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Fluoride is a naturally occurring mineral found in rocks and soil that helps prevent tooth decay. Over the last 70 years, small amounts of fluoride have been added to drinking water, toothpaste, mouth rinses, and professional dental materials to help strengthen tooth enamel.
Once ingested, your blood absorbs the mineral through the digestive tract and collects in the bones and teeth. In children, it is especially useful in preventing dental caries (cavities). This is because baby tooth enamel is thinner and more susceptible to decay.
Since the introduction of added fluoride, there has been a dramatic decrease in dental caries in children and adults.
Concerning cavity prevention, there are three main benefits of fluoride:
Water fluoridation is the foundation of dental caries prevention in children and adults. In short, fluoride reduces decay by strengthening tooth enamel.
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The mineral is naturally present in some portions of the country’s water supplies. Although, most municipal water sources add the mineral into tap water.
The concentration of fluoride in water depends on the depth where the water is found and how many fluoride-bearing minerals are present in the area. For example, water supplies in the southwestern and midwestern sectors of America have high levels of natural fluoride, while low-income areas typically have low levels.
In addition, proper water fluoridation is backed by over 70 years of research. It is also safe, effective, and healthy. Moreover, the mineral is cost-saving, cost-effective, and reliable.
“Studies have shown that fluoride reduces the risk of decay by up to 50 percent in primary (baby) teeth and up to 65 percent in permanent teeth of children exposed to fluoridated water since birth.”
Since the mineral is a highly toxic substance on its own, excessive consumption can cause a range of adverse health effects. For example, common conditions include:
The ideal amount of fluoride in drinking water is 0.7 parts per million (ppm). Excessive consumption from water with more than 0.7 ppm of fluoride can cause dental fluorosis. In short, fluorosis is the hypomineralization of tooth enamel, which leads to abnormal enamel development and the formation of white streaks, yellow stains, or brown stains on teeth.
Excessive consumption can also lead to skeletal fluorosis, which damages the parathyroid glands (glands in the neck that control calcium levels). Further, the condition may cause joint stiffness, joint pain, weak bones, or fractures in older adults.
According to the International Association of Oral Medicine and Toxicology (IAOMT), an organization against added fluoride, long-term exposure may be linked to other health conditions, including:
The effects of fluoride are either topical or systemic:
Topical effects are obtained through the use of fluoride mouth rinses, toothpaste, and other concentrated forms of the mineral that are used at home or professionally in a dentist’s office. It also strengthens teeth and makes them less susceptible to decay-causing bacteria.
Dentists recommend this type of treatment for children between 3 and 6 years of age. Adolescents, teens, and adults also benefit from topical treatment. This includes self-applied toothpaste and professionally applied treatments, such as gels, pastes, and varnishes.
You can use self-applied topical treatments at home every day. In particular, the most common forms include fluoride-containing toothpaste and mouthwash:
Fluoridated toothpaste is the most popular form of self-applied fluoride in the world. Additionally, children and adults should brush their teeth with fluoridated toothpaste twice a day for optimal protection. Parents should also consult their child's dentist about the use of fluoridated toothpaste if they are under two years old.
Children under six years of age should only use only a pea-sized amount of toothpaste every time they brush to prevent dental fluorosis.
Similar to fluoridated toothpaste, rinsing with mouthwash reduces the chance of decay in children and adults. The most common compound used in mouth rinse is sodium fluoride, which is retained in saliva, reduces dental plaque, and ultimately helps prevent tooth decay.
Unlike self-applied treatments, professional topical treatments are completed in a dentist’s office at least twice a year:
Professional foams, rinses, and gels contain more fluoride than self-applied toothpaste and mouthwash. Although, since this treatment is only necessary a few times a year, fluoride gel poses little risk for dental fluorosis, even for patients under 6 years of age.
Professional treatment is typically beneficial for people who have a high risk of tooth decay. Those living in areas with low water fluoridation and patients who do not brush with fluoridated toothpaste also benefit from this treatment.
Systemic effects are obtained through the ingestion of liquids with natural fluoride levels, including water that contains natural fluoride and water with added fluoride. Patients can also obtain fluoride through dietary supplements (tablets). In addition, supplemental fluoride is commonly prescribed to children between 6 months and 16 years of age who live in areas with drinking water low in fluoride or those with a high risk for tooth decay.
In essence, systemic forms of the mineral help form tooth structure and provide topical protection against tooth decay.
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Fluoridation Facts. American Dental Association, 2018.
Fluoride: Topical and Systemic Supplements, www.ada.org/en/member-center/oral-health-topics/fluoride-topical-and-systemic-supplements.
“Fluoridation FAQs.” Fluoridation FAQ, www.ada.org/en/public-programs/advocating-for-the-public/fluoride-and-fluoridation/fluoridation-faq.
Nowak, Arthur J. Pediatric Dentistry: Infancy through Adolescence. Elsevier, 2019.
Recommendations for using fluoride to prevent and control dental caries in the United States. Centers for Disease Control and Prevention. MMWR Recomm Rep 2001;50(Rr-14):1-42.