I am looking for guidance. My 12-year old son has severe fluorosis stains on his permanent teeth, and he is very self-conscious. His bottom teeth are extremely blotchy and yellowish, and his top front teeth (central and lateral incisors) have very dark stains. His left lateral incisor is quite jagged on the outside edge. He has braces right now, so we do not plan on doing anything for a while, but our dentist doesn’t seem as concerned as we are about the staining and has not given us a satisfactory plan of action for dealing with the stains when the braces come off.
Am I overly concerned with these stains? My son is so embarrassed by his teeth. He almost never smiles. I want to do something about that.
Annette in Colorado Springs
Dear Annette,
Many general dentists are not well-equipped to be sensitive about self-esteem issues. If your son’s teeth are physically sound and functioning properly, then your dentist may not be concerned with what they look like. After his braces come off, I strongly suggest you seek the help of an accredited cosmetic dentistto help you address the staining. If the staining was uniform, I would suspect some other cause of staining and recommend bleaching, but the blotchiness you describe does sound like fluorosis.
If your son’s teeth have not fully erupted, it might be possible and prudent to do some direct tooth bonding to provide a short-term fix for the staining. If his front teeth have fully erupted, porcelain veneersare probably the best choice for dealing with fluorosis stains as severe as those you describe. There is no minimum age for placing porcelain veneers, so if you are working with a highly skilled and experienced cosmetic dentist who can factor in the degree of current and future tooth eruption, your son could have veneers placed right away.