Fluoride is a naturally occurring element that helps strengthen tooth enamel and make it more resistant to acid exposure. Exposing teeth to acidic food and beverages is a major factor in tooth decay, an infectious disease afflicting most people.1
Enamel is made of a slightly porous mineral with tiny spaces and holes. Acids can get into these small areas and begin the process of tooth decay. When fluoride comes in contact with enamel, it decreases the number and size of the spaces. This makes the tooth less vulnerable to acids and decay.
For most people, daily exposure to appropriate levels of fluoride through drinking water and toothpaste is important to preventing tooth decay. It should be an essential part of your family's oral health routine, including brushing, flossing, good nutrition, and regular dental visits. In fact, individuals at low-risk for tooth decay may not need any other forms of fluoride to reduce tooth sensitivity, slow or reverse the progression of cavities, or aid in the proper development of teeth.
While fluoride treatment is available as part of regular dental visits, daily exposure to fluoride is what's most important to strengthen your teeth. Fluoride is available through a variety of sources. Drinking fluoridated water, brushing with fluoride toothpaste, or using other dental products containing fluoride can raise fluoride concentration in saliva 100 to 1,000 times. Be sure to tell your dentist about all the fluoride to which you and your family are exposed. If your dentist determines that your normal daily fluoride is insufficient, they can recommend additional at-home or in-office methods to increase your exposure to sufficient levels.
Most public water supplies in the US add a small amount of fluoride. Some locations have naturally occurring fluoride levels that are higher than recommended. If you use private well water, you should have your water checked to ensure you and your family are not getting more fluoride than recommended. It is a good idea to share the results of these tests with your dentist. If the fluoride level in your water supply is low, your dentist may recommend supplements or other ways to increase your family's exposure. If the fluoride level in your water supply is high, it may influence the frequency and type of fluoride treatment they recommend.
Most bottled waters do not contain fluoride. You can check the label or the manufacturer's website to see if fluoride is in your bottled water. In addition, filters in your refrigerator or directly attached to your faucet can remove fluoride from tap water.
Children up to age 18 should always use a toothpaste containing fluoride. However, studies show that using fluoride toothpaste is beneficial for everyone. Prescription-strength fluoride toothpastes are available for people with higher risk factors for tooth decay. Some risk factors include taking medications that cause dry mouth, radiation therapy of the head and neck, and diminished salivary gland function.
Fluoride supplements for home use are available in other forms, including over-the-counter or prescription tablets, lozenges, gels, and rinses. No matter which type you use, be sure to tell your dentist about them and follow all directions. Keep any fluoride supplements out of the reach of children, as they can be dangerous when ingested in large amounts.
It's important to know how much fluoride you and your family are getting to ensure that it is not too much.
Too much exposure to fluoride over time can cause a fairly common condition known as dental fluorosis. Fluorosis isn't a disease, and it doesn't generally affect the health of your teeth. Dental fluorosis causes white to gray or brown lines or streaks on the teeth of younger children. Severe fluorosis can cause larger brown or gray discolorations to the teeth. In most cases, the effect is so subtle that only a dentist would notice it during an examination. Cosmetic treatment can address any concerns by removing the lines or shading resulting from fluorosis. Some cosmetic services, like bleaching, are unlikely to weaken teeth. In severe cases, more invasive procedures, like dental bonding or veneers, may be needed.
Overdoses from fluoride are rare and primarily occur in small children. Fatalities are extremely rare. You should always help children when using fluoride products to ensure that your child does not consume too much. Children should be encouraged not to swallow toothpaste.
If you suspect you or someone you are with is experiencing a fluoride overdose:
A dental professional is the best person to assess your or your child's risk for tooth decay and development. Follow your dentist's advice on how to achieve the maximum benefit from the fluoride they have recommended.
Last updated: 4/6/2021 • Medical review: Thomas J. Greany DDS, 12/28/2020
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