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Infants on Formula at Risk of Developing Fluorosis?
Posted on 3/18/2013 by Jessica Edgerton
Dental fluorosis commonly appears as faint, white flecks or spots with frosty edges that are difficult to see. Fluorosis is linked to fluoride intake by children under the age of 9, including infants who take formula made with tap water.

Most cases of dental fluorosis in the U.S. are so mild that only a dental professional can see them. Oftentimes barely detectable, these specks actually represent areas of stronger, more acid-resistant enamel, due to the incorporation of fluoride mineral. Fluorosis only affects teeth that are forming under the gums, and occurs when younger children consume excessive amounts of fluoride over long periods of time.

The most common source of excessive fluoride intake is toothpaste – a good reminder for kids to spit not swallow! Another source of fluoride intake is tap water, which explains why infant formula that requires mixing with water is linked to the condition, especially in babies fed exclusively on formula.

ToothpasteIs this an issue you should be worried about? Community water fluoridation has been a favorable practice in the U.S. for decades as a means of preventing tooth decay and has been shown to reduce cavities by as much as 70% in many areas. Fluoride concentrations in the public water supply usually range from 0.2 mg/L on the low end to 2.0 mg/L on the high end, according to the Centers for Disease Control and Prevention. The optimum level is anywhere from 0.7 to 1.2. Unregulated rural communities that use well water may have even higher natural fluoride concentrations and should be tested thoroughly.

Check with your local water utility to see if your fluoride concentration is low or high. If your baby is on formula and your water system’s fluoride concentration is on the high end, you may wish to rotate the use of tap water with low-fluoride bottled water to reduce the chances of your baby developing mild dental fluorosis.


Fluoride intake can come from many different sources. Lots of processed foods and beverages are made with fluoridated water, including soda and juice.
Use a non-fluoride toothpaste for babies under the age of 2, and a pea-sized amount of fluoride toothpaste when your child shows that they can reliably spit it out.
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