The most common complaint people have about the color of their teeth is discoloration. Stains from food can make your smile look dull, aged, and unhealthy. However, some people experience the opposite problem: white spots all over their teeth. These white patches can make you self-conscious about your smile.

Those white patches may be the result of something called fluorosis. While mild fluorosis is not rare, many people don’t like the way fluorosis looks. If you want those white patches gone, an experienced Wilmington, NC cosmetic dentist can help.

young man with amazingly white smile

What Is Fluorosis?

If you have fluorosis, chances are you’ve had it for a long time, as it generally occurs in the first eight years of life. Fluorosis, in a nutshell, are white patches which form on the enamel as a result of hypomineralization. When the body is overexposed to fluoride when enamel is forming around the permanent teeth, it causes problems in the way the teeth incorporate minerals. Which is why most people with fluorosis have had the resultant discoloration since they were a child.

Fluoride in appropriate doses helps build strong enamel that better resists cavities. Adding it to drinking water reduces the risk of cavities by about 25%.

However, excessive fluoride can cause irregularities in the tooth’s crystalline structure. These are the white spots  you see. In severe cases, fluorosis can also damage teeth. This excess of fluoride can come from many sources. One common source is children ingesting fluoridated mouthwash or toothpaste. Children should use toothpaste without fluoride until they learn to rinse and spit properly without swallowing toothpaste. Children don’t need mouthwash, and you should keep it out of their reach as the flavor and color might entice them. Use fluoride supplements only when recommended by your child’s dentist. Drinking water that contains too much fluoride can also lead to fluorosis. Some public water supplies are fluoridated intentionally, but the levels are low and relatively safe. Most excess fluoride exposure from drinking water occurs because of naturally high fluoride levels in water.

Most fluorosis is mild. It doesn’t put your teeth at risk. Severe fluorosis can make teeth more susceptible to decay, but mild fluorosis can actually make teeth more resistant to cavities. However, many have cosmetic concerns about the white patches, which can stand out particularly on teeth that are yellowed or stained.

Recent Changes in Fluoridation in the Wilmington Area

In April 2018, the Cape Fear Public Utility Authority (CFPUA) issued a “Do not drink” alert after crews discovered high fluoride levels at the Richardson Nano Groundwater Treatment Plant in New Hanover County. These fluoride levels were 8 mg / L. That is twice the legal safe limit for fluoride set by the EPA, and more than ten times the recommended level set by the US Public Health Service, 0.7 mg/L. The 0.7 mg/L level is also endorsed by the American Dental Association as effective for fighting tooth decay.

Then in January 2020, the CFPUA announced that it was resuming fluoride additions at this plant.

However, most of the water in the Wilmington area is supplied by the Sweeney Water Treatment Plant. Fluoride levels at this plant did not spike and fluoridation continued uninterrupted.

How to Treat Fluorosis

There are multiple cosmetic dentistry approaches we can take to improve the appearance of mild fluorosis on your teeth.

Teeth Whitening

Professional teeth whitening seems the most obvious solution to fluorosis. However, whitening treatments whiten your entire tooth and can make the white patches stick out more due to dehydration. After a couple of days, the white patches will become less conspicuous. Sometimes this makes them invisible, but other times you have to seek out a more powerful solution.


We never like to remove natural tooth enamel if we don’t have to, but sometimes it’s the best solution. For shallow fluorosis, we can buff it out of your teeth. However, this does remove some of your tooth’s precious, irreplaceable enamel. It might also increase your risk of cavities in the future.

Porcelain Veneers

Porcelain veneers are generally the best option for fluorosis-affected teeth, because they don’t rely on recoloring natural tooth enamel. Instead, porcelain veneers use wafer-thin porcelain which is applied to the visible surfaces of teeth in order to correct staining, unseemly gaps, and the general size and shape of your teeth. This lets you take care of fluorosis at the same time as other cosmetic complaints. With proper treatment, porcelain veneers can even last up to twenty years.

Porcelain Crowns

Porcelain crowns are similar to veneers because they cover your teeth with a ceramic shell. Unlike veneers, porcelain crowns cover the entire tooth above the gumline. This means they’re not just good for covering mild fluorosis, they are effective for protecting teeth made vulnerable by more severe fluorosis.

Cover, Conceal, or Eliminate White Patches on Teeth in Wilmington, NC

If you are unhappy with your fluorosis, we can help you correct the problem. To learn how we can improve your smile, please call (910) 392-6060 or contact Kuzma Advanced Dentistry for an appointment with a cosmetic dentist in Wilmington, NC.