Fluoride and Your Health
What is fluoride, and why is it good for my teeth?
Fluoride is a compound of the element fluorine, which is found universally throughout
nature in water, soil, air and in most foods. Existing abundantly in living tissue
as an ion, fluoride is absorbed easily into tooth enamel, especially in children's
growing teeth. Once teeth are developed, fluoride makes the entire tooth structure
more resistant to decay and promotes remineralization, which aids in repairing
early decay before the damage is even visible.
"Systemic" fluoride is ingested when added to public and private water supplies,
soft drinks and teas, and is available in dietary supplement form. Once systemic
fluoride is absorbed via the gastrointestinal tract, the blood supply distributes
it throughout the entire body. Most fluoride not excreted is deposited in bones
and hard tissues like teeth.
What's a "topical" fluoride, and when should I use it?
"Topical" fluoride is found in products containing strong concentrations of
fluoride to fight tooth decay. These products, including toothpastes and mouthrinses,
are applied directly to the teeth and are then expectorated or rinsed from the
mouth without swallowing. Dentists recommend brushing with a fluoride toothpaste
at least twice a day or after every meal, combined with a regimen of flossing
and regular dental checkups.
Professionally-administered topical fluorides such as gels or varnishes are applied
by the dentist and left on for about four minutes, usually during a cleaning
treatment. For patients with a high risk of dental caries, the dentist may prescribe
a special gel for daily home use, to be applied with or without a mouth tray
for up to six weeks.
Why is most of the water we drink fluoridated?
Fluoridated water protects against cavities and root caries-a progressive erosion
of adult root surfaces caused by gum recession-and helps remineralize early carious
lesions. Thanks to these preventive benefits, public water fluoridation is considered
the most efficient and cost-effective dental caries prevention measure available.
More than 144 million United States residents in more than 10,000 communities
drink fluoridated water, most from public water supplies with sodium fluoride
added artificially. A small percentage get water from private wells with naturally
The Environmental Protection Agency has determined that the accepted "optimal"
range of fluoride in water lies between 0.7 and 1.2 parts per million (ppm) or
mg per liter. The limit allowed by the EPA in public water is 4 ppm. Backed by
results from more than 140 documented studies undertaken in 20 different countries
over the past several decades, fluoridated water adhering to these standards
has been scientifically established as safe for drinking. Water fluoridation
is endorsed by nearly every major health and safety-related organization. Fluoridation
of community water supplies is the single most effective public health measure
to prevent tooth decay and to improve oral health for a lifetime.
Can I get too much fluoride?
In general, the use of fluoride is considered safe unless it's misused or over
concentrated. Drinking excessively fluoridated water can cause dental fluorosis,
a harmless cosmetic discoloring or mottling of the enamel, visible by chalky
white specks and lines or pitted and brown stained enamel on developing teeth.
Avoid swallowing toothpaste, mouthrinses or other topical supplements, check
with your dentist on proper dosage, and be careful not to accidentally take too
If you are concerned about the fluoride levels in your drinking water, call
the local public water department.
If the source is a private well, request a fluoride content analysis taken via
a water sample through your local or county health department.
Are children more sensitive to fluoride?
Children are more vulnerable to dental fluorosis because their developing teeth
are sensitive to higher fluoride levels. They are at greater risk if they swallow
or overuse toothpaste and fluoride supplements, or regularly drink water containing
excessive fluoride levels. Monitor your child's intake and use of fluoride, and
consult with your family dentist on the matter.
Sources: "Federal Panel Backs Fluoride in Water "ADA News, Sept. 6, 1993. "FDI Policy
Statement on Fluorides and Fluoridation for the Prevention of Dental Caries,"
FDI Dental World, May/June 1993. "Current Thoughts on Prudent Fluoride Use,"
Journal of the
American College of Dentists, Fall 1992. "Workshop Report-Water Fluoridation,"
Journal of Restorative Dentistry, May 1992. "When Your Patients Ask About Fluoride,"
JADA, Aug. 1991; "New Study Underscores Fluoride Safety," ADA News, March 5,
1990. "Don't Drink the Water?" Newsweek, February 5, 1990.
This information was compiled for you by the Academy of General Dentistry. Your
dentist cares about long term-dental health for you and your family and demonstrates
that concern by belonging to the Academy of General Dentistry. As one of the 35,000
general dentists in the United States and Canada who are members of the Academy,
your dentist participates in an ongoing program of professional development and
continuing education to remain current with advances in the profession and to
provide quality patient treatment. Visit the AGD's website at www.agd.org. You
have permission to photocopy this page and distribute it to your patients.
AGD IMPACT July 1999
Posted July 4, 1999 [TCJ]