Treatment
Mild Fluorosis
Microabrasion and bleaching
- • Enamel microabrasion: mixture of hydrochloric acid (18%) and pumice applied to remove superficial opacities — removes 25-300 μm of enamel
- • In-office or home bleaching with hydrogen peroxide or carbamide peroxide — lightens intrinsic brown staining
- • Combination: microabrasion followed by bleaching is highly effective for mild-to-moderate cases
- • Resin infiltration (ICON): low-viscosity resin fills enamel pores, reducing white opacity — particularly for mild lesions
Moderate Fluorosis
Composite resin bonding
- • Microabrasion first to remove surface staining
- • Direct composite resin veneer — bonded resin covers the discolored enamel
- • Good results as fluorotic enamel bonds adequately to resin (though etching patterns differ)
- • Bleaching followed by composite for optimal color match
Severe Fluorosis
Porcelain veneers or crowns
- • Porcelain laminate veneers for anterior teeth — conservative preparation to cover pitted and stained surfaces
- • Full-coverage porcelain-fused-to-metal or all-ceramic crown for severely compromised teeth
- • Delay major restorations until late adolescence (18+) when tooth development is complete and gingival margins are stable
- • Monitor for functional issues in children and manage conservatively until adulthood