I have many patients who ask me about the benefits of fluoride for themselves and their children. I believe fluoride is beneficial to everyone and can dramatically reduce the amount of decay a patient will develop when used in the proper, recommended way. I have my patients use a variety of topical applications at home, based on individual need, and have my hygienists use a variety of professional applications in the office, as well. On a daily basis, the outer layer of the tooth (the enamel) is in a constant state of re-mineralization and de-mineralization. This means that the outer layer of the tooth has minerals taken away from and added to it all day long. During the re-mineralization process, minerals such as fluoride, calcium and phosphate are added to the enamel layer through foods and drinks that may contain these substances. De-mineralization occurs when acid from foods, beverages or bacteria come in contact with the tooth’s enamel, removing some of the essential minerals. Tooth decay will occur when the enamel looses more minerals than it gets back.
Fluoride comes from Fluorine, the thirteenth most naturally occurring element and is released naturally through water and the air. Fluoride may be found in varying concentrations in soil, air, fresh water, sea water, plants and foods. Although there are many naturally occurring sources to get fluoride such as foods, seafood and some teas, the primary source is through tap water. Tap water in most cities in the U.S. contains fluoride and some, but not all, bottled waters have fluoride as well. Proper use of fluoride works to stop, even reverse, tooth decay. Fluoride keeps the tooth’s enamel strong by keeping the enamel hard which makes it more resistant to acid produced by bacteria. Fluoride also helps to speed up the re-mineralization process of erupted teeth in children and adults.
There are many ways to introduce fluoride to the teeth. Fluoride can be placed directly on the teeth through toothpastes and mouth rinses. Most of these products may be purchased over the counter at pharmacies or grocery stores. However, your dentist or dental hygienist can apply fluoride to the teeth in the form of gels, foam, varnish or pastes. These professional, topical applications of fluoride are applied in the dental office and usually contain higher levels of fluoride than over the counter toothpastes or rinses. Your dental professional may also recommend a more regimented, at home use of prescription strength fluoride for the most at risk patients. This may be in the form of simple topical applications on the teeth, custom trays that the patient wears to hold the fluoride on the teeth or a Perio Protect tray that will apply holds medications to kill large quantities of bacteria that cause decay as well as hold fluoride on the teeth.
The best time to get a fluoride treatment is immediately after your polishing by the hygienist. During the polishing process, the hygienist removes plaque (food and bacteria) and stain from the tooth’s surface but also during that process she is removing a substance called the pellicle protein coat. The removal of the pellicle coat can also be achieved by using gritty toothpastes and vigorous cleaning by the patient at home. This protein coat is produced by the body to coat and cover the teeth to protect them from the affects of acid exposure. It is like an invisible barrier to keep the acid off your teeth but the outside wall of the pellicle coat gets covered with bacteria over time. When the pellicle coat is removed the teeth are better able to “soak up” the fluoride, thus gaining more protection from bacteria and acids caused by bacteria, foods and drinks. Almost immediately after polishing or brushing at home, the pellicle coat begins to re-form. There is about a 30-45 minute window of opportunity for the teeth to utilize the fluoride best.
So how can you best use fluoride?
Always use fluoride as recommended by your dentist or physician.
Expectorate don’t rinse after brushing (this washes away the fluoride from your toothpaste).
Have a professional fluoride treatment in your dental office after cleanings.
Infants and children between the ages of 6 months and 16 years should receive fluoride. This age group’s primary and permanent teeth are still developing and can benefit from the fluoride by strengthening the enamel as it is forming. The Centers For Disease Control and Prevention recommends prescribing fluoride for children between the ages of six months and sixteen years who are at risk for developing cavities and whose communities do not have fluoridated water.
Adults can also greatly benefit from the use of fluoride. It is just as important to protect the already erupted teeth as it is to strengthen developing teeth. Your dentist can suggest a topical fluoride to use daily based on individual need.
Fluoride is an important factor for healthy, decay free teeth but it becomes an absolute must when there certain kinds of oral conditions such as:
Dry Mouth- this reduction in salivary flow increases the chance of decay because our saliva acts as a buffer to the acid. Caused most commonly by medications taken but can also happen with radiation treatment and through some autoimmune diseases.
Gum Disease- this may cause exposure of the root surface of the teeth. The root surface is made up of a much softer substance and decay increases.
Cavities or (High Rate of Decay)
The simple use of fluoride can be the difference between a healthy smile and a costly reconstruction. Ask your dentist about the benefits fluoride for yourself and your children.