All About Fluoride
Fluoride therapy is the delivery of fluoride to the teeth topically or systemically, which is designed to prevent tooth decay which results in cavities. Most commonly, fluoride is applied topically to the teeth using gels, varnishes, toothpaste/dentifrices or mouth rinse. Systemic delivery involves fluoride supplementation using tablets or drops which are swallowed. This type of delivery is rarely used where public water supplies are fluoridated.
Benefits of Fluoride
Fluoride use in the modern dental field is generally agreed upon as being useful. Fluoride combats the formation of tooth decay primarily in three ways:
- Fluoride promotes the remineralization of teeth. Fluoride found in saliva will absorb into the surface of a tooth where demineralization has occurred. The presence of this fluoride in turn attracts other minerals (such as calcium), thus resulting in the formation of new tooth mineral.
- Fluoride can make a tooth more resistant to the formation of tooth decay. The new tooth mineral that is created by the remineralization process in the presence of fluoride is actually a “harder” mineral compound than enamel, the tooth’s original protection.
- Fluoride can inhibit oral bacteria’s ability to create acids by decreasing the rate at which the bacteria that live in dental plaque can produce acid. By disrupting bacteria’s ability to metabolize sugars, less acidic waste will be produced to participate in the demineralization process.
Where Can You Get Fluoride?
Fluoride is available in several formats, including at home therapies and professionally applied topical fluorides. At home therapies can be further divided into over-the-counter (OTC) and prescription strengths. Whether OTC or prescription, fluoride therapies are generally categorized by application: dentifrices, mouth rinses, gels/ foams, varnishes, dietary fluoridate supplements, and water fluoridation. Some fluoride is naturally present in many water sources, though generally thought not to be enough for any real benefit without supplementation. The most common forms of fluoride available to patients today are:
Dentifrices – Toothpaste containing fluoride is an effective way to expose teeth to the benefits of fluoride. Use of toothpastes containing fluoride have shown to be effective at reducing dental decay in patients of all ages, though close supervision is recommended for children who may accidentally swallow toothpaste while brushing. Prescription strength fluoride toothpaste contains a higher level of sodium fluoride to increase exposure when needed, this prescription dental cream is used once daily in place of regular toothpaste.
Mouth rinses – The most common fluoride compound used in mouth rinse is sodium fluoride. Over-the-counter solutions for daily rinsing are available and considered safe for everyday use. Again, adult supervision for children is recommended. The fluoride concentration in these mouth rinses, however, is not strong enough for people at high risk for decay, prescription mouth rinses are considered more effective for these patients.
Gels/foams – Gels and foams containing fluoride are most often used for patients who are at high risk for dental decay, orthodontic patients, patients undergoing head and neck radiation, patients with decreased salivary flow, and children whose permanent molars should, but cannot, be sealed. The gel or foam is applied through the use of a mouth tray which contains the product. The tray is placed in the mouth and held in place by the patient gently biting down. Application generally takes about four minutes, and patients are advised not to rinse, eat, smoke, or drink for at least 30 minutes after application to maximize effect. Some gels are available for home application and are used in a manner similar to toothpaste. Of course, the concentration of fluoride in these gels is much lower than professional products.
Varnish – Fluoride varnish has practical advantages over gels in ease of application, a non-offensive taste, and the benefit of smaller amounts of fluoride required than for gel applications. Varnish is intended for the same group of patients as the gels and foams and is applied with a brush, it sets within seconds.
Fluoride is important for everyone, but most importantly for children whose teeth are developing. As teeth are developing within their jaw bones, enamel is being laid down. Fluorapatite is a hard mineral that is formed when teeth are exposed to fluoride, making tooth enamel more resistant to acidity and decay. Studies have shown that the systemic ingestion of fluoride, as opposed to topical application alone, results in a greater component of fluorapatite in the mineral structure of the tooth’s enamel and, ultimately, stronger and healthier teeth!