Re: Cosmetic help for severe fluorosis

thatwave@xxxxxxxxx wrote:
I have pretty bad case of fluorosis. My permanent teeth came in brown
and mottled with hardly any enamel and looked bad from the start.
Dentists have theorized that I must have been given large doses of
fluoride as a baby, perhaps my mom took something when she was
pregnant, I grew up in an area with abnormal amounts of fluoride in
the water, etc.

I am very meticulous about dental care. I brush after every meal with
my electric toothbrush the dentist recommended, don't snack in
between, floss, mouthwash etc. I'm a model dental patient, yet, I look
like I don't brush and have never visited a dentist. In fact, I know
people who brush once a day and rarely visit the dentist that have
much nicer teeth than mine! Despite my best efforts, I have several
new, ugly cavities a year. The areas with no cavities just have ugly
stains. The hygienists tell me that my teeth are pretty clean when I
go in, and that I seem to do a good job at fighting plaque. Every
dentist I've seen has been surprised at the severity of the fluorosis
and they always ask where I'm from. (Apparently certain areas have
higher levels of fluoride in the water with worse fluorosis.) I also
have very tiny teeth if that means anything.

I have been told by four dentists that my fluorosis is too bad to do
much with. Two dentists recommended just keeping up with regular
fillings until there wasn't enough tooth left to hold them. One
recommended crowning every tooth. Finally, one told me to just pull
all the teeth and get some attractive dentures because it would be
much cheaper than all the dental work I'd need =( This is very
embarrassing. I come from a good family, good area, am well educated
etc., but people look at me like I'm a hillbilly.

I've been told that the staining is too severe for normal bleaching
and stain removal.
I've inquired around about veneers, caps, bonding, etc. and several
specialists told me that I don't have enough enamel on my teeth to
hold the bonds required for these things. Is this true?

I want to preserve my natural teeth even if they're ugly, but would
like to have cosmetic work to hide the ugliness.

Can anyone recommend what I can do to enhance my teeth without
removing them or grinding them down for crowns? I'm barely 30, and
desperately need a way to protect my non-enamel teeth!

I have only occasionally seen fluorosis with focal areas of hypoplastic enamel. Usually this is seen in families with similar dietary habits living in the same area or nearby. I have never seen fluorosis so severe that ALL the teeth have little or no enamel. If you had excessive fluoride as a baby you would expect the teeth mineralizing at the time to be infected, but not all of them.
It is likely in my mind that you have one of the genetic enamel or dentin dysplasias, such as amelogenesis imperfecta or dentinogenesis imperfecta. There are a whole family of similar conditions where the entire dentition is variably affected.
Most people I've seen with this condition affecting all the teeth eventually need full crowns on all existing teeth in order to save them.

Steve
.

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