This 50-year female has mottled upper teeth. It is also called Dental Fluorosis and it is due to excessive fluoride concentration in water during the development stage of the affected teeth.
This lady came to me today for toothache of some back tooth (“molar”). It was not at all surprising to me that she was not bothered about her discolored teeth. Not surprising? – ‘cos I get scores of such men and women who are in no way concerned about such discolored teeth.
Why they are not concerned? – they are not concerned, that’s all! Over the years I have tried to analyse these middle and lower middle class patients. Beautifying such “brown” teeth is not their priority. They are more concerned about the health of their family members, the education of their children and of course sky-rocketing prices of essential commodities.
Most of my patients are from middle class families. That’s why I never ever try to put the expensive options in front of these people that such discolored teeth can be managed by expensive “porcelain laminates”. I know they will never be ready for such an expensive treatment where they will have to shell out a couple of thousand rupees.
An important point here is that if the patients are just okay with such teeth, then why should they be co-erced into getting expensive cosmetic solutions. This is more so if the integrity of discolored teeth is otherwise okay. Personally, I don’t find that all teeth in such a patient (as shown in this picture) should get a “light-cure composite” facing (it is a tooth matching material – called “cement” by laymen -which has got chemical union with the tooth structure). There are some quacks in this country who just “convince” such patients into getting all such teeth “capped”—I am against this practice.
For the management of such teeth, the less intervention the better because we are dealing with natural tooth structure and trying to replace it with artificial materials which, howsoever advanced these may be, will always be poor substitutes for Mother Nature. However, our treatment planning varies from case to case as it is dependent on a number of factors. Suppose there is a youngster who is too much anxious about his looks because of such teeth, we need to do everything to restore his self-esteem.
So while I was talking about this lady whose dental photograph is given here , I want to add that she appears to be at ease with her teeth because everything else is just matching – look at the color of her gums (not a disease, just increased melanin pigmentation) and overall her facial skin was matching with other paraphernalia. So, there was no complaint perhaps. Neither I made her conscious about that – could be that nobody pointed this out to her during all these years.
I don’t know what was there in this post which inspired me to write on this. The bottomline is that esthetics has got different meaning for different socio-economic groups, different cultures, different communities, different ethnic groups ….and so on and so forth. Anyway, it is just the fine it is …………why should it bother anybody else? It’s their life anyway…..
As we age in our professions, we keen on realizing that management of our patient is not always written in our text books, it has got many more angles which keep on unfolding throughout our professional lives…