I have two sons, ages 10 and seven. My oldest has white spots on some of his adult teeth, specifically his two upper front teeth and first adult molars. My youngest has one hypoplastic molar in his adult molars. As his front adult upper teeth emerge, at least one is already showing white spots. What causes this? How possible is it that both of them have this?

White spots (also known as hypoplasia) on one or two adult teeth is relatively common, although most of the time it’s difficult to identify the exact cause. Both environmental and hereditary factors could be at play. Fluorosis is a common culprit, although it sounds unlikely in your children’s case. The most current recommendation for preschoolers is to use only a pea-sized amount of toothpaste with fluoride and to make sure they spit out the toothpaste and do not swallow it. Hypoplasia can also be caused by local infection from baby tooth decay or trauma to the mouth during the development of permanent teeth (such as a hard bump on a table corner, biting into a fork too hard, rough play with siblings, a sports injury, etc.). Other factors include viral infection while calcification of the teeth is still occurring. Most of the time, it’s really hard to pinpoint a specific event or cause for the white spots. If you’re concerned about them, I would encourage you to make an appointment to see your dentist.

My tongue seems to be continually covered in a fine (not chunky) white film. I scrape it off with a tongue scrape but it comes back the next time I brush. I brush twice or three times per day and use hydrogen peroxide mouthwash.

Unfortunately, I cannot tell you what the white film is without a physical exam. There could be many potential causes such as dry mouth from certain medications, or dehydration. It could also be an accumulation of dead tissue or food debris. Please consult your dentist to rule out any potential candidiasis, which is a fungal infection.