Public Health Dentistry
Importance Of Flouride

Fluoride is a naturally occurring element that strengthens teeth. This can help to prevent tooth decay Experts say the best way to prevent tooth decay is to use several sources of fluoride.

Fluoride is found naturally in water sources in small amounts. Some foods, such as meat, fish, eggs and tea, contain fluoride. Many toothpastes, rinses and professional treatments contain fluoride. Prescription fluoride tablets are available for children who do not get fluoride in their water.

What It’s Used For

Enamel is the outer layer of the crown of a tooth (the visible part). It is made of closely packed mineral crystals. Every day, the enamel loses and gains minerals. The loss of minerals is called demineralization. Gaining new minerals is called remineralization. These two processes balance each other.

Demineralization begins with the type of bacteria that cause plaque on your teeth. These bacteria feed on sugar in your mouth and produce acids. The acids dissolve the crystals in your teeth. Remineralization builds the enamel back up. In this process, minerals such as fluoride, calcium and phosphate are deposited inside the enamel. Too much loss of minerals without enough repairs of the enamel leads to tooth decay.

Fluoride strengthens teeth by helping to speed remineralization. This strengthens the enamel. Fluoride also helps to stop bacteria from making acids.

Fluoride can strengthen teeth in two ways — from the outside or the inside.Teeth absorb fluoride on the outside in several ways:

  • When you get a fluoride treatment at the dental office.
  • When you brush with fluoride toothpaste or use a fluoride rinse
  • When fluoridated water washes over your teeth as you drink

Fluorides that are absorbed by making contact with the outside of the tooth are called topical fluorides.

Fluoride also strengthens teeth from within. Swallowed fluoride enters the bloodstream and becomes part of the permanent teeth as they develop. This is called systemic fluoride. The teeth become stronger, so it is harder for acids to destroy the enamel. Children swallow systemic fluoride in any of the following ways:

  • Fluoridated water and drinks made from it
  • Prescription fluoride supplements
  • Small amounts of fluoride in food

Dental office fluoride treatments commonly are given to children as their teeth are developing. A child who has a history of cavities or is at high risk of decay should use additional fluoride. This promotes remineralization of the teeth.

Many children get fluoride treatments every six months. The treatments provide extra protection against cavities, even if children already drink fluoridated water.

Fluoride mouth rinses also can help children with a history of cavities or a high risk of decay. These rinses are recommended for children over age 6. You can find them in the mouthwash section of most stores. Prescription fluoride rinses and gels that provide a higher level of fluoride also are available.

Fluoride supplements generally are reserved for children 6 months to 16 years old who have low levels of fluoride in their drinking water. These are available as liquids or drops for younger children and tablets for older children. Either your pediatrician or your dentist can prescribe them.

Fluoride treatments help to prevent decay in both children and adults. Anyone who is at risk of dental decay is a good candidate for fluoride treatments.

Factors that increase the risk of tooth decay include:
  • A history of cavities
  • Infrequent dental visits
  • Poor brushing habits
  • Poor diet habits, especially frequent snacking

Many common medicines can cause the mouth to be dry. Examples include antihistamines and medicines for high blood pressure, anxiety and depression. Without enough saliva, tooth decay gets worse quickly.

The fluoride treatments you receive in a dental office have more fluoride than over-the-counter fluoride mouthwash or toothpaste. They are used for both children and adults. Dental-office treatments also are different chemically and stay on the teeth longer.

There are two common types of professionally applied fluorides. Acidulated phosphate fluoride (APF) is acidic; neutral sodium fluoride is not. Neutral sodium fluoride usually is used for people who have dry mouth (xerostomia) or who have tooth-colored fillings, crowns or bridges. An acidic fluoride may irritate a mouth that is dry. It also can create small pits in tooth-colored plastic composite fillings.

Risks

Fluoride is safe and effective when used properly. However, it can be hazardous at high doses. All water-fluoridation systems are checked daily to maintain safe fluoride levels. Parents should supervise the use of all fluoride products, including toothpaste, in the home. Keep fluoride tablets stored safely away from young children.

If they swallow too much fluoride, young children may become nauseous. Also, too much fluoride can cause spots to form on the enamel of any developing teeth. The spots will be visible when these teeth come into the mouth. Discuss these concerns with your dental professional. He or she can recommend which fluoride products are best for your child.

Advice

It is important that you seek advice from your dentist, on any supplemental fluoride products you wish to use especially for children, before embarking on it.