The Tricks of Healthy Treating

Halloween goes with candy like candy goes with… well, cavities.  To be fair, we have managed to associate sugar with most of the major holidays in our country, but this one takes the cake… no pun intended.  And I’m guilty here too.  I’ve got as big a sweet tooth as anyone. Because of this, I have a hard time telling people to cut all sugar out of their diets.  Moderation is definitely key.  Fortunately, most people can afford to eat simple sugars in moderation if a few simple measures are taken to counteract the negative impact sweets have on your teeth. We’ve touched on some aspects of this (like healthier ways to snack) in other posts.  Today we will focus on fluoride.

What is Fluoride?

Fluoride has gotten a bad rap.  If you do a Google search for fluoride, you will stumble upon a multitude of opinions on supposed benefits and purported risks about this naturally occurring substance.  So what is the deal?

Fluoride is the ion form of fluorine, a naturally occurring element that can be found on the periodic table you had to memorize in your high school chemistry class.  It is found in freshwater, sea water, as well as some foods.  Fluoride-containing compounds are also used in many modern technologies like Teflon, Gore-Tex, and surgical implant materials to name a few.

In the dental world, fluoride plays a key role in preventing decay.  Hydroxyapatite, the building block of tooth enamel becomes fluorapatite in the presence of fluoride.  This fluorapatite molecule is more resistant to the acids produced by decay-causing bacteria and results in a lower decay rate.  Fluoride has also been shown to reduce bacterial activity in the mouth.

Topical Vs. Systemic Fluoride
It is believed by many, including the American Dental Association, that consuming a consistent, low dose of fluoride during early childhood (the years the adult teeth are forming) will result in teeth that are more decay resistant.  We now know, however, that most of the benefits of fluoride are derived from the topical exposure, not the systemic exposure. Put simply, brushing, swishing, or painting fluoride on your teeth directly – not swallowing it.

The source of almost all of the controversy surrounding fluoride is the adding of fluoride to our public water supply.  For decades, fluoride has been added to public drinking water in the U.S. and is credited with the substantially lower decay rates that we see today.  Many of the concerns about fluoride toxicity from ingesting high levels, especially in children, are valid concerns.  For this reason and because alternative sources of fluoride are now available, some are suggesting that we should cease the addition of fluoride to our drinking water and turn to products like those dispensed by your dentist to get the necessary fluoride exposure.  This would allow dentists to assess the individual patient’s fluoride exposure and supplement only when necessary. This does not, however,  address the underserved population that is not receiving regular dental and medical care and is currently benefitting from water fluoridation.

Sources of Topical Fluoride

Most people’s main source of topical fluoride in the United States is fluoridated water and fluoride toothpaste.  Most over the counter toothpastes that people use contain 1000 times as much fluoride as normal city drinking water.  This amount of fluoride is sufficient for many people.  Those with more risk factors for decay (diabetes, dry mouth, high sugar intake, acidic diet, etc.) may require a prescription fluoride application.  These can be prescribed by your dentist or applied at the dental office and contain 5 to 22 times more fluoride than over the counter toothpastes.

While it is important to get a fluoride boost from your dentist at your cleaning appointments if you are prone to decay, it is more important to get adequate levels of fluoride in your home hygiene routine.  If your teeth are being subjected to all the ingredients needed for tooth decay on a daily basis, it is important that your teeth are being exposed to some things that prevent decay on a regular basis also.

…just right

You can have too much of a good thing.  Getting the right amount of fluoride is best—not too much and not too little. Your dentist can help you determine how to optimize your fluoride intake but here are some tips from the American Dental Association on the safe use of fluoride:

–          Do not use fluoride toothpaste for children under two years old unless advised to do so by a dentist or other health professional.

–          Unless you are advised to do so by a dentist or other health professional, the ADA does not recommend the use of fluoride mouth rinses for children younger than six years old. Many children younger than six have not yet fully developed their swallowing reflex and may be more likely to swallow fluoride mouth rinse rather than spitting it out.

The Bottom Line

Fluoride, at proper levels, is a valuable tool in the fight to curb dental disease and maintain dental health for life.  Contact your dentist with any questions about adequate fluoride intake and what steps you can take to preserve your smile!