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My child’s adult teeth have white spots on them. Why, and what can be done about them?

There are several causes of white marks on teeth in older children – in other words, on their adult teeth.

Most commonly, it is a condition referred to as dental fluorosis. This is caused by an excessive intake of fluoride during the period in which the child’s adult teeth are still developing. The development period for the adult front teeth is generally around the first three years of a child’s life. If you see white spots on a child’s recently erupted adult teeth, it is important to determine:

  • where the child was living up to the age of three and the amount of fluoride present in the water supply there
  • whether any fluoride supplements were consumed at the time
  • whether the child used a children’s or an adult toothpaste
  • whether the child had a habit of swallowing the toothpaste.

All of these can be contributing factors.

White marks on teeth can also be due – albeit rarely – to an inherited genetic condition. When this is the case, both adult and milk teeth are affected. This condition is the most likely cause of white spots on teeth if any of the child’s siblings are also affected and if anyone in their mother’s or father’s family is also affected.

What are the risks of white marks on teeth and what can be done about them?

White spots on teeth are porous and can absorb the colouration in foods and drinks to become brown stains over time. While these stains generally don’t affect the health of the teeth, they are unsightly and can be treated using a technique known as microabrasion. Whitening or bleaching can also improve appearance. More severe cases may call for composite veneers, which can be replaced by porcelain veneers once the child is over 16 years of age.

On the other hand, if the white spots on a child’s permanent teeth are close to the gum line, they might be a sign of early dental decay. When this is the case, effective preventive treatment can arrest the development of the decay. If left untreated, these spots can eventually develop cavities and need to be filled.

Can white spots also develop in adults?

Sometimes illnesses or trauma in the first two years of a child’s life can mean that the incisor and the molar teeth do not develop normally and the child might report sensitivity or pain from these teeth. Typically, white spots appear on the affected teeth when the sufferer becomes an adult and sometimes there is even breakdown of these teeth. In such cases, there is a direct link between the timing of the illness suffered and the part of the developing tooth that is affected. The management of these adult cases is complex and can involve treatments ranging from placement of fillings (in mildly affected teeth) to stainless steel crowns or appropriately timed removal of the affected teeth (in more severe cases).

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