Fluoride and Your
Importance to the Teeth
Enamel, the outer layer of the crown of a
tooth, is made of closely packed mineral
crystals. Every day, minerals are lost and
gained from inside the enamel crystals in
processes called demineralization and
Demineralization is when acids in the mouth
dissolve the enamel crystals that make up
the outer layer of the crown of the tooth.
These acids are formed by the combination of
plaque bacteria and sugar in your mouth.
This process is balanced by remineralization,
in which minerals such as fluoride, calcium
and phosphate are deposited inside the
enamel. Too much demineralization without
enough remineralization to repair the enamel
leads to tooth decay.
Fluoride helps teeth in two ways. When
children eat or drink fluoride in small
doses, it enters the bloodstream and becomes
part of their developing permanent teeth and
makes it harder for acids to cause
demineralization. Fluoride also works
directly on teeth in the mouths of children
and adults by helping to speed
remineralization and disrupt the production
of acids by bacteria.
Fluoride in foods, fluoride supplements and
fluoridated water enter the bloodstream
through the stomach, then are absorbed into
the body. In children, the fluoride then
becomes available to the teeth that are
developing in the jaw.
Topical fluoride products are applied
directly to the teeth. They include
toothpaste, mouth rinses and professionally
applied fluoride treatments. Topical
fluoride treatments are in the mouth for
only a short time but fluoride levels in the
mouth remain higher for several hours
afterward. Fluoride found in the water and
in food products also works this way because
the water washes over the teeth and some
fluoride remains in the saliva.
Fluoride treatments are given in a dental
office and are applied as a gel, foam or
varnish during a dental appointment. The
fluoride used for these treatments is at
much higher strength than mouthwashes or
toothpastes. Fluoride supplements also are
available by prescription, and usually are
reserved for children who live in areas
without community water fluoridation.
Children who need supplements receive them
from ages 6 months to 16 years.
Supplements: Who Needs Them?
Children between the ages of 6 months and 16
years who are not drinking fluoridated water
should take fluoride supplements. They are
available as liquids for younger children
and tablets for older children, and can be
prescribed by either your pediatrician or
All children should use fluoridated
toothpaste. If your children are younger
than 6, be cautious about how they use
fluoridated toothpaste, because young
children are more likely to swallow it after
brushing instead of spitting it out. Use
only a pea-sized amount of toothpaste when
they brush, and encourage them to spit out
as much as possible. Avoid flavored
toothpastes that might encourage swallowing.
If your child has a history of cavities or
is at high risk of decay, he or she should
use additional fluoride to promote
remineralization. Fluoride mouth rinses are
recommended for children over the age of 6
and are found in the mouthwash section of
most stores. Prescription fluoride rinses
and gels are available from your dental
office to provide a higher level of fluoride
when needed. Parents should carefully
supervise their children when using any
fluoride product and keep fluoride out of
reach of young children.
Can Fluoride Cause Harm?
As with other compounds, fluoride is
safe and effective when used properly, but
it can be hazardous at high doses. All
water-fluoridation systems are checked daily
to maintain safe fluoride levels. Parents
should supervise the use of all fluoride
products in the home.
Fluoride-supplement tablets should be stored
safely away from young children. These
supplements are taken each day in small
quantities, ranging from 0.25 to 1 milligram
per day based on the child's age and amount
of fluoride in the water. Dentists limit the
amount of tablets they prescribe at one time
because the toxic dose of fluoride for a
2-year-old child weighing 22 pounds is 320
milligrams. To avoid any chance of overdose,
do not stock up on fluoride tablets. If you
have any questions regarding fluoride risks,
talk to your dentist or physician.
Toxic fluoride doses are based on weight,
and a toxic dose of fluoride for an
8-year-old child weighing 45 pounds is 655
milligrams. In comparison, an 8-ounce glass
of water fluoridated to 1 part per million
contains 0.25 milligrams of fluoride. Since
these fluoride products are used in such
small amounts, it is very difficult to
receive toxic doses when using fluoride
products at home.
American Dental Association
211 E. Chicago Ave.
Chicago, IL 60611
Phone: (312) 440-2500
Fax: (312) 440-2800
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