How does fluoride prevent cavities? -

Effectiveness. / How it aids the tooth remineralization process. / Fluoride side effects- Dental fluorosis.

A) How important is fluoride as a cavity preventer?

An exposure to fluoride (like that contained in toothpaste or possibly your city's tap water) is probably the most effective cavity-prevention measure available today.

For example, studies have shown that introducing fluoride into a previously unfluoridated city's drinking water supply can lower its citizens' rate of tooth decay between 40 and 70 percent. Those are giant numbers.

FYI: Is your tap water fluoridated?

Are you curious if your city's water supply is adjusted so it has the proper amount of fluoride for optimal cavity prevention? If so, it's easy enough to check.

Click here to visit the website of the US Centers for Disease Control and Prevention, and look for information about your state and town.

Just want a quick overview about municipal fluoridation? Take a look at our Fluoridation USA infographic!

B) Fluoride precautions.

As beneficial as it can be, fluoride must be used judiciously. For example, if young children swallow too much during that time frame when their teeth are developing, a type of tooth staining termed dental fluorosis can result.


A bottle of fluoride oral rinse.

How does fluoride help to prevent tooth decay?

It plays a role in three separate anti-cavity effects:

1) Fluoride promotes tooth remineralization.

Researchers have discovered that fluoride enhances the all-important tooth remineralization process.

(Remineralization is a little bit like "tooth decay in reverse." If you're not already familiar with this phenomenon you really should use the link above to learn more about it.)

Here's how it assists.
  • Fluoride, drawn from a person's oral fluids (saliva), is adsorb onto the surface of teeth where
    demineralization (tooth decay formation) has already occurred.
  • The fact that the fluoride is present attracts other minerals (such as calcium) to the damaged area. This helps to speed up the rate and raise the degree to which remineralization (reformation of tooth mineral) will occur.

2) Fluoride helps to make a tooth more decay resistant.

Amazingly, the new tooth structure that's created during remineralization when fluoride is present (the process we just mentioned) is actually "harder" than the tooth was originally.

  • Teeth are generally composed of the minerals hydroxyapatite and carbonated hydroxyapatite.
  • The type of tooth mineral that's created during the remineralization process when fluoride is present is fluorapatite.
  • Fluorapatite is "harder" than the other tooth minerals, in the sense that it is more resistant to damage caused by bacterial acids (tooth demineralization, cavity formation).

Preventing
cavities using:

So, astoundingly, not only does fluoride promote tooth remineralization but it also helps to create a tooth surface that's even more resistant to the formation of tooth decay than it was originally.

3) Fluoride helps to reduce bacterial acid production.

Research has shown that fluoride tends to inhibit the rate at which bacteria living in dental plaque are able to produce acidic waste products (the actual cause of tooth decay).

This effect is due to the fact that it disrupts the bacteria's ability to metabolize sugars. And the fewer sugar molecules that the bacteria consume, the less tooth-damaging waste products they will produce.

Tips for preventing tooth decay -

Fact - Tooth remineralization, a process that can help to repair the damage caused by tooth decay, is aided by the presence of fluoride. To receive this benefit, however, it must be present in your mouth (saliva).

Cavity prevention suggestions :

  • Drinking fluoridated tap water throughout the day makes a better choice than unfluoridated bottled water.
  • Make sure your toothpaste contains fluoride, so you get an extra exposure every time you brush.
  • Look for toothpastes that have the American Dental Association's (ADA) "Seal of Approval." This seal indicates that the ADA has reviewed evidence about the product and found its fluoride content to be appropriate.


Fluoride side effects - Dental fluorosis.

Dental fluorosis is a type of tooth staining. It's caused by the ingestion of too much fluoride over the time period during which a child's tooth enamel was forming.

Teeth showing bands of fluorosis stains.

Mild-dental fluorosis. Sometimes called "snow capping."

a) Types of fluorosis.

  • The vast majority of cases that occur in the United States involves a mild form characterized by the appearance of chalky-white lines, or opaque white patches, in a tooth's enamel.
  • More severe forms can occur. In extreme cases, the affected areas have a yellow or brown discoloration. They may also have tooth surface pitting.

[Here's an Animated-Teeth.com digital smile makeover that illustrates and discusses the treatment of severe fluorosis.]

b) It's young children who are at risk.

Dental fluorosis only occurs if excessive amounts of fluoride are ingested (swallowed) during that time period when a child's tooth enamel is forming.

Streaks of fluorosis like these would have all form during the same general time frame.

Teeth showing bands of fluorosis stains.

They show at different levels because the teeth were at different stages of development at the time of the exposure.

  • That means the most critical years for the risk of fluorosis lie between birth and age 6 or 7.

But because the staining forms while the teeth are developing (and therefore still lie in the jawbone), it's not visible until the affected teeth have come in, which is typically between the years 6 through 12.

c) Swallowing toothpaste is frequently the cause.

The problem.

Small children, especially those younger than age 6, may not be able to reliably spit out when brushing. And as a result, they may end up swallowing essentially all of the toothpaste that's been placed on their brush. If the one they're using contains fluoride, over time they may ingest enough that fluorosis forms.

Teeth that have fluorosis staining.

Severe dental fluorosis.

Prevention.

The following suggestions can help to minimize a child's risk for fluorosis.

  • Children should be given instructions about how to properly brush and rinse. So to help them avoid swallowing toothpaste, they should be supervised when brushing.
  • Read your toothpaste's instructions. In most cases only a small amount is needed, such as a dab the size of a green pea. Fluoridated toothpaste should always be dispensed by an adult, not the child.
  • As a general rule, unfluoridated tooth cleanser should be used with children 2 years and under. Ask your dentist for their specific recommendation.
  • Store fluoridated toothpaste out of the reach of children (some kids like the way it tastes and eat it).
  • When purchasing fluoride toothpaste, look for one that has the American Dental Association's (ADA) "Seal of Approval." These products have been shown to be both safe and effective.

d) Fruit drinks can be the culprit too.

Bottled juices and juice-flavored drinks manufactured with water can have fluoride levels that significantly exceed the 0.7 to 1.2 ppm (parts per million) that are considered appropriate and optimal.

 

 
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