Why should you be a fluoride fan? As the American Dental Association (ADA) notes, fluoride is often called "nature's cavity fighter," especially for developing teeth. The good news is that you've probably been getting the right amount of fluoride, and all its benefits without even trying! Fluoride from water, food or supplements helps build strong tooth enamel, which is better able to resist decay. After the teeth have erupted, fluoride helps rebuild enamel and can even reverse the earliest stages of tooth decay.
However, like most things in life getting too much — or too little — of something can be an issue. Fluoride is an excellent example of the importance of balance. Overall, the mineral is safe and effective against cavities, but you should be aware of the minor risks of too much fluoride consumption. Most of these concerns stem from taking in too much of the mineral, particularly at a young age which can cause dental fluorosis.
What Is Dental Fluorosis?
According to the ADA, dental fluorosis, also known as mottled teeth, is a cosmetic issue caused when children consume a high concentration of fluoride while their teeth are developing, causing streaks, spots or pits that may develop on the surfaces of the teeth once they come up above the gums. In severe cases, the enamel can develop brown, black or gray spots and the teeth can become pitted.
Don’t worry! It won't have a negative impact on your child's dental health, although the streaks and spots are permanent. Often, it’s so mild that only a dental professional can detect it. Most cases of fluorosis result from young children taking fluoride supplements or swallowing fluoride toothpaste when the water they drink is already fluoridated.
How to Prevent Fluorosis
The chance of developing fluorosis exists until about age eight because teeth are still forming under the gums. Here are some helpful guidelines around safe fluoride use for babies and kids.
Infant to three years old:
- Breastfed infants are unlikely to develop fluorosis, since breast milk is very low in fluoride. Even if they're drinking fluoridated water, nursing moms and pregnant women don't pass large quantities of fluoride to their babies.
- Moms who feed their babies formula should mix low-fluoride or fluoride-free water with powder or liquid concentrate. Ready-to-feed formula is also an option, since it contains minimal amounts of fluoride.
- When teeth come in use a smear size (no bigger than a grain of rice) of fluoride toothpaste and have them brush twice a day.
- Spit it out! As they are able, teach your child to spit out toothpaste after brushing instead of swallowing it.
Ages three to eight:
- Continue brushing teeth thoroughly twice a day with a pea-sized amount of fluoride toothpaste.
- DO NOT use fluoride mouth rinses for children under six unless advised to do so by a dentist or other health professional. Children younger than six haven’t fully developed their swallowing reflex and may swallow more than they spit out.
Remember, most cases of fluorosis are best prevented by minimizing the amount of toothpaste that gets swallowed.
Fluorosis Treatment Options
Fluorosis isn't a medical condition that causes cavities or jeopardizes your child's health. It's only a cosmetic issue. Some dental fluorosis cases are minor enough that treatment isn't necessary, especially if it occurs on the back teeth. However, there are treatment options if you're concerned. Cases that affect the front teeth can be treated with teeth whitening. Severe cases might require bonding, crowns or veneers, though your child may also lose the affected teeth in a short time depending on their age.
Dietary Fluoride Supplements
Use dietary fluoride supplements only as prescribed by a physician or a dentist. Fluoride supplements are recommended for children between 6 months and 16 years old living in non-fluoridated areas and at high risk of developing tooth decay. The prescription should follow the dietary fluoride supplement schedule approved by the ADA.
Fluoride in Your Drinking Water
Under the Safe Drinking Water Act, the U.S. Environmental Protection Agency (EPA) requires public water systems to notify its customers if the natural occurring fluoride level exceeds 2.0 mg/L or parts per million. People living in areas where naturally occurring fluoride levels in drinking water exceed 2 parts per million should consider an alternative water source or home water treatments to reduce the risk of fluorosis for young children.
While the EPA does not have the authority to regulate private drinking water wells, it recommends that private well water be tested once a year. If you home is hooked up to a private well, it’s a good idea to have the well tested for the fluoride level yearly especially if there are young children in the home. Naturally occurring fluoride levels can vary greatly from location to location. Provide your dentist and physician with the results of the well water testing so that they can provide you with accurate information on your family’s fluoride needs.
All in all, fluoride has very minor risks and major benefits for your child's whole mouth health. Don't worry, while some parts of teaching proper oral care aren't easy, making sure your kids get the right amount of fluoride is pretty simple. If you have questions your dentist, pediatrician or family physician can help you determine the proper amount of fluoride for your child.