One of the words synonymous with dental offices is fluoride. Most people know that fluoride is considered by dentists to be helpful for teeth, but may not know why. What is it about fluoride that helps teeth? It’s all in the chemistry. Fluoride works in three ways:
1) it helps to m ake enamel resistant to acids created by bacteria,
2) it helps enamel to “recover” or remineralize once it has been attacked by acids created by bacteria, and 3) it inhibits the ability of plaque bacteria to grow and produce acid that can attack the teeth.

Sources of fluoride

Fluoride can be found naturally in the environment and has many uses. In the 1940’s it was discovered that in areas with a certain level of naturally occurring fluoride in the water, the communities that used this water have a much lower level of dental decay than those who did not. This developed into the “water fluoridation” movement that has been referred to by the Surgeon General and U.S. Centers for Disease Control and Prevention, as well as supported by the World Health Organization, as one of ten great public health achievements of the twentieth century. Most communities in British Columbia do not have fluoridated water, so other sources are recommended to reduce the risk of cavities.

Toothpaste is one of the most important sources of fluoride and is the easiest way to take prevention into your own hands. In a previous article we discussed the importance of toothbrushing and some of the techniques that can be used for children. Although it is recommended that fluoridated toothpaste be used as teeth erupt, it important that the right amount is used. If in doubt, ask your dentist what he or she recommends for your child.

The dental office is another great resource for fluoride. Your dentist, hygienists and dental assistants have a wealth of information that is available to help you and your family determine your cavity risk. The dental team can help you by making a personalized plan to make sure there is just enough, and not too much, fluoride.

Those are the benefits, what are the risks?

If fluoride is used carefully (like anything, too much can be harmful), there is very little risk involved. If too much fluoride is ingested over the time that the permanent teeth are developing, then a condition called “fluorosis” can develop. Fluorosis is a discolouration of the permanent teeth varying from very slight “snow-fleck” appearance of the enamel to improper development of the outer layer of enamel leading to staining. This type of enamel condition is not something that develops from one or a few exposures, but over time during dental development. Having a discussion with your dental team can reduce the chance of your child developing fluorosis.

I read on the internet that fluoride can be very harmful…

Information found on the internet, although plentiful, can be misleading and can be subject to interpretation. If you have questions about fluoride, do not hesitate to ask your dental team. Your dentist has spent a great deal of time learning about the use and safety of fluoride and is your most direct source of trustworthy information. He or she can direct you to evidence based information sources that you can trust. Paracelsus in the 1500’s said it best…the only difference between something that is poisonous and something that is not, is the dose.

Type this link into your browser to obtain a .pdf version of the World Health Organization statement on the effective use of fluorides for the prevention of dental caries:

http://www.who.int/oral_health/media/en/orh_cdoe_319to321.pdf