By Elizabeth May, DDS, MSD and Shannon DeVera, DDS
What is fluoride?
Fluoride is a naturally occurring mineral found in rocks, soil, water, and air. It is considered to be especially beneficial in dentistry, as it promotes enamel remineralization (strengthens tooth structure) and helps prevent enamel demineralization (stops cavity development). In addition, fluoride can also inhibit bacterial metabolism and acid production, thereby protecting even further against tooth decay.
What are some sources of fluoride for children?
Children can be exposed to fluoride both topically (applied to the teeth directly) and systemically (ingested). Examples of topical fluoride sources include toothpastes, mouth rinses, and professional applications at the dental office. Topical fluorides are beneficial as they strengthen the existing tooth structure. Examples of systemic fluoride sources include tap water, certain foods or meals, beverages processed with fluoridated water, and even some infant formulas. Systemic fluoride exposure is beneficial (especially for children) as it helps to promote healthy enamel formation when the tooth is developing.
When can my child start using fluoride products at home? Is it safe?
Yes, fluoride is safe for children. In fact, they can benefit from fluoridated toothpaste as early as the eruption of their first tooth. The American Academy of Pediatric Dentistry (AAPD) recommends using no more than a smear (“rice-sized” amount) of fluoridated toothpaste for children under three years of age. Similarly, children ages 3-6 are recommended to use only a “pea-sized” amount of fluoridated toothpaste. Parents are recommended to supervise their child’s brushing twice per day. By following these guidelines, the risk of fluorosis is significantly reduced.
What does fluoride application look like in the dental office?
Fluoride that is applied in pediatric dental offices is a highly concentrated form of fluoride, which helps to maximize its overall benefits. Professional fluoride comes in many forms, including foams, rinses, gels, and varnishes. Fluoride varnishes are preferred by many dental providers who treat children, as the application is quick and it remains adhered to the tooth for longer (therefore maximizing benefits!). After varnish applications, children may eat or drink immediately but should abstain from hard or sticky foods immediately following the visit. Foams and gels are also great options for fluoride, but application often takes longer and may not be tolerated well by all children.
Like us, our pediatric dental peers recommend a professional application of topical fluoride twice a year. While a single application of fluoride varnish does provide some benefit, most studies of professionally-applied fluoride have shown that at least two fluoride applications a year are necessary to achieve an effective reduction in cavity development. The AAPD clinical guidelines suggest that children with the highest cavity risk may even benefit from applications as often as every three months.
What are some resources I can review if I want more information?
We understand that fluoride can be confusing; there is a lot of conflicting information out there. If you still have questions, we encourage you to check out some of the resources below.
- American Academy of Pediatric Dentistry (AAPD): Fluoride Therapy. https://www.aapd.org/research/oral-health-policies–recommendations/fluoride-therapy/
- American Academy of Pediatrics (AAP): Fluoride Use in Caries Prevention in the Primary Care Setting. https://publications.aap.org/pediatrics/article/146/6/e2020034637/33536/Fluoride-Use-in-Caries-Prevention-in-the-Primary
- Center for Disease Control (CDC): Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm