Nowadays, the differential diagnosis between fluorosis and non-fluoride-induced opacities needs to establish
differences between symmetrical and asymmetrical and/or discrete patterns of opaque defects (25). These
criteria imply that all symmetrically distributed and non-discrete opaque conditions of enamel are fluorosis.
Diagnostic difficulties occur mostly with mild forms of fluorosis, or when a mix of fluorotic and non-fluorotic
conditions is evident. It’s important to emphasize that non-fluoride enamel opacities include all categories of
opacities not defined as fluorosis, i.e. dental hypoplasia lesions that are commonly characterized as discrete,
demarcated white or discolored opacities often affecting a single tooth and, less frequently, multiple teeth, with
a symmetrical distribution (25), and result from a wide variety of systemic or local factors.