Fluoride Information
Benefits and Mechanism
Dental caries, fillings, and tooth extraction used to be a way of life. Over the last fifty years, decay has been reduced a great deal. The main reason is the use of fluoride. Fluoride strengthens the outer enamel surfaces of the teeth, as well as remineralizes areas of incipient decay. Fluoride, like all nutrients, is safe and effective when used properly.Children who receive a balanced diet will get all the nutrients they need, but no fluoride. It is the number one element in nature to produce strong teeth that are resistant to decay. This mineral combines with the tooth enamel and strengthens it by decreasing the solubility of the outer enamel surfaces of the teeth. This makes the enamel more resistant to acid decalcification and breakdown by the bacteria that cause tooth decay. The most effective way to get fluoride is to have the child drink fluoridated water, or take drops or tablets. Fluoride that is in the water is taken internally to strengthen the developing permanent teeth until they all come into the mouth by age 17 to 18.
Dosages
In any non-fluoridated area a child up to the mid to late teens will benefit from fluoride supplementation. The dosages for fluoride supplementation are age related, a quarter of a dose until age 3, a half a dose until age six, and a full dose from six years old until the late teens. Studies show that with the use of fluorides decay will be reduced, up to 70% less than in an area without fluoride. The best scientific studies show that fluoride is safe. There are no reported issues with the supplementation in the water supplies in areas like Massachusetts, where the majority of the population receives fluoride automatically through the water system. This method doesn't rely on compliance and having the parent and child remember to take the supplement. It is not possible to receive adequate fluoride from a conventional diet.If you live in an area that is fluoridated, but you use well or bottled water, you have to evaluate the fluid sources that your children receive. Outside of the home your child may receive fluids with fluoride. One must realize that most children get fluids from many sources. The sink, water fountain, bottled waters, sodas, boxed or bottled juices. One must evaluate if the fluids used are reconstituted with fluoridated water. While fresh squeezed or pressed juices contain no fluoride, most bottled and boxed juices are reconstituted and may be processed using fluoridated water. Most bottled waters also contain little fluoride. Some supplementation is necessary if a child is getting a large proportion of needed fluids from non-fluoridated sources. In non-fluoridated areas it is usually prudent to supplement the normal doses. In a fluoridated area, one must try to take this drinking water/fluid history to determine if supplementation is needed. In general, only a half dose or less is needed in a fluoridated area.
If you feel that your child is getting a respectable percentage of fluoride outside of home, we would limit supplementation to half the normal dose.
Side Affects from Excess
Some children may develop discolorations on permanent teeth, white lines or some spotting on their teeth. This can be cause by developmental variances, fevers, as well as excess fluoride. Discoloration will occur only if the dose is multiple times the normal dose. This can happen in a fluoridated area if a child gets fluoride from tap water, and either receives tablet supplements or swallows excess toothpaste. This condition, which does not weaken the teeth, may need to be cosmetically corrected as the child grows by cosmetic bonding or bleaching to mask the discolorations. As with anything, a food, drug, or vitamin, excess is not good. There are some families in which all children have very white or opaque teeth with no known source of excess fluoride. If fluoride is taken in the recommended dosages there will be no discoloration. Side effects from fluoride are not well documented and only with extreme excesses, as with any vitamin, medicine, or food supplement. By the book in any non-fluoridated area children up to the mid teens will benefit from fluoride supplementation.
Topical Fluoride
Fluoride that is in the water or by tablet supplementation is taken internally to strengthen the developing teeth until they come into the mouth. Teeth that already have erupted into the mouth have no benefit of systemic, internal, fluoride and can be strengthened by fluoride rinses at home and school programs, or topical fluoride treatment in the dental office after the teeth have been cleaned. The visits to the dentist are important for the diagnosis of decay and cleaning of the child's teeth. The professionally applied fluorides are in the form of a concentrated gel, foam, or rinse. These treatments add fluoride to the enamel surfaces of teeth after they have come into the mouth, which creates a tooth surface more resistant to decay. They are more concentrated than the self applied fluorides, and are not needed as frequently. Topical fluoride also reverses the early decay process by counteracting the effect of acid and bacteria and can remineralize tooth structure. The topical fluoride treatments can reduce dental caries an additional 15 percent. It is not a replacement for internal fluoride, but used in addition to it. Topical fluorides are not made for your younger children, as they should not be ingested.
Teens
At approximately 12 to 13 years of age all the permanent teeth, other than the wisdom teeth, are formed and do not benefit from ingested fluoride, in the water system etc. Fluoride rinses at home, school programs, and topical fluoride treatments in the dental office can strengthen these teeth. After the teeth are professionally cleaned, a topical fluoride treatment is beneficial, especially for teens. The enamel gets the benefit of picking up additional fluoride for strength, and also helps prevent decay when teenagers neglect their oral hygiene. Also this is the age most children get braces and it can prevent decay around the brackets and wires. These professionally applied treatments usually follow a professional cleaning twice a year. At home treatments, gels or rinses, for these teens are prescribed when necessary.
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