The European Academy of Pediatric Dentistry (E.A.P.D.) and the American Academy of Pediatric Dentistry (A.A.P.D.) advocate that fluoride should be included in any preventive program aimed at controlling tooth decay in children.
A dentist should develop a personalized fluoride program for each child, considering their age and specific needs. Such a program should be evaluated every 6 or 12 months and adjusted according to the developmental changes occurring in the child.
This is because the key to good oral health ultimately lies in the combination of using appropriate fluoride products, maintaining proper hygiene habits, and following a balanced diet.
FLUORIDE: THE NATURAL DEFENDER AGAINST TOOTH DECAY
Fluoride is a naturally occurring mineral found in all water sources, including oceans. It has been identified as one of the fourteen essential elements necessary for the normal growth and function of the human body.
In oral health, fluoride plays the same role for teeth as calcium does for bones.
Numerous scientific studies worldwide confirm that fluoride is the most effective tool in preventing tooth decay.
How Does Fluoride Work?
Fluoride strengthens teeth through three main mechanisms:
- Strengthening Tooth Enamel During Formation
When fluoride is incorporated into the enamel during its development (e.g., through fluoride tablets), it makes the outer layer of teeth harder and more resistant to acid attacks.
- Acids form when bacteria in dental plaque break down sugars from carbohydrates in food.
- Repeated acid exposure weakens enamel and creates cavities (holes).
Fluoride strengthens enamel, allowing teeth to better withstand acid attacks.
- Topical Protection Throughout Life
Fluoride present in the oral environment—from toothpaste, mouthwash, fluoride tablets, varnishes, or fluoridated drinking water—helps:
- Neutralize acids that cause cavities.
- Prevent enamel demineralization.
- Promote enamel remineralization, repairing early-stage decay.
Fluoride can reverse early tooth decay before cavities fully develop.
- Mild Antimicrobial Effect
Fluoride also has a mild antibacterial action, helping to reduce harmful bacteria that contribute to tooth decay.
In conclusion, fluoride must be consistently present in the oral environment to effectively prevent tooth decay.
Research has shown that fluoride reduces cavities in both children and adults and helps reverse early signs of decay.
Forms of Fluoride Intake
Fluoride can be absorbed in two ways:
- A) Topical Application
- Strengthens existing teeth, making them more resistant to cavities.
- Found in toothpaste, mouthwash, fluoride gels, varnishes, and professional fluoride treatments at the dentist’s office.
- B) Systemic Intake
- Fluoride enters the body through fluoridated water, food, and supplements.
- Helps strengthen developing teeth before they erupt.
Topical Fluoride Methods
- Home Fluoride Products
These can be used independently or under a dentist’s guidance.
- Fluoride Toothpaste
- The maximum fluoride content allowed in toothpaste is 1,500 ppm.
- Toothpastes are categorized as:
- Low fluoride: <500 ppm
- Moderate fluoride: 500–1,000 ppm
- High fluoride: ≥1,000 ppm
Over the past 20 years, the use of fluoride toothpaste has led to a 20-40% reduction in cavities.
Brushing 2-3 times a day is essential for preventing both cavities and gum disease.
Fluoride Toothpaste for Children
A pediatric dentist should determine the appropriate fluoride toothpaste concentration for each age group.
For children under 6 years old, fluoride intake from all sources must be carefully monitored to:
- Maximize cavity prevention
- Avoid excessive fluoride consumption, which can lead to fluorosis (tooth discoloration)
- Fluoride Mouthwash
- Reduces cavities by 35%.
- Not recommended for children under 6, as they might swallow the solution.
Professional Fluoride Treatments at the Dentist’s Office
What Happens During a Fluoride Treatment?
After teeth cleaning, the dentist applies a high-concentration fluoride gel, foam, or varnish using special plastic trays or brushes.
Why Are Professional Fluoride Treatments Important?
- These treatments should not be performed at home, as they use high fluoride concentrations.
- Dentists recommend them every six months to significantly reduce the risk of cavities.
- Combined with regular dental check-ups, they help maintain optimal oral health.
Is Fluoride Safe?
The World Health Organization (WHO) recognizes fluoridation as a universal and irreplaceable method of preventing cavities.
Are There Any Health Concerns About Fluoride?
Despite past controversies, scientific research has proven that fluoride is both effective and safe.
- The concerns regarding fluoride have been scientifically disproven.
- Epidemiological and laboratory studies confirm fluoride’s effectiveness and safety.
Final Thoughts
- Professional fluoride treatments at the dentist’s office, twice a year, significantly reduce cavities.
- Global health organizations endorse fluoride as a critical tool for cavity prevention.
Fluoride remains one of the most valuable and scientifically supported methods for maintaining strong and healthy teeth.