The impact of fluoride on ameloblasts and the mechanisms of enamel fluorosis

J Dent Res. 2009 Oct;88(10):877-93. doi: 10.1177/0022034509343280.


Intake of excess amounts of fluoride during tooth development cause enamel fluorosis, a developmental disturbance that makes enamel more porous. In mild fluorosis, there are white opaque striations across the enamel surface, whereas in more severe cases, the porous regions increase in size, with enamel pitting, and secondary discoloration of the enamel surface. The effects of fluoride on enamel formation suggest that fluoride affects the enamel-forming cells, the ameloblasts. Studies investigating the effects of fluoride on ameloblasts and the mechanisms of fluorosis are based on in vitro cultures as well as animal models. The use of these model systems requires a biologically relevant fluoride dose, and must be carefully interpreted in relation to human tooth formation. Based on these studies, we propose that fluoride can directly affect the ameloblasts, particularly at high fluoride levels, while at lower fluoride levels, the ameloblasts may respond to local effects of fluoride on the mineralizing matrix. A new working model is presented, focused on the assumption that fluoride increases the rate of mineral formation, resulting in a greater release of protons into the forming enamel matrix.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Ameloblasts / drug effects*
  • Amelogenesis / drug effects
  • Animals
  • Cariostatic Agents / adverse effects
  • Cariostatic Agents / analysis
  • Cariostatic Agents / pharmacology*
  • Cells, Cultured
  • Dental Enamel / drug effects
  • Disease Models, Animal
  • Fluorides / adverse effects
  • Fluorides / blood
  • Fluorides / pharmacology*
  • Fluorosis, Dental / etiology*
  • Fluorosis, Dental / pathology
  • Humans
  • Models, Biological
  • Odontogenesis / drug effects
  • Tooth Calcification / drug effects


  • Cariostatic Agents
  • Fluorides