All About Fluoride

The use of fluoride to help make teeth stronger is a controversial topic but research has proven that there are many benefits to treating children with fluoride when their teeth are still forming.

What is fluoride, and what are the benefits of fluoride when it comes to dental health?

Dr. Darren McKeever: Fluoride is an element. It’s a natural element that’s on the planet. The benefits of fluoride are when teeth are exposed to fluoride, it gets absorbed into the calcium matrix that the teeth are made of. Basically, what I’m saying there is, the fluoride is absorbed into the teeth and it makes the teeth stronger in their ability to resist the acids that bacteria create, which leads to cavities.

The benefits of fluoride are two-fold that we tend to see. One, it definitely leads to a reduction in decay for people who are exposed to fluoride. Two, in people who have sensitivity, because of the absorption of the fluoride, we tend to see a reduction in the sensitivity in their teeth.

Fluoride has a lot of benefits, but I’m going to admit it’s a controversial topic. It’s a controversial topic no different than vaccinations. The research supports that fluoride does not cause, especially in the low dosages that we use it in dentistry, it does not cause any harmful effects.  But yes, if you expose people to massive amounts of fluoride, you’re going to get negative effects. Nobody in the dental world is a proponent of those massive levels of fluoride, but I will admit it’s a controversial topic.

Why is it more important for children to be exposed to fluoride than adults?

Dr. Darren McKeever: Like I said, the fluoride is absorbed into the teeth, and the most optimal time for the fluoride to be absorbed is when the teeth are being formed. If you’re exposing the child to fluoride internally, they’re actually taking the fluoride in, whether it’s through vitamins, or in some parts of the country, they still fluoridate the water, as their adult teeth are forming, more fluoride is being incorporated into the teeth, and that protects the teeth.

Later on, when we expose kids to fluoride in the office, it’s usually a topical fluoride being applied to the outside of the teeth. We do that for adults as well, but now you’re only able to improve the structure of the outside of the teeth. That’s why we tend to want to get the fluoride on board when we’re kids because when we’re kids, we can have a more profound effect than when we’re adults.

Is it standard procedure for dentists to provide fluoride treatments to all children? How often should a child be getting these treatments, and what is involved?

Dr. Darren McKeever: It’s definitely on an office by office basis about the commitment to fluoride, but by and large, it is definitely a standard procedure for a child’s re-care visit to have a fluoride treatment. By exposing their teeth to the fluoride, and it is a slightly more concentrated fluoride, it’s not something that you could rinse with at home, you’re going to get a bigger benefit to the teeth. The teeth are going to become a lot more bulletproof when we do that.

In my office, we do it at every checkup. Kids are getting that like twice a year basically. More often than not, I think it’s better to expose them to a much lower level of fluoride, like a rinse at home or a fluoride vitamin.

In what forms is fluoride available to a consumer at home? How can people know if they are getting enough fluoride in their tap water?

Dr. Darren McKeever: We’ve touched on it a little bit here. I know here in New Jersey, we have almost no fluoridation in our water at all. You can actually check that on your town’s website usually whether or not they’re fluoridated. Fluoride in the water has been proven as the child is growing and they’re taking the fluoride in internally, it’s going into the teeth as the teeth are forming.

After that, another thing that people can do is they can actually get fluoride rinses, where you’re exposing the outside of the teeth where you rinse with fluoride to being strengthened.

For kids, you also have fluoride vitamins and supplements that they can take. Usually, the pediatrician, when they prescribe vitamins for the kids, they’ll ask the parents, “Do you want one with or without fluoride?” I highly recommend the ones with fluoride.

Other than that, usually we reserve a prescription-level fluoride for people who have significant issues, people with a lot of decay, people unfortunately undergoing chemotherapy or radiation treatment, people with extensive sensitivity in their teeth due to root exposures, things like that. Really, most often when we’re adults, other than in the toothpaste, where you have a very low level of fluoride but it’s still effective, I always recommend for adults that they should do a fluoride rinse once a day as well. For kids, I like giving them the vitamins. You never really know if you’re going to be getting it in your tap water. Then, of course, we can always treat anybody at any age with a fluoride treatment at their checkup in the office.

Do you recommend that people take fluoride supplements?

Dr. Darren McKeever: The only supplements I recommend are for children. As adults, taking fluoride internally is not going to have the same effect that you think it will because the teeth have already formed. For adults, the supplement I would say is the rinse that you can do one time a day. Ideally, when you’re doing a rinse, in my opinion, you need to do it before you go to bed because fluoride takes time to be absorbed into the teeth. If you do it when you go to sleep, your salivary glands tend to shut down a little bit, and you won’t wash the fluoride out as quickly. During the day, when you’re running around, within 30 minutes, your salivary flow and function has cleared that fluoride right out of your system.

Supplements in terms of pills, vitamins, those are really best reserved for young people because their teeth are still forming and the fluoride is not only going to get into the enamel of the teeth, which you can do with the rinses and topical fluoride treatments in the office, but it’s going to get into the internal part of the tooth, the dentin. That’s where you want to make your tooth as bulletproof as possible. You can’t do that later once the tooth is completely formed with rinses and fluoride treatments. It’s really a two-pronged approach, supplements as kids, and then direct exposure later as the teeth have completely developed and erupted into the mouth.

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