There are a lot of things that can leave stains on a child’s teeth, which may be seen in many different colors. One can see yellow stains, brown stains, or even the temporary stain from eating brightly colored candy, but what about when the stain is white? Where do those white spots come from, and is there anything we can do about it?

Surface stains that affect the tooth enamel sometimes appear on a tooth that is otherwise healthy. One cause of this kind of stain is Fluorosis. It occurs when developing permanent teeth are exposed to too much fluoride. It doesn’t damage the teeth, but it does unevenly bleach them, leaving white spots on them before they even grow in.

To avoid white spots from fluorosis, it should be made sure to limit the amount of fluoride toothpaste when brushing a child’s teeth. A tiny smear (no bigger than a grain of rice) is sufficient for babies and toddlers (2 to 3 year olds). A pea-sized dab is the most one should use for a young child (4 to 6 year olds). For age groups of 0-2 years we must use Fluoride Free Toothpastes. For 2-6 year olds we can use any kids toothpaste (with fluoride content no more than 500 ppm). From 7 years and above a child can switch over to a normal adult toothpaste.

A more harmful cause of white spots is Demineralization. It is the gradual leaching of crucial minerals like calcium from the tooth enamel. Plaque buildup and acid exposure over time lead to demineralization. Children with braces are particularly susceptible to it.

Preventing demineralization is all about good brushing and flossing habits, as well as regular dental visits. All children should be brushing for two minutes twice a day and flossing daily. Orthodontic patients should take extra care to clean away all the food residue and plaque around the brackets to avoid white spots when the braces come off.

At times white spots don’t come from demineralization or fluorosis, but from Enamel Hypoplasia. It is a condition that leaves the teeth with thinner enamel than usual and therefore more vulnerable to stains and decay. Causes of enamel hypoplasia in a child’s teeth include the mother smoking while pregnant, malnutrition, and premature birth.

There are a few ways to treat them, such as microabrasion and veneering. With microabrasion, a thin layer of enamel is scraped away to restore the tooth’s uniform appearance.

Not all stains can be removed with just microabrasion. In these cases, veneers are an excellent option. The way these work is that the Pediatric Dentist attaches thin pieces of porcelain to the teeth, for a natural, uniform, white appearance.