In my last article, I talked about cavities and how it all starts with the teeth becoming demineralized as the sugar bugs eat sugars/carbs and “poop” acid on the teeth. I touched on hygiene and diet, but now I want to talk about fluoride as the 3rd in the list of powerful modifiers.
Fluoride is a mineral found in natural water supplies. When we process water for sanitation and safety, it is filtered and disinfected. Various chemicals are used in this process, which includes chlorine to kill parasites/bacteria/viruses, chemicals as needed to adjust for hardness and pH levels, or to prevent corrosion, all dependent on the original quality of the naturally occurring water source that’s being drawn from. Fluoride as a chemical is then added or removed, depending on the original water source, in order to optimize the level. The discovery of fluoride’s benefits and risks came from areas of the US and the world where fluoride levels were high. We’ve since learned how much is just right. As they say in pharmacy, the dose makes the medication. Too little and it does nothing, too much and it’s harmful – you need the right amount. This is the core fact about fluoride safety: the amount we use is well within safe levels.
The cool thing about fluoride is that it can become incorporated into the chemical structure of teeth. Fluoride ions can switch out with ions within the hydroxyapatite mineral that makes up our tooth structure. With acid attack from eating, teeth are always being slightly demineralized, and then the calcium and phosphates (bone/tooth ions) in our saliva remineralize it. As long as things are more remineralizing on average during the day than demineralizing, you don’t get cavities! But this means that fluoride toothpaste, fluoride in drinking water, fluoride varnish at the dentist, can take advantage of the daily times of demineralization and become incorporated into the tooth structure. This even means that someone with “watches, ”areas of teeth with chalky white demineralization that we want to treat with prevention and never allow to become cavities, are even more receptive than usual to being treated with fluoride, becoming stronger than ever before.
By stronger, what I mean is that fluoro-hydroxyapetite is 10x more resistant to acid dissolution than otherwise, making it harder for the sugar bugs to dissolve teeth with fluoride. Like – a LOT harder! Fluoride’s optimization in the water supply is credited with about a 25% reduction in cavities in children and adults. It’s considered to be one of the 10 greatest public health achievements in the 20th century, along with vaccination and the recognition of tobacco use as a health hazard, and has proven safe and efficacious for over 70 years.
I, along with the ADA, AAP, WHO, and the CDC, therefore recommend fluoridated toothpaste and fluoride varnish applications at the dentist. Fluoride toothpaste is recommended for every age. The big question I get from parents is if it’s ok for littles. Many families allow children to apply their own toothpaste, and many adults, themselves, see toothpaste commercials with the generous schloop on the toothbrush extending beyond the borders of the bristles on either side. While over-lubricating isn’t the end of the world for the adult brusher, our kids under 4 or 5 years of age who tend to swallow instead of spit will end up consuming too much fluoride via toothpaste. This leads to fluorosis, where excess fluoride incorporation into developing teeth (kids only) can actually cause defective tooth enamel formation. As mentioned at the beginning, it’s all about the right amount! So, YES, we recommend fluoride toothpaste for all ages, including littles, but only the size of a grain of rice until they can spit it out.
At PlayWell, every now and then, we have a kiddo choose the fluoride flavor stinky sock, wet dog, or smelly armpit (just kidding!), but most go for bubblegum, marshmallow, chocolate, strawberry, or mint.
The PlayWell Membership Plan has your kiddo covered with the quality pediatric dental care they need and deserve to grow well with bright oral health. Check out our plan perks and give your child the gift of a beaming smile by joining our patient family today!
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