Patient Information

Does my child need fluoride supplements?

Fluoride is a mineral found in the earth's crust and is typically present in water. The amount of fluoride in the water varies with the location. Some communities have a large amount of fluoride in the water, and some have a very small amount. The US government issues recommendations on the amount of fluoride in the water that will allow more people to benefit safely from it.

WHAT IS GOOD ABOUT 
FLUORIDE?


Fluoride has been proven to prevent or slow down the development of cavities. The United States and many other countries decided to put fluoride in the community water in order to protect teeth from decay. Fluoride supplements were developed for those people living in communities without fluoridated water. By using supplements, those people could still get the benefits of fluoride and protect their teeth. Later, fluoride toothpastes came on the market and cavity rates decreased even further. Eventually, even more fluoride-containing products became available. These ranged from fluoride mouth rinses to fluoride varnishes applied to the teeth by the dentist. 


WHAT IS BAD ABOUT 
FLUORIDE?


At the beginning, adding fluoride to the water dramatically decreased rates of dental cavities. However, as more and more fluoride-containing products came on the market, concern arose over getting too much fluoride. Swallowing too much fluoride while teeth are developing can cause them to have permanent white or brown spots or streaks, a condition called dental fluorosis. In the United States, dental fluorosis is mostly mild, with just white spots or streaks on the tooth surface. However, getting dental fluorosis is unnecessary and does not have to happen if care is taken to prevent exposure to too much fluoride during tooth development. 


HOW CAN I PROTECT MY CHILD'S TEETH?


During infancy, breastfeed or use bottled water (without added fluoride) to prepare the baby's formula. Use fluoride-free toothpaste for the first year to get children used to brushing their teeth, and try to teach them not to swallow the toothpaste. Then, when children are old enough, you can switch to fluoride-containing toothpaste. The most important thing is supervision. Do not let your children brush their teeth by themselves until you are absolutely sure that they will not swallow the toothpaste. They need to spit out the toothpaste and rinse the mouth thoroughly. 


Another important point is to use only a pea-sized amount of toothpaste and rub it into the bristles so that it does not fall off in clumps inside the mouth. Putting the toothpaste across the brush rather than along the brush is one way to measure out a pea-sized amount. Promote toothbrushing twice per day and make sure that the appropriate amount of time is spent actually brushing the teeth and not just playing and pretending to brush. Do not use fluoride supplements unless your doctor is absolutely sure that your child is at a great risk for cavities. 


BOTTOM LINE


Overall, fluoride is good. It has been proven to decrease and prevent cavities. However, too much fluoride during tooth development can cause permanent white spots and streaks on the teeth. Supervised toothbrushing is one way you can limit your child's exposure to fluoride. JAAPA