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
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