Management of moderate fluorosis : A conservative approach

Auteurs: Haythem Ben Hadj Belgacem , Kawther bel Haj Salah, Imene Gnaba, Souha Ben Youssef

Abstract

Introduction:
Dental aesthetics play a critical role in self-esteem and social interactions, with dental dyschromias, particularly fluorosis, being common concerns. Fluorosis manifests in varying severity, requiring tailored therapeutic approaches that respect the principle of minimal intervention. This report discusses a case of moderate dental fluorosis managed using a minimally invasive protocol.

Observation:
An 18-year-old female presented with symmetrical yellow-brown stains affecting the vestibular surfaces of her maxillary anterior teeth. Clinical examination confirmed moderate fluorosis (Dean’s classification, score 3). Prophylactic cleaning excluded extrinsic causes, and tooth mapping alongside transillumination guided a personalized treatment plan.
The adopted protocol combined microabrasion, ambulatory bleaching, and erosion-infiltration. Three microabrasion sessions with Opalustre paste (6.6% HCl) effectively reduced the discoloration. Ambulatory bleaching using 16% carbamide peroxide further enhanced enamel brightness. Residual white spots were treated with Icon’s erosion-infiltration technique, achieving excellent optical integration. The minimally invasive approach ensured optimal aesthetic results with no postoperative complications.

Discussion:
Fluorosis results from excessive fluoride exposure during amelogenesis, leading to enamel hypomineralization and porosity. The described protocol exemplifies a conservative treatment strategy that effectively restores dental aesthetics while preserving healthy tissue.

Conclusion:
This case demonstrates the success of a personalized, minimally invasive approach in managing moderate dental fluorosis. The protocol serves as a model for addressing similar cases, balancing aesthetics, functionality, and tissue preservation.

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