Falling for Fluoride

Fluoride has long been recognized as a safe and effective measure to prevent and control cavities.  And no wonder!  It wields a double-edged sword to keep cavities in check, with its effects being either topical or systemic.  The systemic effect occurs through ingestion, usually in the form of fluoridated drinking water that mineralizes the teeth.  Application of fluoride, either fluoride toothpaste or treatment at a dentist’s office, directly onto the teeth remineralizes them through the topical effect and — presto! — alters the bacterial metabolism to help prevent tooth decay.  We’ve clearly got ourselves a winner.

A Delicate Balance

For all fluoride’s importance to healthy teeth, sometimes you can get too much of a good thing.  It’s important for parents of young children to be aware that an excess intake of fluoride can lead to fluorosis, a condition that causes defects in tooth enamel, especially during infancy.  An early visit to the dentist can answer all your questions about your child’s risk for fluorosis as well as those about tooth formation and oral hygiene.

In addition to toothpaste, drinking water also contains fluoride.  To determine the level of fluoride in your water supply, you can consult the Centers for Disease Control and Prevention (CDC) website.  If you live in Chicago, the fluoride in the water is regulated to 1 part per million.  This is the optimal percentage for the general population.

The Right Formula

An infant is already in the process of forming adult teeth, and appropriate nutrition during the first years of life plays a crucial role in the appearance of the permanent teeth to come.  The American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) recommend breastfeeding for babies based on the fact that breast milk provides an optimal level of nutrition.  However, if you have to rely on formula at some point, there are a few things to consider.

Infant formulas, both powdered and liquid, and water bottled specifically for infants have varying concentrations of fluoride.  The CDC states that fluoridated water can be used to prepare infant formula.  However, if your child is exclusively consuming infant formula reconstituted with fluoridated water (usually until he or she is 4 – 6 month old), he or she may be at an increased risk for mild dental fluorosis.  Mild dental fluorosis appears as white spots on the teeth.  To lessen this chance, parents can periodically use low-fluoride bottled water to mix infant formula.  These bottled waters are labeled as de-ionized, purified, demineralized, or distilled.

A Topical Treatment

Fluoridated toothpaste should be used twice a day.  Ask your child’s dentist for specific advice on the appropriate volume of toothpaste, the optimal size of toothbrush for your child’s age, recommended frequency of brushing, and how or if you should assist your child in his or her dental hygiene regimen.  For children less than 2 years of age, a smear of fluoridated toothpaste is the recommended amount, and a pea-sized amount is ideal for children aged 2 through 5 years.  To maximize the beneficial effect of fluoride in the toothpaste, rinsing after brushing should be kept to a minimum or eliminated altogether.

Dental checkups and cleanings offer another effective way to ensure that your child is reaping the benefits of topical fluoride.  Children at a higher risk for tooth decay may require additional or more frequent fluoride therapies.  Whatever the case may be, your dentist will assess your child’s individual needs and provide the necessary fluoride treatment.

Make the trip to the dentist a fun adventure and start your child on a lifetime of healthy smiles.

~By Flavia Lamberghini DDS, MS, MPH, Professor in the Postgraduate Program of Pediatric Dentistry, UIC

Visit Dr. Flavia and her wonderful team at www.appledentalcare.org!