However, this good news is tempered by the fact that cases of dental fluorosis in North America increase up to 65 percent in some areas where water is fluoridated. Dental fluorosis occurs when excessive amounts of fluoride are ingested during the early period of tooth development. Mild cases are exemplified by small opaque areas on the tooth surface. Severe cases include confluent pitting and brown stains on all tooth surfaces. It is the cumulative amount of fluoride swallowed from water, toothpaste, supplements, and other sources that determine if fluorosis will occur.
Some studies suggest that children are now drinking less water and consuming more sodas and juices.
On average, children less than a year old drink 3 ounces of juices and beverages per day. Children ages 1 to 2 years drink about 9 oz. This difference is due to several factors including the fluoride concentration in the water at the location where the juices are made. Parents and dentists should consider the type and amount of fruit juice consumed by children to insure that correct levels of cavity-fighting fluoride protection are achieved while the risk of developing dental fluorosis is minimized. One alarming find of the Kiritsy et al.