Exposure to an abnormally high concentration of fluoride during the early stages of tooth development can lead to hypomineralization of the tooth’s enamel and increased porosity that is reflected in the opacity of enamel as chalky white lines or stains. In general, teeth with more severe dental fluorosis have significantly higher levels of fluoride in enamel than those with less severe forms of dental fluorosis. Also, the extent and degree of hypomineralization increases with increased fluoride exposure during development. In cases of severe hypomineralization, porous enamel appears brown and it can be very fragile, with surface damage occurring quite easily during chewing, attrition, and abrasion.1,11
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