An investigation of mottled teeth: an endemic developmental imperfection of the enamel of the teeth, heretofore unknown in the literature of dentistry. Dent Cosmos 1916; 58: 477-484.

28. Thylstrup A, Fejerskov O. Clinical appearance of dental Fluorosis in permanent teeth in relation to histological changes. Community Dent Oral Epidemiol 1978; 6: 315-328.

29. Alkhatib MN, Holt R, Bendi R. Aesthetically objectionable Fluorosis in the United King- dom. Br Dent J 2004; 197: 325-328.

30. McKnight CB, Levy SM, Cooper SE, et al. A pilot study of esthetic perception of dental Fluorosis vs. selected other dental conditions. J Dent Child 1998; 233-238.

31. Loyola-Rodriguez JP, Pozos-Guillen A, Hernandez-Hernandez F, et al. Effectiveness of treatment with carbamide peroxide and hydrogen peroxide in subjects affected by dental fluorosis: a clinical trial. J Clin Pediatr Dent 2003; 28(1): 63-68.

32. Sulieman M. An overview of bleaching techniques: 3. in-surgery or power bleaching. Dent Update 2005; March: 101-108.

33. Ronald W, Bailay GC and Arden GC. Effect of a bleaching technic on the labial enamel of human teeth stained with endemic dental fluorosis. J Dent Res. 1970; 49(1): 168-170.

34. Buchalla W, Attin T. External bleaching therapy with activation by heat, light or laser- A systemic review. Dent Mater. In press 2006.

35. Haywood VB, Hayman HO. Nightguard vital bleaching. Quintessence Int 1989; 20: 173- 176.

36. Haywood VB. Nightguard vital bleaching, a history and product update. Part 1. Esthet Dent Update 1991; 2: 63-66.

37. Sulieman M, Andy M, McDonald E. Development and evaluation of a method in vitro to study the effectiveness of tooth bleaching. J Dent 2003; 31: 415-422.

38. Sulieman M, Andy M, McDonald E. The effective of hydrogen peroxide concentration on the outcome of tooth whitening an in-vitro study. J Dent 2004; 32: 295-299.

39. Sulieman M, Andy M, McDonald E. The bleaching depth of a 35% hydrogen peroxide base in-office product: a study in vitro. J Dent 2004; 33: 33-40.

40. Irfan A. Masking tooth discoloration with All- Ceramic Restorations. Quintessence Dent Technol 2004; 9-18.

41. Kirby MB, Haywood VB. Treatment of endemic fluororsis and tetracycline staining with macroabrasion and nightguard vital bleaching: A case report. Quintessence Int 2003; 34: 87-91.

42. Dohl J.E, Pallesen U. Tooth bleaching A critical review of the the biological aspects. Crit Rev Oral Biol med 2003; 14(4): 292-304.

43. Cotton FA, Wilkinson G, Oxygen in: Advances in inorganic chemistry. A compre- hensive text. New York: Interscience Publisher, 1972: 403-420.

44. มนตรี จันทรมังกรทัดจันทร์ ครองบารมี, Tooth bleaching: A review of the biological aspects and their adverse effects. J Thai Oper Dent 2546; 4(2): 6-17.

45. Jone A, Diaz-Arnold AM, Vargas MA, et al. Colorimetric Assessment of laser and home bleaching techniques. J Esthet Restor Dent 1999; 11(2): 87-94.

46. Sun G. The role of lasers in cosmetic dentistry. Dent Clin North Am 2000; 44(2): 831-850.

47. Josef S. Color Atlas of Dental Medicine, Aesthetic Dentistry. New York: Thieme; 2000: 35-54.

48. Wray A, Welbury R. UK National Clinical Guidelines in Paediatric Dentistry: treatment of intrinsic discoloration in permanent anterior teeth in children and adolescents. Int J Paediatr Dent 2001; 11: 309-15.

49. Clinical Research Associates. Vital tooth bleaching, in-office. CRA Newsletter May 2002 with permission from 2000; 24(4); 1-3.

50. Clinical Research Associates. New generation in-office vital tooth bleaching, part 1.CRA Newsletter Jan 2003 with permission from 2000: 24(4); 1-3.

51. Miller MB. Are bleaching lights the real ideal? Dental Mater 2005; 21: 105.

52. Luk K, Tam L, Hubert M. Effect of light energy on peroxide tooth bleaching. J Am Dent Assoc 2004; 135: 194-201.

53. Lu AC, Margoutta A, Nathoo SA. In office tooth whitening: Current procedures. Com- pend Contin Educ Dent 2001; 22(9): 798-805.

54. Nash RW. In-office bleaching system for quick esthetic change. Compend Contin Educ Dent 1999; 20(10): 986-990.

55. Dadoun MP, Bartlett DW. Safety Issues when using carbamide peroxide to bleach vital teeth ñ A review of the literature. Eur J Prosthodont Rest Dent 2003; 11: 9-13.

56. Haywood VB, Berry TG. Fundamental of Operative dentistry: A Contemporary approach. 2nd Edited by Summitt JB, Robbins JW, Schwartz RS. Quintessence Publishing Co, Inc. 2001, 401-426.

57. McCloskey RJ. A technique for removal of fluorosis stains. J Am Dent Assoc 1984; 109: 63-64.

58. Croll TP. Enamel Microabrasion. Illinois. Quintessence Co Inc. 1991.

59. Rodd HD, Davidson LE. The aesthetic management of severe dental Fluorosis in the young patient. Dent Update 1997; 24: 408- 411.

60. Croll TP, Killian CM, Miller AS. Effect of enamel microabrasive compound on human gingival: report of a case. Quintessence Int 1986; 17: 271-275.

61. Jagger RG, Rayes SA. Hydrochloric acid- pumice treatment of Fluorosis-stained enamel. Restor Dent 1990; Feb: 4-6.

62. Wary A, Welbury R. Treatment of intrinsic discoloration in permanent anterior teeth in children and adolescents. Int J Pediatr Dent 2001 Jul; 11(4): 309-15.

63. Waggoner WF, Johnston WM, Schumann S. Microabrasion of human enamel in vitro using hydrochloric and pumice. Pediatr Dent 1989; 11: 319-323.

64. Croll TP. Esthetic correction for teeth with Fluorosis and Fluorosis-like enamel dysmine- ralization. J Esthet Dent 1998; 10:21-29.

65. Ross W.N. Esthetic restoration of discolored teeth using porcelain laminate veneers. Compend Contin Educ Dent 1998; 19(5): 518- 538.

66. Thomas D.L. 25 Years of veneering: What have we learned? J Minnesota Dent Assoc 2003; 88(4): 1-6.

67. Wakiaga J, Brunton P, Silikas N. Direct versus indirect veneer restorations for intrinsic dental stain (review). The Cochrane library Issue2. Wiley Publishers 2005; 1-10.

68. Lai SCN, Tay FR, Cheung GSP. Reversal of compromised boning in bleaching enamel. J Dent Res 2002; 81(7); 477-481.

69. Ateyah N, Akpata E. Factors affecting shear bond strength of composite resin to fluorosed human enamel. Oper Dent 2000; 25: 216-222.

70. Opinya GN, Pameijer CH. Tensile bond strength of fluorosed Kenyan teeth using acid etch technique. Int Dent J 1986; 36(4): 225- 229.

71. Weerasinghe DS, Nikaido T, Wettasinghe KA, et al. Micro shear bond strength and mor- phological analysis of self-etching primer adhesive system to fluorosed enamel. J Dent 2004; 33: 419-426.

72. Al-Sugari MH, Akpata ES. Effect of fluorosis on etching of human enamel. J Oral Rehabil 1999; 125(7): 521-528.

73. Benderli Y, G?kce K. B?y?k?gkcesu S. In vitro shear bond strength of adhesive to normal and fluoridated enamel under various conditions. Quintessence Int 1999; 30(8): 570- 575.

74. Peyton JH. Direct resin veneers using Esthet- X? Micro matrix restorative. ADA continuing education recognition program 2003.

75. Yamada K. Porcelain laminate veneers for discolored teeth using complementary colors. Int J Prosth 1993; 6(3): 242-247.

76. Frankenberger R, Kramer N, Sindel J. Repair strength of etched vs. silica-coated metal ceramic and all ceramic restorations. Oper Dent 2000; 25(3): 209-215.

77. Leirock A, Degenhart M, Behr M, et al. In vitro study of the effect of thermo- and load- cycling on the bond strength of porcelain repair systems. J Oral Rehabil 1999; 26(2): 130-137.

78. Leirskar J, Nordbo H, Thoresen NR. A four to sick years follow-up of indirect resin com- posite inlays/onlays. ACTA Odontol Scan 2003; 61: 247-251.

79. Shaini FJ, Shortall AC, Maruis PM. Clinical performance of porcelain veneer. A restro- spective evaluation over a period of 6.5 years. J Oral Rehabil 1997; 24(8): 553-559.

80. Troedson M, Derand T. Effect of margin design, cement polymerization, and angle of leading on stress in porcelain veneers. J Prosthet Dent 1999; 82(5): 518-524.

81. เพ็ญทิพย์ จิตต์จำนงค์, วิกุล วิลาสเสสถ์, มัลลิกา ตัณฑลเวศม์, เกณฑ์คุณภาพน้ำประปาดื่มได้ของกรม อนามัย, เอกสารสรุปการประชุมสัมนา เรื่อง ปริมาณ ฟลูออไรด์สูงสุดในน้ำบริโภคบรรจุขวด, กองทันต สาธารณสุข กรมอนามัย กระทรวงสาธารณสุข นนทบุรี 2543; 50.

82. กองทันตสาธารณสุข กรมอนามัย กระทรวง สาธารณสุข. รายงานผลการสำรวจทันตสุขภาพ ครั้งที่ 5 พ.ศ. 2543-2544. บริษัท สามเจริญพาณิชย์ จำกัด กรุงเทพ. 2545; 20-21,126-127,

Kunawarote S, Jittidecharaks S. Dental Fluorosis : Treatment Approaches and Aesthetic Correction: Review articles. CM Dent J [Internet]. 2024 Dec 11 [cited 2025 May 03];27(2):67-88. Available from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=437

Kunawarote, S. & Jittidecharaks, S. (2024). Dental Fluorosis : Treatment Approaches and Aesthetic Correction. CM Dent J, 27(2), 67-88. Retrieved from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=437

Kunawarote, S., and Sumana Jittidecharaks. 2024. "Dental Fluorosis : Treatment Approaches and Aesthetic Correction." CM Dent J, 27(2), 67-88. https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=437

Kunawarote, S. et al. 2024. 'Dental Fluorosis : Treatment Approaches and Aesthetic Correction', CM Dent J, 27(2), 67-88. Retrieved from https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=437

Kunawarote, S. and Jittidecharaks, S. "Dental Fluorosis : Treatment Approaches and Aesthetic Correction", CM Dent J, vol.27, no. 2, pp. 67-88, Dec. 2024.

Sitthikorn Kunawarote, Sumana Jittidecharaks "Dental Fluorosis : Treatment Approaches and Aesthetic Correction." CM Dent J, vol.27, no. 2, Dec. 2024, pp. 67-88, https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=437