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A medical student's personal experience with dental fluorosis – by Hilary P., South Australia.
I come from a happy home with a Mum and Dad that loved me and took really good care of me. When I was a little girl my Mum was very proud of the fact that I brushed my teeth twice every day and she didn’t give me soft drinks and cordials because they were high in sugar and not good for me. My Mum was a stay-at-home Mum and she made sure I ate healthy home-cooked meals and drank lots of milk for healthy bones and healthy teeth. I didn’t have many childhood infections or a lot of antibiotics.
For most of my childhood we lived in the suburbs in NSW and Victoria where we had a fluoridated water supply. I was given fluoride tablets when we went to Brisbane for several months in 1984. I brushed with regular toothpaste because that was all that was available back then, and I sometimes swallowed the toothpaste instead of spitting it out. My baby teeth were completely normal and I didn’t have any cavities.
When my adult teeth erupted they were badly discoloured. Several dentists have told me that this is caused by fluoride. I guess I sneer a bit at people who complain when they have a little white mark on one tooth because all my teeth were a ghastly chalky white. The two top front teeth were the worst because they also had two dark coffee-coloured stains that covered about half of each tooth.
I remember my first year of high school we had to write anonymous ‘warm fuzzies’. We had to write our name down on a piece of paper and then pass it around the class and everyone was supposed to write a compliment about you. When I got my paper back five people had written, “You are ugly”. Someone else had tried to set up one of the boys and had written, “I love you, from Grant”, and there were a few nice comments from my friends. It is silly, but that memory has stayed with me for many years.
It is a bit of a cliché but children can be cruel and they can ask brutally honest questions. When I was a teenager I remember one of my younger cousins asking me, “Why are your teeth rotten?” It hurt inside but I told them, “because when I was younger I sometimes swallowed my toothpaste instead of spitting it out, and that is very bad for your teeth”.
Like most people I have always disliked speaking in public but I was a much quieter child than most. I became a good listener because I didn’t like people looking at me when I talked, and I only really talked to people that I felt safe with. I went through a phase where I smiled without opening my mouth so that I could hide my teeth in photographs. In year 12 one of my friends wrote in my yearbook, “You are a lovely friendly person but you should smile more because you have a nice smile”.
Up until recently, I thought that dental fluorosis was just a cosmetic problem. When I went to the dentist they were always really nice about it and said that although my teeth look awful they are really strong teeth and I probably won’t ever need a filling. I started to get scared about two years ago when I noticed my teeth were becoming pitted where the enamel had started to chip off. This is a problem that many dentists don’t know about because it is fairly rare. When teeth are really badly affected by fluoride they become porous and brittle, and are very prone to damage.
My teeth were crooked and a lot of my friends have had braces. I would have liked them too but I felt “why bother?” For most people, a year or two in braces and they have nice, white, perfectly straight teeth. My teeth would still be discoloured.
Bleaching doesn’t work for severe fluorosis. The already very white bits get whiter (not desirable), and the brown bits will only lighten by a few shades. I have had micro-abrasion and that has helped. It is not a complete fix, as you can see for yourself in the photos. Unfortunately the only thing that can be done is to remove the outer part of the enamel and cover it up with a veneer, which is very expensive, especially when you have a mouth full of “rotten” teeth.
It took a long time but I feel like I have reached a turning point in my life. To you it might not sound much, but for me it is huge. It was late one night and I was chatting with a boy that I was romantically interested in. He made a comment about having had orthodontics and I said, “I hate my teeth”. He said, “Get them fixed then”. More than that, he wanted to make an appointment for me with his orthodontist and made me promise that I would do it before the end of the year. “Don’t be useless,” he said. He made me show him my teeth and it was extremely difficult for me – it really made me realize how self-conscious I had become.
I am a medical student so it is important that I can communicate with people and present a professional appearance. I’m now 3 months into my treatment and I really believe it is one of the best things I have ever done. I wish I had done it sooner. I plan to have veneers once the orthodontics are complete and I am really excited about it!
All up I am expecting to pay about $14,000 to straighten and veneer the teeth that are visible when I smile. I realise this is a cosmetic fix to an irreversible structural problem. The teeth that are not veneered will continue to deteriorate, and the veneers will not last forever.
I was at a BBQ recently with some other medical students when one of them brought up the topic of fluoride in drinking water. It made me quite cross to realise that there is really very little knowledge about the harm fluoride can do, even in the medical community.
I think there is sufficient evidence to say that ingesting high amounts of fluoride is harmful. As a medical student, we are taught that all drugs are poisonous in high doses, and that side effects need to be balanced against the benefits of a treatment. It concerns me that when fluoride is put in drinking water the dose that a person gets isn’t monitored or controlled. There is no weighing up of the risks and benefits to that individual, and they don’t have a choice whether or not they take the drug. The side effects in children aren’t obvious until several years down the track when their adult teeth erupt.
Water is a basic commodity and all children and adults should have access to a clean and safe supply. I have heard it quoted that as many as one third of children in Adelaide have some degree of dental fluorosis. If you are a parent of a young child, you should be using low fluoride toothpaste that has been especially designed for children. I urge you to consider carefully the risks and benefits of drinking fluoridated water, and to write your concerns to your local member of parliament.