Conservative approach to hypomineralization and fluorosis-related stains: a case report

White spot lesions on the dental surface, resulting from enamel hypomineralization and/or dental fluorosis, arise from disturbances in enamel development. When anterior teeth are affected, these lesions may compromise smile esthetics and negatively impact self-esteem. The treatment protocol is defined according to lesion severity, taking into account their extent, depth, and color, as well as the patient’s chief complaint. This clinical case report describes a minimally invasive approach for the management of white spot lesions in anterior teeth. A systemically healthy 21-year-old patient sought dental care reporting dissatisfaction with tooth color and the presence of white spots on the maxillary anterior teeth. Clinical examination identified mild fluorosis, areas of hypomineralization, and an existing restoration with inadequate shade and marginal adaptation. The esthetic impact of the condition was assessed using the Oral Health Impact Profile (OHIP-14), with an initial score of 16, indicating impaired oral health-related quality of life. Treatment included enamel microabrasion to remove or reduce superficial fluorosis-associated stains, in-office dental bleaching to harmonize tooth color, and direct composite resin restorations to correct hypomineralized areas and replace the pre-existing restoration. After one year of follow-up, clinical stability was observed and the OHIP-14 score decreased to 1, demonstrating a significant improvement in psychosocial impact. The proposed approach proved effective for esthetic rehabilitation, addressing the patient’s complaints and achieving satisfactory outcomes with maximal preservation of tooth structure.