Fluoride
Author: George Ghidrai, MD
Fluoride is a natural mineral that is found in many foods and in all drinking water. The amount of fluoride in water varies from area to area.
What are the benefits of fluoride ?
Fluoride can help dental health by strengthening the tooth enamel, making it more resistant to tooth decay. It also reverses early decay and reduces the amount of acid that the bacteria on your teeth produce.
How does fluoride work ?
Fluoride is absorbed easily into tooth enamel, especially in children's growing teeth. Once it is absorbed, fluoride binds to the hydroxyapatite crystals in enamel, strengthening tooth structure.
In children, fluoride becomes incorporated into the development of permanent teeth, making it difficult for acids to demineralize the teeth. Moreover, children who have fluoride when their teeth are developing tend to have shallower grooves in their teeth, so plaqueDental plaque is a biofilm, usually a pale yellow, that develops naturally on the teeth formed by colonizing bacteria trying to attach themselves to the tooth's smooth surface. can be more easily removed.
Adults benefit from fluoride, too. When plaque bacteria and sugars are left on teeth, they can attack the enamel (and dentin) causing demineralization, which is the dissolution of mineral content. This will progressively destroy tooth enamel and dentin, resulting in tooth decay.
Minerals such as fluoride are redeposited (remineralization) to the enamel layer and help reverse early decay by repairing the enamel layer.
In what forms is fluoride available ?
Fluoride is found in foods and in water. It can also be directly applied to the teeth through fluoridated toothpastes and mouth rinses.
A dentist (in his office) can also apply fluoride to the teeth as a gel, foam, or varnish. These treatments contain a much higher level of fluoride than the amount found in toothpastes and mouth rinses. Gels and foams are painted on the teeth or are put into a mouth guard or common tray, which is applied to the teeth for several minutes.
Fluoride supplements are also available as liquids and tablets and must be prescribed by the dentist or family doctor.
When is fluoride intake important ?
It is certainly important for infants and children up to the ages of 16 years to be exposed to fluoride. This is the timeframe during which the primary and permanent teeth are formed and/or come in.
Adults benefit from fluoride in toothpastes, mouth rinses, and in fluoride treatments, which are as important in fighting tooth decay. In addition, people with certain conditions may be at increased risk of tooth decay and additional fluoride treatment is indicated. These include :
Dry mouth conditions -- caused by diseases such as Sjogren's syndrome, certain medications (such as allergy medications, antihistamines, high blood pressure drugs etc) or head and neck radiation.
The lack of saliva makes it harder for food particles to be washed away and acids to be neutralized so the likelihood of dental decay is increased.
Gum disease or gingivitis, can expose more of the teeth and teeth roots to bacteria, increasing the chance of tooth decay.
Genetic predisposition for plaque build-up or cavities
Presence of crowns and/or bridges or braces. These treatments can put teeth at risk for decay at the point where the crown meets the underlying tooth structure or around the brackets of orthodontic appliances.
Many dental professionals include applications of topical fluoride solutions or gels as part of routine visits.
What are the side effects ?
The most common side effect is called fluorosis. Fluorosis is caused by having too much fluoride. This can happen when fluoride supplements are taken (especially by children) in areas where the water supply is fluoridated. It can also happen when children swallow toothpaste.
There are two forms of fluorosis :
Mild fluorosis appears as very fine pearly white lines or flecking on the surface of the teeth.
Severe fluorosis may lead to the enamel being pitted and discolored. It can also affect other organs (such as bones).
Conclusion
Many reports have been published throughout the world about the pros and cons of fluoride and the benefit or harm of water fluoridation.
The general scientific conclusion is that fluoride can be of great benefit to dental health and causes no harmful side effects to general health if it is correctly applied and/or prescribed.
As mentioned, the amount of fluoride in water varies from area to area and it is possible that not all waters are correctly fluoridated.
To be on the safe side, always check with your dentist and/or other medical specialists before starting a fluoride treatment for you or your children.