If children take in too much fluoride before their permanent teeth have erupted, the tooth enamel can become pitted or stained with brown, black or grey spots. In milder cases, the teeth may seem to have some odd white spots or streaks on them. Sometimes only a dentist can tell that fluorosis has occurred. Children may get an excess of fluoride if they drink water that is fluoridated and brush their teeth with fluoride toothpaste that they then may swallow. Fluorosis can only affect teeth that are still under the gum. It does not affect other parts of the teeth; only the enamel, which in severe cases can become misshapen. It is important to realise that teeth affected by fluorosis are not suffering from a disease. If the stains are only at the back of the teeth where it cannot be seen, no treatment is necessary. If the problem is at the front then cosmetic treatment can be done to make the teeth appear whiter. If the fluorosis is really bad, the teeth may be covered by bonding or crowns. Fluorosis will not fade away with time, but spots may become even darker. To prevent fluorosis, use non-fluoride toothpaste until you are sure your child can spit properly. Other conditions can cause similar symptoms so be sure to consult the dentist if your child’s teeth seem stained.