White Spots on Teeth

Dear Dr. Ellie

I am mother of a 9 year old daughter and 4 year old son. I am very upset about my daughter because she has white spots in her two new teeth (in front of the mouth).

Searching in the internet to get the possible solution I found your website and I think your comments and support will be very helpful for me.

My daughter so far is a healthy girl (she never had any serious problems with her health ) and I would like to ask you the possible causes of the white spots and the further treatment in order to prevent the teeth decay. Every day I give to my daughter and to my son the quantity of the fluoride recommended by the dentist. I would like to ask you if I have to continue with the fluoride as the possible treatment of the white spots ?

I really appreciate your comments because I am looking for the solution,

All the best to you


Hi M,

I thank you for your confidence in my advice and I understand your concerns.
There are two main kinds of white spot one is the start of tooth decay the other is caused by excess fluoride while teeth are developing. Reviewing your story, my hunch is that your daughter’s white spots are not caused by decay but perhaps from ingesting too much fluoride while she was very young.

Do not feel badly: I have a daughter with white spots on her front teeth – the result of my giving her fluoride supplements when she was a young child. Dentists used to believe in supplemental fluoride in the 1970s and 1980s. Today health professionals usually do not recommend fluoride supplements because of this risk to teeth (a problem called fluorosis).

Fluorosis can only occur when fluoride is ingested during the years when adult teeth are forming.
Adult teeth grow underneath baby teeth in the jaw and they are invisible to you. Adult teeth form in the jaws of a baby between birth and 3 years of age.

There is no risk of fluorosis after age three, since adult tooth enamel will be completely formed and can no longer be affected. This is why it is not recommended for children under 3 to be allowed to eat fluoride containing toothpaste. I usually suggest that if a child needs some fluoride early in life, we brush the teeth with a tiny drop of ACT bubblegum rinse on a toothbrush (in place of toothpaste).

Adult teeth finish forming in the jaw several years before they erupt into the mouth (molars start to erupt around 5 years of age). The first adult teeth are usually the back teeth. These molars erupt behind the line of baby teeth with no loss of baby teeth.

Next are adult front teeth, taking the place of baby incisor teeth that loosen and fall out. Lower teeth are quickly followed by upper incisors. Teeth that began to grow in the jaw when your child was a toddler, are now seen in the mouth between the ages of 5 and 9.

If your child ingested just a fraction too much fluoride during the time these teeth were developing (before age three) there is a risk of fluorosis to these adult teeth. The enamel-forming cells are disrupted by the ingested fluoride and they stop producing enamel. If you looked under a microscope you would see empty voids holes where the enamel did not form.

These empty spaces in the enamel look white if they are small and brown if they are larger.
It is ironic that the substance given to children to strengthen teeth can kill the cells that form tooth enamel.

What can you do? Well the most important thing now is to protect these teeth and I would suggest my complete mouth care system.

You may be surprised that I would recommend more fluoride but ACT used as a rinse is safe for teeth and will help them heal as much as is possible. ACT at this age cannot harm her teeth.
Fluoride is very misunderstood the effects of a rinse are very different from the effects of fluoride that is ingested. Fluoride is NOT a vitamin and should not be viewed as such.It is a useful topical rinse for teeth one that will help heal any soft white spots.

I would not suggest bleaching or any other dental treatment for these teeth for at least 3-4 years. If, four years from now, you feel that the color is unacceptable then a good cosmetic dentist may be able to drill out the white spots and put in a tooth color filling. If you work to strengthen your daughter’s teeth naturally with my system you may find that the white spots fade over a period of years.

Let me know if I can help in any other way or if you have more questions.
Ellie Phillips DDS
Dental Health for Everyone!
26 Corporate Woods
Rochester NY 14623

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  • Anonymous says:

    I stumbled across your blog while looking for information about white spots on my 6 year old daughters newly emerged top, middle incisor. I am excited to learn about your dental care system and the potential benefits for my whole family. I've been very intrigued by xylitol for a while now.I do have a few questions…1. You stated that "there are two main kinds of white spot – one is the start of tooth decay the other is caused by excess fluoride while teeth are developing." What about enamel hypoplasia/hypocalcification caused by trauma or some other disturbance during development of the enamel?2. For years, my gums have bled a lot during dental cleanings so my dentist has me coming in for cleanings every 3 months and using a prescription flouride gel (Pro-Den Rx, 1.1% Sodium Flouride) every night after brushing. Does ACT really work as well as the stronger Pro-Den Rx?3. Do you have concerns about the toxicity of flouride? A lot of "health gurus" think that flouride is dangerous.4. I consumed xylitol gums and mints for a while last year after learning of its dental benefits, but couldn't afford to continue purchasing them (my 4 kids love them, too!). Is the less expensive granular xylitol dissolved in water just as effective?5. What are your specific recommendations for my 6 year old daughter with the white spots on her newly emerged incisor?As I said, I am excited and very grateful about the information you've provided.Thanks!

  • Anonymous says:

    I am confused by the good dr's answer as I did not give my child flouride 'anything' until she hadher adult teeth! She has white spotsat the corners of each of her adult front teeth (had beautiful baby teeth!) this is quite upsetting.

  • Dr. Ellie says:

    There are many reasons for white spots.Adult incisors are starting to develop in the jaw at birth – and anything that upsets the metabolism can be reflected in teeth. The most common source of white spots is from ingestion of fluoride as a small child.Don't forget that fluoride is in tap water – also at a high dosage in formula milk – in many juices and even baby foods….. There is research to show that formula milk mixed up with local fluoridated tap water is enough to cause these spots on teeth.I advise using Evian water to mix formula milk – never fluoridated water. Ellie http://www.zellies.com26 Corporate WoodsRochester, NY 14623(585) 272-1270

  • Jenni says:

    I am 14 years old, and this morning I discovered white spots on my own teeth, the front four to be more exact. Those were the only ones that had the white spots/blotches on them. What would have caused mine? Since I am older then most kids who get it because of Fluorosis.

  • Dr. Ellie says:

    White spots caused by fluorosis are built "into" the tooth while it is forming.This kind of white ( or brown) spot – caused by fluorosis are visible as new adult teeth erupt into the mouth – ( this happens about 7-9 years of age).New teeth are always soft and very vulnerable as they erupt into the mouth.It takes a new tooth about a year to develop a natural protective "cover" ( called a pellicle or biofilm) that is going to protect it.Unfortunately bleaching teeth or using whitening toothpaste destroys this "cover" and will leave teeth vulnerable to acid erosion and white spot damage.If you drink citrus or soda drinks (snapple, propel, diet sodas etc) these drinks easily cause white spots – if this protective layer has gone.What to do now:Eat Zellies and rinse with ACT anticavity rinse as soon as possible ( and rinse with this mouth rinse EVERY morning and night)Check out my Complete Mouth Care System if you want to ensure your teeth stay safe and healthy and develop a healthy covering as quickly as possiblehttp://www.drellie.com/pdfs/The-Kissing-System/Complete-Mouth-Care-System-Cliff-Notes-Version.pdfWith Best Wishes,Ellie

  • Martin says:

    Hello Dr EllieI have an 9 yr old granddaughter who has white spots on her incisors, and also her teeth are very yellow. Her Mum wd like to know the causes – they live on an island in the middle of the Indian Ocean, and have limited access to your standard of dental care. For example, what is ACT, and what are Zellies, etc? This is a genuine enqiry! Thank you, Martin.

  • Dr. Ellie says:

    There is a lot of information on my website http://www.DrEllie.com

  • Anonymous says:

    Hi, I have been trying to find our for years what is wrong with my teeth and this sounds about right. I am a 16 year old girl and I have white spots on most of my teeth, including a large one taking up half of my front top left tooth. I have perfectly straight teeth, and have never had braces, whitening, or anything dont to them; eccept regular exams. After reading this page, I asked my and she said that as a child I used Colgate tooth paste. I'm assuming that is has floride in it and that it is the cause of my white spots, because I take very good care of my teeth. I absolutely hate the white spots, and I Just want them to go away!!! My dentist said she didnt know what caused them or what they were. Do you have any suggestions on getting rid of the spots, or anything i can do to make them fade. My spots come and go, some days they are more prominant than others, and some days you wouldnt even notice they were there. I would love to get my teeth whitened, but I'm afraid to because I dont want them to become permanantly noticable or anything like that. I am embarased by them and I hope you can help!

  • Dr. Ellie says:

    Can you send me a picture – through my personal e-mail zellie2@me.com please?

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