"Armchair" diagnosis and cosmetic dentistry treatment plan.

• History: Both the brown and the excessively white areas on this young man's teeth are typical of a type of tooth staining termed "fluorosis."
  
  
• Cosmetic dentistry treatment plan step #1: Utilize a teeth whitening process in an attempt to lighten the teeth to a shade close in color to the white fluorosis staining. The idea is that even though the white fluorosis stains will still be present after the whitening treatments, hopefully they will be less noticeable. The whitening process may have an effect on the brown fluorosis staining, but most likely will not resolve this discoloration totally.
  
  
• Cosmetic dentistry treatment plan step #2: The teeth whitening process should give the teeth a more consistent and uniform shade, and hopefully one that can be matched by white filling material (tooth bonding, dental bonding). Now that the whitening process has been completed, any brown fluorosis staining and tooth imperfections that exist can be remedied with the placement of dental bonding in just that area.