Comparison of relative efficacy of two techniques of enamel stain removal on fluorosed teeth. An in vivo study

J Clin Pediatr Dent. 2014 Spring;38(3):207-13. doi: 10.17796/jcpd.38.3.0h120nkl8852p568.


Objective: The present study was conducted to compare and evaluate the relative efficacy of enamel microabrasion (using 18% HCl) and bleaching with McInnes solution in the esthetic improvement of fluorosed teeth and to check postoperative sensitivity.

Study design: 30 children aged between 9-14yrs with a mild or moderate grade of fluorosis as classified according to Dean's fluorosis index and who complained of objectionable esthetics were selected. Split mouth study design was selected in our study. Each subject had one of their maxillary central incisor randomly selected for Enamel microabrasion and the contra lateral maxillary central incisor for McInnes bleaching. Esthetic improvement was assessed by comparing the pre and postoperative digital photographs. During the evaluation session, the pre and postoperative photographs of 30 subjects were incorporated into a power point presentation and were projected side by side in a darkened room. Four calibrated and blinded examiners, including a layman rated the photographs under standardized viewing conditions. Esthetic improvement was assessed for both short and long term improvement. The postoperative sensitivity was recorded for both the procedures immediately after treatment and at one, three and six months interval.

Results: The results proved that both immediate and long term (6 month) esthetic improvement achieved by McInnes bleaching were superior to enamel microabrasion. There is a reduction in aesthetics of teeth in both the procedures after six months, which was very minimal in McInnes procedure and significant in enamel micro abrasion. Postoperative sensitivity in both techniques were negligible. The sensitivity observed were transient and subsided within an one-month post operatively. None of the subjects reported sensitivity at one, three and six months intervals.

Conclusion: McInnes bleaching is a better procedure compared to enamel microabrasion in improving the appearance of fluorosed teeth. Both techniques are conservative and safe.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Air Abrasion, Dental / instrumentation
  • Air Abrasion, Dental / methods*
  • Child
  • Dental Enamel / drug effects
  • Dental Enamel / pathology*
  • Dentin Sensitivity / etiology
  • Esthetics, Dental
  • Fluorosis, Dental / therapy*
  • Follow-Up Studies
  • Humans
  • Hydrochloric Acid / therapeutic use
  • Hydrogen Peroxide / therapeutic use
  • Photography, Dental / methods
  • Silicates / therapeutic use
  • Tooth Bleaching / methods*
  • Tooth Bleaching Agents / therapeutic use
  • Tooth Discoloration / therapy*
  • Treatment Outcome


  • Silicates
  • Tooth Bleaching Agents
  • Hydrogen Peroxide
  • pumice
  • Hydrochloric Acid