Teeth that are over-exposed to fluoride as they are forming beneath the gum line can develop a condition called enamel fluorosis, which is characterized by a streaked or mottled appearance. Mild fluorosis takes the form of white spots that are hard to see. In more severe cases (which are rare), the discoloration can be darker, with a pitted texture. The condition is not harmful, but may eventually require cosmetic dental treatment. Tooth decay, on the other hand, is harmful to your child’s health and can also be quite painful in severe cases.

The risk for fluorosis ends by the time a child is about 9 and all the permanent teeth have fully formed. Until then, we would be happy to discuss with you how much fluoride your child needs and in what form. Since fluoride use is cumulative, we need to take into account all the sources your child comes in contact with — including powdered infant formula mixed with fluoridated tap water — along with sugar consumption and other risk factors for decay, to make the appropriate recommendation. But while caution is advised, it would be a mistake to forgo the benefits that this important mineral can bring to your child’s teeth — and his or her overall health.