Dental care - fluoride

Fluoride is a mineral found in food, water, plants and toothpaste. Brushing with fluoride toothpaste and drinking fluoridated water both help protect teeth against decay. Water fluoridation is recommended by leading national and international health organisations.

Fluoride is a mineral, not a medication#

Fluoride occurs naturally in rock, air, soil, plants and water. All fresh water and sea water contains some fluoride, and many foods and drinks contain it as well. Fluoride is also used in dental products, including toothpastes, gels and mouth rinses, and in treatments that a dental professional paints onto the teeth.

How fluoride protects teeth#

Tooth decay happens when acid attacks the surface of the tooth. Fluoride helps repair this kind of damage before it becomes serious, and a constant low level of fluoride works best for this. Fluoride in your drinking water acts like a steady “repair kit” for your teeth throughout the day.

Tooth decay affects communities in many ways, through pain, suffering and cost. Fluoride is helpful because it benefits everyone, and it is especially valuable for people in lower-income communities who may have less access to other forms of fluoride treatment.

Fluoride protects both young and older teeth. In children it helps prevent the early loss of baby teeth to decay. Baby teeth matter because they guide the adult teeth developing underneath into the right position; losing them too early can lead to the need for orthodontic treatment later. Fluoride also helps prevent painful and costly problems such as tooth abscesses and other permanent damage.

Even if your water is fluoridated, it is still important to look after your teeth by using a fluoride toothpaste.

Protecting children’s teeth#

Children’s teeth need particular protection as they develop. Suggestions include:

• Brush without toothpaste until around 18 months of age.
• Introduce a low-fluoride toothpaste designed for children at about 18 months.
• Use a child-size toothbrush with soft bristles and only a pea-size amount of toothpaste.
• Encourage children to spit out toothpaste rather than swallow it, and not to rinse.
• Supervise brushing until you are confident the child can do it well.
• Continue using low-fluoride children’s toothpaste until about six years of age.

Do not use fluoride supplements in the form of drops or chewable or swallowable tablets, as these can affect the development of a child’s adult teeth. If your drinking water is not fluoridated, ask a dental professional for advice about fluoride toothpaste for children. They may suggest more frequent use, starting toothpaste at a younger age, or starting standard toothpaste earlier.

Dental fluorosis#

Too much fluoride at an early age can cause a child’s adult teeth, which form underneath the baby teeth, to become stained. This is called dental fluorosis. It looks like fine, pearly-white mottling, flecking or lines on the surface of the teeth and is usually very hard to see. It cannot develop once teeth are fully formed and does not affect how the teeth work.

Dental fluorosis can occur in areas with or without water fluoridation. Following the toothpaste guidelines above minimises the chance of it happening. If fluoride is not the cause of staining, it is not dental fluorosis; mottling of the teeth may instead be caused by other things, such as childhood infections, injury to the teeth, or certain medications.

Water fluoridation and water quality#

Water fluoridation does not noticeably change your water. Fluoride has no taste or smell, so adding it does not change the taste or smell of drinking water. Your local water authority can tell you whether your supply has fluoride added.

A few other facts about fluoride and water quality:

• Boiling water does not significantly change the amount of fluoride in it.
• Most home water filters do not remove fluoride, with the exception of reverse osmosis systems.
• Fluoride is added to water in carefully controlled amounts, and only very small amounts are used.
• The total amount of fluoride in the water is monitored regularly.

Safety#

Water fluoridation is supported by leading national and international health, medical and dental organisations. The current evidence confirms that it is a safe and effective way to help protect teeth against decay. There is no evidence that fluoride in water fluoridation programs affects bone development or causes hip fractures or cancer.

Other ways to protect your teeth#

• Eat a healthy diet.
• Brush and floss regularly.
• Have regular dental check-ups.

Key points#

• Fluoride protects both young and older teeth and helps prevent the early loss of baby teeth to decay.
• Baby teeth are important because they guide the adult teeth developing underneath into the right place.
• Too much fluoride at an early age can stain a child’s developing adult teeth, a condition called dental fluorosis.
• If fluoride is not the cause of staining, it is not dental fluorosis; mottling may be caused by other things, including childhood infections.

Where to get help#