Fluorosis in children is primarily caused by excessive fluoride exposure during the years when teeth are developing, particularly in children under the age of 6. The main causes from your list include:
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Swallowing toothpaste - Children may swallow toothpaste that contains fluoride, leading to excessive fluoride intake.
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Swallowing dental rinses - Similar to toothpaste, swallowing fluoride mouth rinses can contribute to fluorosis if used inappropriately.
Drinking too much water is typically not a direct cause unless the water has extremely high fluoride levels, which is uncommon in most municipal water supplies. Brushing teeth too frequently is not a recognized cause of fluorosis, as fluoride exposure from brushing alone (when done correctly and without swallowing toothpaste) is usually not excessive.
So, the correct answers are:
- Swallowing toothpaste
- Swallowing dental rinses