Minimally invasive techniques for dental fluorosis: microabrasion and whitening

Alexander Nishida e Carlos Francci
Alexander Cassandri Nishida- Mestre em Biomateriais pelo Programa de Pós-Graduação em Materiais Dentários (FOUSP-SP);- Aluno nível Doutorado do Programa de Pós-Graduação em Materiais Dentários (FOUSP-SP).Carlos Francci- Graduado em Odontologia (FOUSP-SP);- Mestre, Doutor e Livre Docente em Materiais Dentários (FOUSP-SP);- Professor Assistente do Departamento de Materiais Dentários (FOUSP-SP);- Coordenador de Cursos de Especialização e Atualização em Dentística (EAP APCD Central e EAP ABO Pouso Alegre-MG);- Coordenador do Curso de Atualização de Dentística (FUNDECTO-USP);- Coordenador do GFree (Grupo Francci de Estudos em Estética).

Female patient, 20.


Teeth with brown stains and many white stains.


Initial appearance of fluorosis stains. The brownish stains on the anterior teeth were causing embarrassment to the patient and were her main complaint.



Stains on teeth were classified as grade 5 fluorosis in accordance with the TF index (Thylstrup & Fejerskov).


After prophylaxis/scaling and shade taking, supervised take-home whitening, it was carried out with 10% carbamide peroxide for 4 hours daily (only one syringe) aimed at smoothing the stains and whitening the substrate. By decreasing the difference between the color of the stains and the color of the teeth, less microabrasion would be needed. Microabrasion was divided into two sessions: the first consisting of 10 applications on each upper arch and the second session covering the lower arch. Desensitizing agent was used for greater comfort to the patient. When the microabrasion step was completed, take-home whitening was performed again with the same concentration.