Fluoride: What parents need to know - Part 2

In Part 1 we discussed the benefits of fluoride and the risks of over-exposure to fluoride.

Fluoride can be useful in strengthening teeth and protecting them from decay, if used in the right way. 

As we discussed in the previous section, there is a risk of dental fluorosis, or mottling of teeth, if children swallow too much fluoride.

In this second part we will look at the uses of fluoride and safety guidelines.

Products which contain fluoride

Fluoride Toothpaste 

This is the most common application of fluoride as it can easily be used regularly at home. Regular use of fluoridated toothpastes has been shown to reduce tooth decay by up to 50%. 

Safety guidelines for using fluoride toothpaste:

• Young children who cannot spit out should use either plain drinking water or a training toothpaste which does not contain fluoride for brushing.
• Children generally learn to spit out from around 5 or 6 years old. At this stage fluoride toothpaste can be introduced with adult supervision.
• It is best to use a lower fluoride toothpaste up to 7 or 8 years old, when children still tend to swallow some paste and their developing teeth could still be at risk of fluorosis.
• The amount of fluoride is usually shown on the toothpaste packet in parts per million (ppm). In India, most adult toothpastes contain 1000 ppm and toothpastes designed for children often contain 500 ppm or less of fluoride. 
• No more than a small pea-sized amount of toothpaste should be used. Instruct your child to spit out after brushing and not to swallow it. 

• Keep toothpaste out of the reach of young children. Swallowing large amounts can cause stomach problems and other health issues. Seek immediate medical attention if a child swallows a large amount of toothpaste. 

Fluoride Mouthwash or Rinses

Mouthwashes are not recommended for children. If a teenager or young adult is at a high risk of cavities, or wearing braces which make their teeth more difficult to clean, their dentist may recommend a fluoride mouth rinse to be used at a different time from brushing. This should of course not be swallowed. Avoid mouthwashes that contain alcohol.

Fluoride Varnish

Fluoride varnishes are useful for children who are at a higher risk of tooth decay. As they contain a very high level of fluoride they can only be used by dentists and applied no more than twice a year. 

The varnish is painted onto teeth and sets quickly, sticking to the tooth surface to minimize swallowing and maximize its effect. If a tooth has very early dental caries in enamel, it can help to stop the decay and prevent it becoming a cavity. Fluoride varnish is also beneficial for sensitive teeth.

Glass Ionomer Fillings

Glass Ionomer is commonly used for fillings and sealants in baby teeth. In addition to being able to adhere directly to tooth surfaces it also releases small amounts of fluoride over an long period of time. The level of fluoride released is too low to cause any health problems but helps to prevent decay and the need for future fillings.

In Summary

When used in a controlled way, the benefits of fluoride outweigh the risks. 

Parents and dentists need to take into account the overall fluoride exposure from all sources when making decisions about the use of products or treatments which contain fluoride. 

In areas with high levels of fluoride in drinking water, fluorosis  (mottling and staining of the teeth) is common. In these areas it is wise to minimise fluoride exposure as much as possible. 

Dental Fluorosis

In areas where the is no significant fluoride in water the appropriate use of some fluoride therapies will be important in preventing decay.

If you need more information and advice, please speak to your dentist.

If you live in Bangalore, you can contact us at Small Bites, Exclusive Dental Care Centre for Children (click for link) where we will be happy to help.