Fluoride is a naturally occurring mineral in water and many foods. In addition, fluoride is intentionally added to the public water supplies, because it has been demonstrated that communities with fluoride added to their water supplies have significantly reduced incidence of tooth decay in children. Fluoride makes teeth more resistant to the acid formed by bacteria in the mouth by preventing these acids from removing essential minerals from the tooth surface. Fluoride also helps to repair damaged tooth enamel.
What is dental fluorosis?
Dental fluorosis is a change in the appearance of the tooth's enamel attributed to exposure to too much fluoride. According to the US Centers for Disease Control (CDC), over 90% of fluorosis observed in the United States is mild to very mild in severity and is observed as white spots or streaks on the tooth surface. Dental fluorosis can occur when children regularly consume higher-than-recommended amounts of fluoride during the teeth-forming years (age 8 and younger). Individuals on private well water supplies that contain excessive amounts of fluoride may develop moderate to severe forms of dental fluorosis, including more extensive enamel changes. In very unusual instances, pits may form in the teeth. Severe cases of dental fluorosis rarely occur in communities where the level of fluoride in water is less than 2 milligrams per liter.
How can I ensure that my child is getting enough fluoride to prevent cavities while avoiding dental fluorosis?
According to the US CDC, if your community water supply is optimally fluoridating at 0.7 to 1.2 milligrams per liter and you are following recommended guidelines with respect to your child's tooth brushing habits, it is highly unlikely that your child is being exposed to too much fluoride. The CDC recommends that children under the age of six who are using fluoride toothpaste should use a small, pea-sized amount on the brush, spit out the excess paste, and rinse well after brushing. It is recommended that use of fluoride-containing toothpaste begin when your child is two years old. Fluoride-containing toothpaste should only be used with children under the age of two if recommended by your child's doctor or dentist. The correct use of fluoride treatments and fluoride-containing toothpaste can be discussed with your child's dentist. In addition, the CDC's website offers guidance on how young children can use fluoride-containing products to prevent dental fluorosis. See Brush Up on Healthy Teeth.