What is fluoride, and is it safe?

Fluoride is a natural mineral found in many foods, water, plants, rocks, and even in the air. Fluoride is commonly used in dentistry to strengthen the enamel of our teeth and to prevent cavities. It’s also added in small amounts to public water supplies in the United States and in many other countries. This process is called water fluoridation.

So why do we use it?

In the sense of human health, fluoride is mostly used to improve dental health. Fluoride helps prevent tooth decay by making the tooth more resistant to acid attacks from plaque bacteria and sugars in the mouth.

Each day minerals are added to and lost from a tooth’s enamel layer through two processes, remineralization and demineralization. When minerals are lost from the enamel layer we call it demineralization. This happens when acids that are formed by plaque and sugars attack the enamel. Minerals such as fluoride, calcium, and phosphate are redeposited to the enamel layer from the foods and waters consumed — this is called remineralization. Too much demineralization without enough remineralization to repair the enamel layer leads to tooth decay.

Fluoride can be found in toothpaste, mouth rinses and in-office dental products like fluoride gel. If you are more susceptible to cavities, a dentist might recommend using a prescription mouth rinse with fluoride. These varieties contain higher levels of fluoride than over-the-counter mouth rinses do.

Other types of fluoride products and uses include:
● Supplements
● Foam fluoride products
● Fluoride varnishes
● Silver diamine fluoride

Dangers of fluoride

The ADA recognizes the use of fluoride and community water fluoridation as safe and effective in preventing tooth decay for both children and adults but there are risks associated with consuming too much fluoride.
Fluoride toxicity is when there are elevated levels of the fluoride ion in the body. Chronic fluoride toxicity can lead to the development of fluorosis — a hypomineralization of tooth enamel caused by ingestion of excessive fluoride during enamel formation. Fluorosis varies in appearance from white striations to stained pitting of enamel.

Two other diseases associated with fluoride toxicity include dental and skeletal fluorosis. Dental fluorosis happens when you consume too much fluoride while your teeth are still forming under your gums. This results in white spots on the surface of your teeth. Other than the appearance of white spots, dental fluorosis doesn’t cause any symptoms or harm. Children who still have permanent teeth coming in are at the highest risk for this condition.

Skeletal fluorosis is similar to dental fluorosis, but it involves bones instead of teeth. Early symptoms include joint pain and stiffness. Over time, it can alter bone structure and cause the calcification of ligaments. It tends to result from long-term exposure to high levels of fluoride, often in drinking water.

Fluoride in drinking water

Fluoride is a mineral that is found in all-natural water sources and is the ionic form of the trace element fluorine. Fluorine reaches water sources by leaching from soil and rocks into groundwater. Additional amounts of fluoride are added to many cities in the United States and in other countries but not every city is fluoridated. The decision about whether or not to fluoridate is made by each city. Check to see if your city fluoridates the water you drink here.

Fluoride and children

Fluoride is an especially important mineral for children. It protects the teeth from acid damage and helps reverse early signs of tooth decay. Be sure that your children are drinking plenty of water and brushing with toothpaste that has fluoride in it.
The American Dental Association (ADA), American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) agree that water fluoridation is a safe and effective way to prevent tooth decay in children. The ADA has also issued that it is safe to use fluoridated water to mix infant formula.

In some cases, fluoride supplements are even prescribed to children as young as six months old who are at high risk of tooth decay and whose primary drinking water has a low fluoride concentration.

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When consumed at the proper level, fluoride is a safe and effective way to mitigate cavities and prevent decay. If you’re concerned about your fluoride intake, ask your local government about the fluoride in your city’s water and talk to your dentist about fluoride and oral health.

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