Aesthetic management of dental fluorosis

Abstract

Significant numbers of patients visiting the paediatric dental clinics have aesthetically objectionable brown stains and desire treatment for them. Intrinsic tooth discolouration can be a significant aesthetic, and in some instances, functional, problem. Dental fluorosis, tetracycline staining, localised and chronological hypoplasia, and both amelogenesis and dentinogenesis imperfecta can all produce a cosmetically unsatisfactory dentition. The aetiology of intrinsic discolouration of enamel may sometimes be deduced from the patient's history, and one factor long associated with the problem has been a high level of fluoride intake. Optimal use of topical fluorides leads to a decrease in the caries prevalence but may show an increase in the prevalence of fluorosis staining because of metabolic alterations in the ameloblasts, causing a defective matrix formation and improper calcification. A 12-year-old male patient was screened at the dental clinic for routine dental care. He wanted us to remove and/or minimise the noticeable brown/yellow staining of his teeth. He requested the least invasive and most cost-effective treatment to change his smile. Various treatment modalities are present for the treatment of fluorosis stains. This report discusses the microabrasion technique in the patient having dental fluorosis.

Interventions for dental fluorosis: A systematic review

“…Even though the esthetic perception of enamel mottling is variable across patients, this may have considerable psychosocial effects on many patients and impact their quality of life . Therefore, considerable efforts have been put in identifying an effective means to treat fluorotic stains that might be chosen according to lesion severity . A wide range of interventions of varying invasiveness have been proposed to treat fluorotic enamel, including external bleaching, microabrasion, dental veneers, or crowns or a combination of methods .…”

“…A wide range of interventions of varying invasiveness have been proposed to treat fluorotic enamel, including external bleaching, microabrasion, dental veneers, or crowns or a combination of methods . As patients with enamel mottling are quite young, with a life expectancy of many decades, minimal‐invasive, hard‐tissue sparing restorative approaches such as microabrasion, external bleaching, or resin infiltration have gained momentum . Microabrasion is based on the application of an etching gel (mostly HCl) followed by pumicing with slow rotation handpiece.…”

“…11,12 As patients with enamel mottling are quite young, with a life expectancy of many decades, minimal-invasive, hard-tissue sparing restorative approaches such as microabrasion, external bleaching, or resin infiltration have gained momentum. 3,9 Microabrasion is based on the application of an etching gel (mostly HCl) followed by pumicing with slow rotation handpiece. Bleaching of vital fluorotic teeth with various kinds of acids (mostly H 2 O 2 ) that produces peroxide ions to penetrate enamel and dental tubules and reduce the contrast between white spotted lesions and sound enamel has also been widely used.…”

Aesthetic treatment of dental fluorosis in a 9-year-old girl: Case report

“…Hence, with microabrasion, management of dental fluorosis would be as optimally preservative as possible. Similarly, Khandelwal et al effectively performed microabrasion on a paediatric patient with moderate fluorosis 37 . This is a rather conservative technique and, should it fail to meet the patient's requirements, some other more invasive methods may be required 38 .…”

Esthetic Management of Developmental Enamel Opacities in Young Permanent Maxillary Incisors with Two Microabrasion Techniques—A Split Mouth Study

“…12 Microabrasion is indicated for fluorosis, post-orthodontic demineralization, localized hypoplasia due to infection or trauma, and idiopathic hypoplasia where the discoloration is limited to the outer enamel layer. [13][14][15][16] This technique is simple to perform and the depth of enamel removed in 10 applications is approximately 100 μm (0.1 mm). The clinical result obtained is directly related to the depth of the stain/defect.…”