Fluoride may be essential for healthy teeth, but can children get too much of it? Surprisingly, the answer is yes. Excessive fluoride can stain kids’ teeth — causing a condition called enamel fluorosis.

The condition shows up during tooth development in early childhood and creates defects in tooth enamel that can cause discoloration of the teeth, from tiny white specks or streaks to brown markings. In severe cases tooth enamel may be pitted and rough, and in rare instances the structure of affected teeth may weaken. Because fluoride is found in drinking ?water, toothpaste and vitamin supplements, many children are at risk for ?ingesting too much of the compound.

“Among most kids, it happens with permanent teeth,” says William Lieberman, D.D.S., a pediatric dentist in Red Bank, N.J. “But even a baby who’s fed formula mixed with tap water high in fluoride can have stained teeth.” The good news is that enamel fluorosis can be prevented. Parents should ask their local water utility how much fluoride is in their drinking water, and then consult with their dentist to determine if fluoride supplements are necessary. Additionally, they should supervise their children during toothbrushing to ensure that toothpaste (a pea-sized dab is sufficient) is spit out rather than swallowed.

Enamel fluorosis can be treated through microabrasion, which uses mild acid to remove stains, followed by dental-office bleaching. A child should be at least 12 before undergoing these procedures.

“Fluoride is still the most cost-effective measure to prevent tooth decay, but it must be taken properly,” says Lieberman.

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