July 10, 2000

Specific changes in early childhood and parental behaviors could prevent many cases of dental fluorosis in children, according to a study conducted by David G. Pendrys, associate professor in the Department of Behavioral Sciences and Community Health at the UConn Health Center, and published in the June issue of the Journal of the American Dental Association.

Dental fluorosis, a disruption in tooth enamel formation, is caused by the ingestion of fluoride above optimal levels. It occurs only during tooth development in early childhood. In its mildest form, white lines or streaks are only visible to dental experts during examinations. Noticeable white lines that often consolidate into larger opaque areas characterize mild to moderate fluorosis. Although the lines may cause cosmetic concern, there are no known health effects.

Using fluoride toothpaste is important for preventing tooth decay, but preschool children should be taught how to use it properly, says Pendrys. Because young children are apt to swallow toothpaste while brushing, a pea-sized amount for children under six - as recommended by the American Dental Association - is all that is needed.

Pendrys says it is important for parents to supervise their preschool children when they brush and encourage them to spit out, rather than swallow, toothpaste. Also, parents should avoid special flavors that may tempt children to eat toothpaste.

Once permanent teeth have erupted, individuals are no longer at risk for fluorosis, since enamel fluorosis occurs while teeth are still forming under the gums.

Pendrys says providing parents of young children appropriate advice for the early use of fluoride toothpaste and fluoride supplements may have a significant effect on the incidence of enamel fluorosis in both nonfluoridated and fluoridated areas.

Jane Shaskan