Every day, your enamel (the protective outer layer of your tooth) gains and loses minerals. You lose minerals when acids, formed from bacteria, plaque and sugars in your mouth, attack your enamel in a process called demineralization. You also gain minerals like fluoride, calcium and phosphate when you consume food and water that contain these minerals, resulting in remineralization. Tooth decay is a result of too much demineralization without enough remineralization. Dental fluoride helps prevent tooth decay by making your enamel more resistant to acid attacks, which also reverses early decay.
There are various sources of fluoride, ranging from foods, fluoridated water, toothpaste, and mouthwash. You can buy low-strength fluoride mouthwash over the counter, while stronger concentrations in liquid or tablet form need a healthcare provider’s prescription.
A dentist or hygienist can give you a fluoride treatment during a routine dental exam or cleaning. A dentist can also apply fluoride to your teeth in the form of:
Foam, which they’ll dispense into a custom tray, then place over your teeth.
Varnish, which they’ll paint directly on your teeth.
Gel, which they’ll either paint on your teeth or dispense in a custom tray.
Many people benefit from fluoride treatments every six months. If you’re prone to cavities, you might benefit from more frequent treatments.
According to the Centers for Disease Control and Prevention (CDC), the average number of missing or decaying teeth in 12-year-old children in the United States dropped by 68 percent from the late 1960s through the early 1990s. This followed the introduction to, and expansion of, fluoridated water in communities, and the addition of fluoride to toothpastes and other dental products.
Infants and children between the ages of 6 months and 16 years need an appropriate amount of fluoride. Developing teeth benefit from fluoride just as much, if not more, than fully erupted (grown in) teeth. The American Dental Association (ADA) recommends watching the intake of too much fluoride in infants and young children. The ADA specifically recommends avoiding reconstituted liquid formulas, such as liquid concentrate or powdered baby formulas that require mixing with fluoridated water.
Instead, the ADA recommends breast milk (chest milk), ready-to-feed formula or prepared formula mixed with fluoride-free water. These recommendations are to guard against enamel fluorosis — faint white streaks that can appear on tooth enamel during a child’s developmental years, even before the teeth erupt through the gums.
For young children, the ADA also recommends:
Using a pea-sized amount of fluoride toothpaste at each brushing.
Spitting out rather than swallowing the toothpaste.
Not allowing children under age 6 to use fluoride mouth rinses unless recommended by a dentist or other healthcare provider.
Not giving fluoride-containing dietary supplements to children under 6 months of age.
Adults definitely still benefit from fluoride, especially if you have:
Dry mouth (xerostomia), a common side effect of some healthcare conditions (like Sjögren’s syndrome) and certain medications (such as allergy medications and antihistamines). Saliva (spit) helps wash away food particles and bacteria therefore slow saliva production makes you more prone to oral health issues like gum disease and cavities.
Gum disease, which exposes your teeth and gums to bacteria and increases your risk of tooth decay.
A history of tooth decay, which usually means that you’d benefit from additional fluoride.
Crowns, bridges, braces or removable partial dentures, which may increase your risk of cavities, especially around orthodontic brackets or where your crown meets your tooth.
Fluoride strengthens teeth and reduces your risk of cavities by approximately 25%.
Specifically, fluoride:
Remineralizes your tooth enamel.
Reverses early tooth decay.
Slows down the process of demineralization.
Prevents the growth of cavity-causing bacteria.
While fluoride is a naturally occurring compound, it can still cause side effects when consumed in large doses. In the United States, the amount of fluoride that’s added to water is usually around 0.7 parts per million (ppm), the maximum allowed as of 2015.
Dental fluorosis happens when you consume too much fluoride while your teeth are still forming under your gums. This results in white spots on the surface of your teeth. Other than the appearance of white spots, dental fluorosis doesn’t cause any symptoms or harm.
It tends to affect only children under the age of 8 who have permanent teeth still coming in. Children are also more likely to swallow toothpaste, which contains significantly more fluoride than fluoridated water. You can reduce your child’s risk of developing dental fluorosis by supervising them when they brush their teeth to make sure they aren’t swallowing large amounts of toothpaste.
Skeletal fluorosis is similar to dental fluorosis, but it involves bones instead of teeth. Early symptoms include joint pain and stiffness. Over time, it can alter bone structure and cause the calcification of ligaments. It tends to result from long-term exposure to high levels of fluoride, often in drinking water. Several things can cause excessive fluoride in water, including accidental contamination from fires or explosions. Some areas, including large parts of Africa and Asia, also have large geologic deposits of fluoride, which can contaminate water supplies. There are also reported cases of skeletal fluorosis in the United States, though it’s rare. In the case of a 52-year-old American man with skeletal fluorosis, experts concluded it was likely due to swallowing toothpaste.
In the United States, about 74% of people with public water supplies have adequate levels of fluoride in their water, but not every city in the United States fluoridates its drinking water. The optimal level of fluoride is 0.7 parts per million. The decision about whether or not to fluoridate is made by each city. However, the CDC has a tool you can use to check your local water supply if you live in certain states. This tool will tell you whether your city fluoridates its water. If it does, you’ll also be able to see how much they add. If your city doesn’t fluoridate its water, but you’re interested in the dental health benefits of fluoride, try:
brushing your teeth twice a day with a fluoride toothpaste
using a fluoride mouthwash once a day (not recommended for children under 6 years of age)
asking your doctor about a professional fluoride treatment
Fluoride is a mineral that is very important to maintaining good oral health . Dentists harness the power of fluoride to strengthen your tooth enamel and reduce your risk of cavities. While large amounts of fluoride can be dangerous, it’s very difficult to reach toxic levels with properly fluoridated water and over-the-counter products that contain fluoride. Talk to your dentist to learn more and find out if you need professional fluoride treatments.
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Assessed and Endorsed by the MedReport Medical Review Board