Join us for an insightful clinical case presentation focusing on a 29-year-old employed born in the township of Newcastle, in KwaZulu-Natal province. He relocated to reside in a village in Zeerust, Northwest province with his parents, at the age of four. Due employment opportunities he moved to Johannesburg, Gauteng province. He reported to the Wits School of Oral Health Sciences clinic, complaining of generalised discoloration of teeth in 2017. The patient reported that the discoloration started when he was a teenager. No sensitivity experienced. In Newcastle, they consumed water from the taps. In Zeerust they consumed water from wells, but later taps water were installed. The pattern of discoloration of the patient’s teeth, explains the years of exposure to fluoride. Patient’s expectation is to have ‘normal looking teeth. According to Dean’s Fluorosis Index (DFI) classification and based on clinical features and history, the fluorosis is classified as ‘Severe’, Code 5.