Fluoride’s Importance for a Healthy Mouth
Everyone’s goal is to have a pain-free mouth and a happy smile. How you take care of your mouth, with the help of oral hygiene providers, has a lot to do with your teeth’s health. Fluoride plays a large role in this. It’s also easily accessible, affordable, and safe.
This article explains why fluoride should be a part of your health journey, how it helps your teeth stay strong, and the different ways you can access it.
What is fluoride & how does it work?
Fluoride is a mineral that is naturally found in some foods and water sources. It, along with calcium and phosphate, helps our teeth stay strong in three ways:
Growing: It helps your body initially grow strong teeth when you are a child (6 months to 16 years) so that the teeth that form beneath the gums with be stronger when they emerge. This is why it’s especially important for infants and children, with the help of their parents, to start caring for their oral health at the earliest ages. This starts when the first tooth emerges, and why having adequate amount of fluoride is important from birth.
Maintaining: Fluoride keeps your teeth strong by keeping them mineralized. It helps prevent tooth decay by combining with the minerals in your teeth to form stronger, more acid resistant tooth enamel. This is the maintenance part.
Correcting: It reverses early decay by neutralizing the acids on your teeth and gums. The acids come from one of a few places: the foods and beverages we eat/drink contain sugars or acids, or the bacteria in our mouth produces a substance called plaque. The acids in the plaque can break down the minerals in our teeth, called demineralization. When the acids reach the inner parts of the tooth where the nerves and blood vessels are it’s called a cavity or carie. When fluoride re-mineralizes tooth enamel, or combines with the enamel on your tooth to make it stronger, it prevents the plaque from being able to form caries. The goal is to re-mineralize your teeth so nothing breaches the enamel surface of the tooth.
How well does fluoride work?
The most common chronic disease in children in the United States is tooth decay. 62% of all Montana children had tooth decay by the time they reached 3rd grade. This is significantly higher for American Indian Children with 84% of the children experiencing decay. There are a lot of statistics and studies that prove that fluoride helps grow and maintain strong teeth. That’s why it’s recommended by the American Academy of Pediatrics, The Center for Disease Control, and The American Dental Association.
Living in Montana, we face a couple challenges to maintaining healthy teeth. First, the state has a great shortage of oral health care providers so it is very difficult for many people to visit a dentist or hygienist. This is the shortage that Smiles Across Montana is trying to ease. Secondly, most of Montana doesn’t have fluoridated water. In fact, only 31.4% of Montanans had access to fluoride in our water in 2020. This ranked us as 48th in the nation. Nationally, an average of 74% of people within a state have fluoridated water. If you want to find out if your municipal water is fluoridated you can visit the Montana of Environmental Quality at Drinking Water Rules | Montana DEQ (mt.gov). If you get your water from a well, you might want to get it tested to see what levels of fluoride it contains. The goal is to have 0.7 parts per million.
Since most of us don’t get fluoride in our water, it means that we have to rely on toothpaste or mouthwash that has fluoride in it, and it’s important for our children to receive an extra boost with fluoride treatments, such as a fluoride varnish, at least twice a year when they visit a hygienist or dentist. Even medical offices can apply a varnish. Children under 17 who received fluoride treatments for even 1 year were 43% less likely to have tooth decay or caries.
While there has been resistance to fluoridated water by some, there’s no proof that it’s harmful in any way, and a lot of proof that it’s beneficial. Before toothpaste was fluoridated in 1956, those who relied solely on fluoridated water were 40-60% less likely to get cavities than those whose water didn’t have it. Even with today’s fluoridated toothpastes, communities that have it in the water have 25% less tooth decay.
Toothpaste, Mouthwash, Fluoride Varnish
When you have fluoridated water, it works systemically – within your body – to build stronger teeth. By using fluoridated products like toothpaste and mouthwash, and having varnish treatments, you are working externally or topically, to help your teeth fight tooth decay and become stronger.
It’s just as important to pay attention to a baby’s teeth as it is anyone else. When the first tooth erupts a very small amount of toothpaste can be applied to the tooth and then wiped off. No more than a rice sized amount or smear should be used. Children under 3 should use the same amount and should be supervised to make sure they don’t swallow when they swish. Once a child reaches 6 years old, the quantity can be increased to pea size, though supervision until they are 8 may be necessary to prevent swallowing. This is also why mouthwash isn’t recommended for very small children. That shouldn’t be swallowed either.
Varnishes are applied by a health professional for children, and also some adults who are at greater risk. It is painted directly onto the tooth where it bonds with saliva to form a layer. You shouldn’t eat or drink for 30 minutes after it’s applied and it can be brushed off after 4 to 12 hours. Children under 5 may have it applied 2-4 times per year starting at 6 months old. Generally, it’s applied once or twice yearly during routine visits with a dentist, hygienist, or medical personnel at your local pediatricians’ office. The same type of product is available in a foam or gel that is placed in a tray. There are even drops that can be prescribed by a dentist or pediatrician for those at great risk.
Believe it or not, some foods naturally contain fluoride: grapes, baby foods, potatoes, and shellfish like blue crab or shrimp. If you have fluoridated water, it will be in soups and stews, hot cereals, and coffee/tea that you make. There are small quantities in cooked spinach, carrots, asparagus, and white rice. For more information, see Top 10 Foods and Drinks Highest in Fluoride (myfooddata.com) You can also purchase jugs of water either with or without fluoridation that might be marketed as “nursery” water.
Special Cases
While people agree that fluoridated water is safe and works to prevent tooth decay, it is possible to get too much fluoride systemically. The primary effect is cosmetic – a discoloration on your teeth called fluorosis. This only happens as the teeth are forming, not once they have grown in so the risk of this happening ends around age 8 when adult teeth start coming in. White to brown spots or streaks may form on the enamel, but this doesn’t affect their health or function, and isn’t painful. The fluoride levels in municipal drinking water wouldn’t cause this; it happens primarily if well water has very high levels of fluoride. Avoiding the intake of too much fluoride is part of the reason why supervision of children brushing is important.
The people most at risk for tooth decay include those who suffer from xerostomia or dry mouth from taking certain medications or naturally have slow saliva production. They are at greater risk of gum disease and cavities so fluoride treatment is especially important. Extra protection is also important for people who have crowns, bridges, braces, or removable dentures because there is an added risk of cavities around brackets.
Final Thoughts…
Fluoridated toothpaste has been around since 1956 when Crest first introduced it. Fluoridated water was first implemented in 1945 in Grand Rapids Michigan. Working together, both topically and systemically, these two innovations have done wonders for reducing the tooth decay that we experience. For those who don’t live where their water is fluoridated, it’s even more important to take special care to use fluoride toothpaste and mouthwash, and if deemed appropriate by your oral health provider, fluoride varnish. Each of these products will help keep your tooth enamel strong, and your gum healthy.
Sources:
The State of the State’s Oral Health (mt.gov)
Safest Ways to Use Fluoride in Your Babies and Children (clevelandclinic.org)
Fluoride: Uses, Benefits & Side Effects (clevelandclinic.org)
Fluoride and Children - Stanford Medicine Children's Health (stanfordchildrens.org)
Fluoride for Children: FAQs - HealthyChildren.org
