Fluoride for Children and Adults

Did you know that fluoride prevents cavities?

What is Fluoride?

Fluoride is a mineral that occurs naturally in air, soil and water. Fruits and vegetables grown in fluoride-rich soil absorb fluoride as well, so the plants themselves are a source of fluoride.

You absorb fluoride through the food you eat and the water you drink. This fluoride helps to strengthen your tooth enamel and bones.

How Does Fluoride Help Teeth?

When bacteria in the mouth interact with sugars, it produces an acid. This acid breaks down tooth enamel.

Ingesting or using products with fluoride helps to rebuild the weakened tooth enamel and protects the teeth from cavities.

In addition to public water sources, fluoride is in toothpastes, mouthwashes, some flosses, fluoride supplements and professionally applied fluoride treatments.

History of Public Water Fluoridation

Water fluoridation is the adjustment of fluoride at an effective level to prevent cavities. In 1945, a 15-year trial of water fluoridation was launched in four cities. The city of Grand Rapids, Michigan, was the first to add fluoride to their water system.

After five years, other Michigan cities became aware that the children of Grand Rapids had far fewer cavities than the children in surrounding cities. The other cities decided to fluoridate their water as well. Within a few years, other states started adding fluoride to their public water systems to help combat dental disease. By 1954, over 20 million Americans had fluoridated tap water.

By 2018, 73% of Americans served by a public water system were receiving fluoridated water, according to the Centers for Disease Control and Prevention (CDC). Public water fluoridation is considered one of the greatest public health success stories in the world.

Not Enough of a Good Thing

Most Americans drink tap water with fluoride every day. However, if your public water isn't fluoridated and/or you are at high risk of dental decay, your dentist may recommend additional fluoride to help protect and restore tooth enamel. Examples of conditions where additional fluoride could be helpful include:

• Dry mouth
• Gum disease
• History of frequent cavities
• Presence of crowns, bridges and/or braces

In these cases, your dentist may recommend professionally applied fluoride treatments. These professional treatments may be in the form of a varnish, gel or foam. The dentist may also recommend prescription strength fluoride toothpaste or rinse, which contains higher levels of fluoride than the over-the-counter options.

Too Much of a Good Thing

Fluoride is safe and effective when used as directed. However, high doses can cause some problems. Absorbing too much fluoride over an extended period can cause a condition called fluorosis. It is commonly associated with high levels of natural fluoride found in well water. Most cases are mild and appear as white spots or streaks on the edge of teeth. More extreme cases may look like pitting and/or brown spots. Fluorosis occurs when teeth are forming.

The level of fluoride added to each public water system varies by area. Local authorities must consider naturally occurring fluoride levels when determining how much fluoride should be added to the water in order to meet U.S. Department of Public Health guidelines. These guidelines outline the level of fluoridation needed to prevent cavities while also preventing overexposure to fluoride.

Steps you can take to prevent overexposure to fluoride include:

• Don't use toothpaste when brushing children's teeth until they are two years of age.
• Once the child is two years old, use only a pea-sized amount of toothpaste.
• Don't brush your child's teeth with fluoride toothpaste more than twice a day.
• Supervise young children when they are brushing, encourage them to spit out toothpaste.
• Follow CDC guidelines regarding preparing infant formula with fluoridated water.
• Don't take fluoride supplements unless instructed to do so by your dentist or doctor.
• Don't swallow fluoride toothpaste or mouthwash.

If you have questions about fluoride intake, discuss them with your dentist. Your dentist can advise you and provide recommendations.

Note: The information in this document is not meant to replace the advice of your dentist or another licensed healthcare professional. Talk to your dentist for any specific dental advice.

Sources: cdc.gov/fluoridation/statistics/2018stats.htm ncbi.nlm.nih.gov/pmc/articles/PMC4547570/?report=classic