Clinical
Treating fluorosis stains using caries-infiltration
By Marie Clément and Renaud Noharet W
hen faced with increasing aesthetic r equir ements, patients need options for the most effective
therapies. Today, fluorosis stains constitute a frequent reason for aesthetic dentistry consultation. These stains, which are white or brown in the most severe cases, may originate from a physical problem. This article will use two clinical cases to illustrate the treatment of white fluorosis stains, using a conservative technique that combines tooth whitening with caries-infiltration.
Options for therapy An attractive smile can be extremely important for a person’s social relations. There are many resources available in dentistry for correcting an aesthetic defect that is caused by a stain: construction of a crown, veneers or a direct composite filling3. However, these procedures are considered to be invasive, because they require more or less extensive preparation of the tooth, which involves a significant alteration to the tooth’s structure. These treatments are not directed towards the preservation of tissue, which is the basis of current dental practice. When young patients present with
this type of defect, the predictability and lifespan of traditional dental restorations must be taken into consideration. It seems obvious that the first course of treatment should be the most conservative. The selected treatment in the two clinical cases presented, according to gradient therapy2, was an external outpatient whitening procedure using
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Fig 1 A young woman attended the practice because of unattractive “white stains” on her teeth
Fig 2 Whitening using thermoformed trays and peroxide gel was satisfactory but not sufficient
Prophylactic paste starts erosion-infiltration Fig 3
15 per cent hydrochloric acid gel is applied Fig 4
Scottish Dental magazine 53
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