Fluoride is a mineral that is found naturally in quite a few foods, as well as some water supplies. It is extremely useful for dental health, as it helps to protect teeth against decay by hardening tooth enamel, making it more resistant to acid.
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Demineralization and Re-mineralization
Tooth enamel comes under attack every single day, as every time something starchy or sweet is eaten, the leftovers are converted into food by plaque bacteria naturally present in the mouth. These bacteria produce acid as a by-product, and this acid attacks the tooth enamel in a process called demineralization. During this process essential minerals such as calcium and phosphate are leached out of the tooth enamel, causing it to become weaker and softer. As the acid attack subsides, then pH levels in the mouth gradually return to normal, and a process called re-mineralization occurs. This is where some of the minerals lost from the tooth enamel are redeposited. If this cannot occur, then the tooth may be permanently softened, leaving the tooth more susceptible to decay. Fluoride is an essential part of this process as it helps the tooth to remineralize, lessening the damage done by acids in the mouth.
Sources of Fluoride
Many people obtain plenty of fluoride through their diet, and fluoride has been added to many public water supplies since 19451. The fluoridation of community water has been heralded by the Centers for Disease Control and Prevention2 as being one of the most important public health achievements of the last century. Approximately three quarters of the American population have access to public water supplies that are optimally fluoridated. This fluoridation is carefully controlled and rigorously tested, and numerous studies have found fluoridation to have been beneficial in reducing tooth decay by around 20 to 40%. Fluoridation is proven to be a cost-effective way of improving dental health. Most dentists also recommend that older children and adult patients use fluoridated dental products such as toothpaste and mouthwash.
Some people are more susceptible than others towards developing tooth decay, and in these situations dentists may offer additional fluoride treatments, or may prescribe supplements. Some dentists offer extra strength fluoride mouth rinse as a routine part of the dental examination, while others may recommend fluoride varnishes that are painted onto the teeth and left overnight for the fluoride to penetrate. Other treatments include fluoride gel which is used in a mouth guard and left in the mouth for several minutes.
Precautions to Take When Using Fluoride
Although fluoride can be a useful mineral, it’s also toxic if ingested in too larger quantities. Dentists may recommend that children under the age of two use fluoride free toothpaste until they are able to spit out the excess, and no one should swallow toothpaste. When using fluoride mouth rinses, it’s essential to follow the instructions properly, and to spit out the mouthwash rather than swallowing. Fluoride products should be kept away from small children, and their use should always be properly supervised. In spite of this it is important for children to be exposed to the correct amount of fluoride while their teeth are still developing, and this is something your dentist can advise you on. You may also wish to contact your local water supply company, local health department or dentist to find out if your tap water is fluoridated. In general it is an extremely safe mineral, and it would be pretty difficult to ingest dangerously large quantities.
Fluorosis
Fluorosis is caused by excess exposure to fluoride before the age of eight, and creates changes in the tooth enamel. It estimated this condition affects around a quarter of the population in the US. Most cases of fluorosis are relatively mild, and may cause white flecks or a white lacy appearance over the surface of the tooth. However a tiny percentage of cases are more severe, and can create brown or yellow stains on the teeth, and may even cause the tooth surface to become pitted. Most cases of fluorosis are caused by fluoride being naturally present in the water supply.
There are various things your dentist can do to help minimize the effects of fluorosis, but if it has only created tiny white flecks then it may be better off to leave it untreated, as most people will not notice it. In other cases fluorosis can be covered up by using dental bonding, or by using porcelain veneers. Another treatment involves removing a tiny amount of the tooth enamel through the use of acid. After this, the area is sanded using a solution of pumice before fluoride is applied topically to re-harden and remineralize the enamel. Applying fluoride topically cannot create fluorosis, as this can only happen when the fluoride is ingested.
The Controversy over Fluoride Usage
Some people feel fluoride should not be added to the public water supply, and are worried about its toxicity. They feel that dental health would’ve improved anyway over the past few decades due to improvements in dental care and access to fluoridated products such as toothpaste and mouthwash. In spite of this, numerous studies have found fluoride usage to be safe, but if you are worried about fluoride, or have young children then you may want to discuss the issue with your local dentist as they should be more than happy to offer advice.
