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Fast Facts About Fluoride

Updated: Mar 4

Let's start with the basics...

What is fluoride? Fluoride is a naturally-occurring mineral compound found in water and soil. It is also present in the foods you eat and the beverages you drink at varying concentrations.

Why does is matter when it comes to my teeth? When used in the appropriate amount, fluoride helps prevent cavities by making teeth more resistant to decay. Decades of research shows that fluoride helps prevent cavities in both children and adults. It makes the entire tooth surface more resistant to acid attacks from the bacteria that live in the plaque on your teeth. It also promotes remineralization (i.e. adding minerals such as calcium back in to your teeth). Remineralization helps to repair early decay before a cavity, or hole, forms in the tooth (once the hole forms, the decay must be removed and a filling placed where the hole was).

How can I get the right amount of fluoride? Most importantly: talk to your dental professional. Like any vitamin, you want to ensure you're not getting too little or too much. Someone who knows the water in your area and can review your fluoride sources can help you to determine the right amount for you. That being said, there are two ways to receive fluoride protection:

  1. Topical applications

  2. Systemic applications

What is topical fluoride? Topical fluoride is applied directly to and absorbed by the surface of the teeth. It is found in personal oral hygiene products such as toothpastes and mouth rinses, which contain a safe and effective concentration of fluoride to fight tooth decay. These products are rinsed from the mouth without swallowing. Professionally administered topical fluorides such as foams, gels, or varnishes are applied by a dentist and left on for a few minutes, usually during a cleaning treatment. For patients with a high risk of cavities, the dentist may prescribe a special gel or toothpaste for daily home use. (To find out if your oral hygiene products contain fluoride: Check the label on your toothpaste to see if fluoride is an ingredient. You should also check for the ADA (American Dental Association) Seal of Approval to ensure that your toothpaste contains the proper amount of fluoride).

Fluoride Facts Graphic 6

What is systemic fluoride? Systemic fluoride is taken into the body through consuming fluoridated water, fluoride supplements, or foods and beverages. Once systemic fluoride is absorbed via the gastrointestinal tract, the blood distributes it throughout the entire body. Fluoride is then deposited into unerupted, developing teeth. It also then appears in saliva where it continually bathes the teeth and protects them from decay.

Tell me more about fluoridated water Studies prove that water fluoridation continues to be effective in reducing dental decay by at least 25 percent in children and adults. In fact, the Centers for Disease Control and Prevention proclaimed community water fluoridation as one of 10 great public health achievements of the 20th century. Fluoride is naturally present in all water sources, but the level varies widely. Water fluoridation is simply the adjustment of the natural fluoride level up to the level recommended to prevent tooth decay. The exact amount is only 0.7-1.2 parts per million...that's pretty small, but enough to make a big difference to your teeth. To give you some perspective: 1 ppm is the equivalent of 1 minute in 2 years. Four drops in a 55 gallon (208 liter) barrel. Or in other words:

I won't go on. Simply by drinking tap water in communities with a fluoridated water supply, people can benefit from fluoride's protection from decay. Research for the past 60 years has shown community water fluoridation to be safe and the single most effective public health measure to prevent tooth decay in adults and children. Water fluoridation is endorsed by nearly every major national and international health organization including the American Dental Association, American Medical Association, World Health Organization and the U.S. Centers for Disease Control (CDC).

How do I find out if the water in my community is fluoridated?

The easiest and most accurate way to find out is to contact your local water company and ask. The CDC web site also has a page "My Water's Fluoride" ( that allows consumers to learn the fluoridation status of their water system.

What if I drink mostly bottled water? If most of your water comes in the form of bottled water, you are missing out on the valuable fluoride found in tap water, which helps to protect teeth from cavities. In most cases, the fluoride concentrations in bottled water (even in some that are fluoridated) fall below the U.S. government's recommended range of 0.7-1.2 parts per million (ppm) of fluoride, the ideal range to prevent cavities. If you drink mostly bottled water, you should talk to your dentist about fluoride supplements (tablets or drops), fluoride mouth rinses, and topical fluoride gels.

Are children more sensitive to fluoride? Fluoride is absorbed easily into tooth enamel, especially in children's developing teeth. In young children, excess fluoride intake can cause dental fluorosis (a typically harmless cosmetic discoloring or mottling of the enamel. It can look like chalky white specks and lines or pitted and brown stained enamel on teeth). This is why it is important to talk to your dentist about your fluoride intake to ensure that you are not taking supplements when unnecessary. Parents should monitor the use of toothpaste, mouth rinses, and fluoride supplements in young children to ensure they are not ingesting too much. Check with your dentist on the proper amount of toothpaste to use or the proper dosage of a fluoride supplement based on your child's age and needs. If you are concerned about the fluoride levels in your drinking water, call the local public water department or your water supplier. If the source is a private well, request a fluoride content analysis from your local or county health department to ensure that the fluoride levels are within the proper range.

So how will I make sure I don't give my child too much fluoride? For children younger than 3 years old, you only need to be using a smear of fluoridated toothpaste. If they swallow some of it, the amount of fluoride they are ingesting is minute. For children aged 3-6, you only need to dispense a pea-size amount of toothpaste.

So...why are there people against fluoride? Likely because they fail to realize that "the dose makes the poison." In other words, anything (including air and water) is toxic if too much is ingested. The toxicity of a specific substance depends on a variety of factors, including how much of the substance a person is exposed to, how they are exposed, and for how long.

The paper that some may be mis-quoting dates from 2012 and led by Anna Choi. Many of the studies her team reviewed included too small sample sizes, but the conclusion they reached was that “the results support the possibility of an adverse effect of high fluoride exposure on children’s neurodevelopment.” BUT the key to the paper’s conclusion is the term “high fluoride exposure.” Choi’s team looked at previous studies that investigated if large amounts of fluoride were dangerous. This wasn’t really a surprise to anyone. Lots of substances that are good for you in small doses are really dangerous when you have too much. The studies looked at by Choi and her team concerned parts of the world – Iran and China, mostly – where natural fluoride levels in the water were extremely high, sometimes up to 10 or 11.4 milligrams per litre (that's 10 ppm...i.e. 10 times more than that of fluoridated levels in the US!). To put it in perspective, if doctors say that 8 glasses of water a day is good for you and you drink 10x that amount (80 glasses) and 24 glasses of water in a day is enough to kill a 165 pound person, then you've died 3 and 1/3 times over. The dose makes the poison. Fluoride levels in ordinary drinking water are about 1 milligram per litre in Australia, and between 0.7 to 2 milligrams per litre in the US. These levels are way below the US Environmental Protection Authority’s maximum safe limit of 4 milligrams per litre. Indeed, study after study has found that 1 to 2 milligrams per litre fluoride in the water is not only safe but good for you – assuming you’d like to avoid fillings and extractions as much as possible.

Now that you know the numbers and facts, decide what's right for you. Don't be scared by people touting the dangers of too much fluoride. That's 100% true. Any dental or medical professional can agree on that and can review the issues that come with too much fluoride. But unless you're ingesting fluoride supplements without the direction and supervision of your health professional or you are eating toothpaste for breakfast - you're definitely safe drinking fluoridated water that is monitored by your city to maintain a safe, low dose. And you're definitely safe - and better off - with your pea-size amount of toothpaste twice a day. 
If you have any further questions, just ask your dental team! That's what we're here for :)

Dr. Stephanie Stephan DDS, Dentist in Auburn Hills, Pontiac, and Waterford Michigan 1590 Baldwin Avenue, Auburn Hills, Michigan 48340

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