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Fluoride Bomb

What is the big deal about Fluorosis?

girl looking over her shoulderWe are often told that Fluoride will help prevent dental decay.  This article is not about that. What is often not discussed is Fluorosis and in particular the dangers of fluorosis.  One form of dental fluorosis can lead to a phenomenon known as the fluoride bomb.  A fluoride bomb is a area of the tooth (normally the pit and fissures) that have started to decay, but due to the high concentrations of fluoride has led to the surface mineralisation of the tooth.

This is however only superficial as the decay will continue to extend deeper into the tooth. Sadly, because of the surface remineralisation, the patient is usually unaware of the problem until the underlying destruction starts to affect the nerve, by which time the damage is very extensive and can be quite complicated to restore.

In 2010 the Centers for Disease Control and Prevention (CDC) reported that 41% of American adolescents had dental fluorosis, with 8.6% having mild fluorosis and 3.6% having either moderate or severe dental fluorosis (Beltran-Aguilar 2010). Anecdotally, these figures are consistent in our clinical experience.

Here are some photos of how potentially damaging a “fluoride bomb” can be.

“A fluoridated “bombed out” tooth clinically can have unique characteristics of good smooth surface enamel yet have extensive dentin decay in the pits and fissures. In contrast, the non-fluoridated bombed out tooth may chip next to the pits and fissures before as much dentin damage occurs and provide earlier detection of the decay by patient or clinician, explaining in part the lack of effectiveness with fluoridation. Cautious removal of the dark groove reveals a deep “bomb” of decay.” Osmunson DDS, MPH
So if you have any white spots that you think might be fluorosis, and are concerned by what is happening, contact us for a chat.

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