Fluoride has found to be extremely effective in strengthening teeth and reducing levels of tooth decay. It is a mineral that is naturally occurring.
Fluoride is naturally present in drinking water (the amount varies depending on where you live). In some areas it is added to the water in very small amounts to help protect the teeth of the population. Fluoride is also present in many foods, including fish, eggs, tea and meat. Some countries add fluoride to salt and milk instead of adding it to the water supply.
As well as getting fluoride from our water or foods, it is available in a range of dental products to help protect teeth. Dental products that may contain fluoride include:
How Fluoride Helps Your Teeth
Fluoride is very beneficial in terms of protecting the teeth against tooth decay. There are several reasons for this:
1. Fluoride strengthens the teeth as they are formed, before they come into the mouth.
The enamel (outer hard shell of teeth) that forms when there is fluoride present in the bloodstream is much stronger than enamel that forms with little or no fluoride present. If fluoride is present when the teeth are growing, the teeth will often develop with shallow grooves on the biting surfaces. These shallow grooves are easier to clean because plaque is less able to stick to them.
2. Fluoride helps protect the teeth when they are in the mouth.
The teeth come under acid attack after every meal. This acid dissolves the outer surface of the tooth. If this attack is regular, it will eventually progress, leading to tooth decay. When there is enough fluoride present, this will act to replace the minerals that the acid has worn away. There is a balance between the plaque acids dissolving the structure of enamel and the minerals in saliva rebuilding this structure. The presence of fluoride will help tip the balance in favor of strong teeth.
3. Fluoride makes plaque less harmful.
Fluoride reduces the amount of acid that is released by plaque bacteria. So after we eat the acid attack the teeth are put under is not as strong.
How to Get Fluoride to Your Teeth
It is apparent that for maximum benefit, there should be fluoride present as the teeth are developing under the gum. The fluoride can come from several sources for developing teeth:
- Fluoride added to water supplies.
- Small amounts in some foods.
- Prescribed fluoride tablets.
Here the teeth are being helped by fluoride from ‘inside’ the body.
We then want fluoride to help the teeth from the ‘outside’, i.e. once they are in the mouth and exposed to plaque acids. Sources of fluoride that help from the ‘outside’ include:
- Fluoridated water.
- Professional gels and varnishes.
- Fluoride tablets. Here the fluoride is released into the saliva from the bloodstream.
Who Should Get Fluoride?
Everyone. We all benefit from fluoride. Both when it is present as the teeth are forming and then once they are through into the mouth. Prevention of tooth decay is much more desirable to needing treatment.
So, all children should get some fluoride as the teeth are growing. There may be enough in your local water supply, whereby supplements are not needed. Ask your dentist for advice.
If there is not enough fluoride present in drinking water, fluoride supplements should be given to all children between 6 months and 16 years old. Supplements are available as drops for younger children and tablets for older children. Your dentist can prescribe them, and will advise you on the correct dose. The dose of fluoride that is best will depend on the age of the child and amount of fluoride in the water locally.
For all kids, as soon as the teeth start to come through the mouth, they should be cleaned with fluoride toothpaste.
There are some children who are high risk of decay and so at particular need of increased fluoride protection, in addition to supplements. Such examples include children with:
- Any decay on teeth that are already in the mouth.
- Siblings with lots of tooth decay.
- Poor oral hygiene.
- Poor diet in terms of sugar intake and amount of snacking.
These children can get extra fluoride from:
- Stronger toothpastes as advised and prescribed by your dentist.
- Mouthwashes. These should only be used in children over 6. Younger kids and infants might swallow the mouthwash if used!
- Gels and varnishes of high-strength fluoride applied by the dentist.
Some adults also need extra fluoride. As well as the factors listed above, extra reasons for adults needing more fluoride include:
- Gum recession leading to root exposure. As the roots of teeth have no overlying enamel, they are at higher risk of decay when exposed.
- Problems with oral hygiene, e.g. as a result of a disability.
- Dry mouth. This can lead to very high levels of tooth decay.
- Dental sensitivity.
Fluoride Treatments for Teeth Include:
- Fluoride supplements. Either drops or tablets. Given to kids between 6 months and 16 years. Works from inside to help the teeth develop stronger.
- Toothpastes. Everyone should use fluoride toothpastes twice daily as part of their oral hygiene routine. Toothpastes have varied levels of fluoride present. The strength (concentration) of fluoride needed changes with age and level of risk of decay. Children should be supervised while brushing until about 7 years-of-age, and a pea-sized smear of toothpaste used. Very strong toothpastes can be prescribed by dentists.
- Mouthwashes. Can be used in children, who are at higher risk of decay, from the age of 6. Also very useful in adults with high levels of decay or increased risk of decay. Very strong mouthwashes can be prescribed by dentists.
- Professional varnishes and gels. These contain very high concentrations of fluoride, and remain in the mouth longer than at-home products. They can be very useful if applied at regular intervals.
An effective tip: Fluoride products are best used at night before going to bed. They will linger longer in the mouth as you are not eating, drinking or speaking.
Is fluoride safe? The benefits of using fluoride in terms of protecting the teeth are well proven.
When used in the proper doses fluoride is safe. This has been proven by many years of scientific research.
Like most substances, if taken in high doses fluoride can be dangerous. Children are more at risk of accidentally getting too much fluoride. Therefore the following points of advice are important to reduce any risks:
- Parents should supervise their children while they are brushing until the age of about 7.
- The correct strength of toothpaste should be used as per the child’s age.
- Use only pea-sized smear of toothpaste.
- Make sure children do not swallow toothpaste when brushing.
- Keep tubes of toothpaste, bottles of mouthwash and fluoride supplements out of the reach of children.
- Children under the age of 6 should not be given fluoride mouthwashes.
- Fluoride supplements should be given in the dose advised by your dentist. They are not needed if the water supply is sufficiently fluoridated in your area.
Swallowing too much fluoride can make children feel nauseous. Dangerous overdoses of fluoride are unlikely given the small amount in home dental products.
When the teeth are growing in the jaw, prolonged exposure to excessive levels of fluoride can cause ‘fluorosis’. Fluorosis causes a cosmetic problem in the teeth. Mild problems include white specks on the teeth. Severe fluorosis is caused by high levels of fluoride and can lead to brown patches and pitting of enamel.
Thankfully severe fluorosis is rare. It is usually confined to areas with naturally very high levels of fluoride present in the drinking water.
Fluorosis can be a result of children regularly swallowing some toothpaste, or when fluoride supplements are given to children who live in an area with fluoridated water.
There are opponents to fluoridation of water supplies. They claim to have evidence of fluoride causing a variety of health problems. Scientific analysis of their evidence does not back up these claims. All good scientific research points to the benefits and safety of fluoride in the water.
The beneficial effects of fluoride in strengthening the teeth against tooth decay are well-proven. This effect is especially useful in young teeth as they are developing in the jaw.
Will you or your child may benefit from extra fluoride supplements? In part the answer depends on the levels of fluoride in your local water supplies. Always ask your dentist for specific advice on fluoride depending on your own dental needs.