How important is fluoride?

March 01, 1999|By Meg H. Partington

Fluoride, which is found in some toothpastes, rinses, vitamins and water, acts as a bandage that protects teeth from the harm people expose them to every day.

Research has shown that fluoride prevents and reverses early signs of tooth decay by making the tooth stronger, according to American Dental Association.

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Fluoride also can repair areas that acid has begun to attack, reversing the early decaying process and creating a surface that is more decay-resistant, ADA says. Acid forms when the bacteria in plaque breaks down sugars and carbohydrates. Repeated attacks by acid break teeth down, causing cavities, according to ADA.

Fluoride, a naturally occurring element, is particularly critical to children, especially before the age of 12 when their teeth still are forming, says Dr. Brenda R. Paul, a Williamsport dentist.


Anyone with teeth should make sure they're getting enough fluoride to take care of them, dentists say.

Some toothpastes and mouthwashes contain fluoride, Paul says, as do some multivitamins. Be sure to check the labels.

Some public water systems also are a source of fluoride.

"Water is a very convenient dispensing system," says Michael Marschner, chief of operations for Bureau of Water and Sewer in Frederick County, Md.

Since 1950, the ADA and U.S. Health Service have endorsed fluoridating community water as a safe means of preventing tooth decay. Today, it is considered the most effective public health measure to prevent decay and improve oral health over a lifetime, ADA says.

However, that may not be enough for some, dentists say.


For youngsters ages 6 months to 16 years who don't live in communities with fluoridated water, ADA recommends daily use of fluoride supplements in the form of tablets, drops or lozenges.

Children younger than 6 months should not be given such supplements, says Dr. Steven Parrett, a dentist in Chambersburg, Pa., and ADA doesn't recommend rinses for children younger than 6 because they may swallow them.

Children younger than 2 should not brush their teeth unsupervised, Parrett says, because they tend to swallow toothpaste rather than spit it out. He advises parents to brush their children's teeth at that age with a small amount of toothpaste.


Tooth health seems to stabilize for those in their 20s unless their diet is unhealthy, Paul says. After that, some people begin to experience receding gums, which exposes the roots of teeth.

Keeping teeth well fluoridated can help prevent root decay, Paul says. Root decay can lead to rampant tooth decay if not taken care of.

Root decay is often seen in older people who have less saliva, which is secreted by the salivary glands and helps rinse away bacteria and provides a buffer against acid, Parrett says.

For adults, what is put on their teeth is more important than what they put in their bodies in terms of fluoride, Paul says. In addition to rinses, topical products are available that can be brushed on teeth and left on for one minute. Any excess can be spit out. No rinsing is necessary.

"The majority of fluoride I dispense here at the office is to people over 50," Paul says.

For his patients who have three or four cavities, Parrett suggests using a tray of flexible vinyl to which fluoride gel can be applied. He makes impressions of their teeth so a tray can be created to fit them. At home, patients apply the gel to the inside of the tray and place it over their teeth for five to 10 minutes a day.

When cultures show a person's saliva is carrying dangerous levels of bacteria, Parrett recommends mouth rinses containing fluoride.

An in-office treatment relatively new to the United States is fluoride varnish, which is painted on teeth as a means of desensitizing them, Parrett says. Such a procedure could help a person avoid fillings or at least reduce their depth, thus lessening the amount of destruction to the teeth, he says.

-- Public water systems that do and do not add fluoride

-- Fluoride facts

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