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DontForgetHiddenFluorideSourcesYourFamilyCouldbeIngesting

In the last half century, fluoride has become an effective weapon against tooth decay. The naturally occurring mineral helps strengthen enamel, the teeth's hard, protective cover.

Although it's safe for consumption overall, too much during early tooth development can lead to fluorosis, a brownish, mottled staining in enamel. To avoid it, a child's daily consumption of fluoride should optimally be kept at around 0.05-0.07 milligrams per kilogram of body weight, or an amount equal to one-tenth of a grain of salt per two pounds of weight.

The two main therapeutic fluoride sources have limits to help maintain this balance: utilities that fluoridate drinking water are required to add no more than 4 parts fluoride per million (ppm) of water; toothpaste manufacturers likewise only add a small amount of fluoride compared to clinical gels and pastes dentists apply to teeth for added decay protection.

But drinking water and toothpaste aren't the only sources of fluoride your child may encounter. Even if you have a non-fluoridated water supply, you should still keep a close watch on the following items that could contain fluoride, and discuss with us if you should take any action in regard to them.

Infant formula. The powdered form especially if mixed with fluoridated water can result in fluoride concentrations 100 to 200 times higher than breast or cow's milk. If there's a concern, use fluoride-free distilled or bottled spring water to mix formula.

Beverages. Many manufacturers use fluoridated water preparing a number of packaged beverages including sodas (two-thirds of those manufactured exceed .6 ppm), soft drinks and reconstituted fruit juices. You may need to limit your family's consumption of these kinds of beverages.

Certain foods. Processed foods like cereals, soups or containing fish or mechanically separated chicken can have high fluoride concentrations, especially if fluoridated water was used in their processing. When combined with other fluoride sources, their consumption could put children at higher risk for fluorosis.

Toothpaste. Although mentioned previously as a moderate fluoride source, you should still pay attention to how much your child uses. It doesn't take much: in fact, a full brush of toothpaste is too much, even for an adult. For an infant, you only need a smear on the end of the brush; as they grow older you can increase it but to no more than a pea-sized amount.

If you would like more information on fluoride and how it strengthens teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fluoride & Fluoridation in Dentistry.”

OfficeFluorideTreatmentsCanAddExtraProtectiontoYourChildsTeeth

Your family uses fluoride toothpaste and your drinking water is fluoridated too. So with the fluoride your child already takes in, is it really necessary for topical fluoride treatments during their regular dental visits?

The answer is most definitely. Fluoride has a unique ability to strengthen enamel, your teeth’s protective cover against decay and other diseases. It does this by infusing itself in the enamel structure and making it that much more resistant to acid attack and decay.

This infusion occurs in two ways. First, growing teeth obtain it through the bloodstream as they incorporate other minerals that make up the enamel structure. The very small amount of fluoride added to drinking water — as low as one part per million (ppm) — imparts sufficient fluoride to developing teeth. In the absence of fluoridated water, dietary fluoride supplements can achieve the same effect.

The second way is just after the teeth have erupted and are still quite young. In this case, fluoride coming in direct contact with the enamel surface is absorbed, resulting in changes to the enamel’s crystalline structure that will create added strength. This can occur to a limited degree through fluoride toothpaste or other dental products. The concentration of fluoride in these products, though, is relatively low (850-1500 ppm) as mandated by the U.S. Food and Drug Administration for safety.

Professional applications, on the other hand, are much higher — 12,300 to 22,600 ppm depending on their form. They’re applied, of course, under strict clinical guidelines to cleaned tooth surfaces, usually as a gel, foam or varnish. The latter form will often continue leaching fluoride into the enamel for a month or more.

These topical applications can greatly strengthen the teeth of children who don’t have the benefit of fluoridated water or may be at higher risk for dental disease because of socio-economic conditions. But they can still be helpful for children with adequate fluoride exposure and low risk factors for disease. At the very least, fluoride treatments can give your child an added boost of protection as their teeth continue to develop.

If you would like more information on topical fluoride treatments for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Topical Fluoride.”

By Gallery Dental
November 15, 2013
Category: Oral Health
Tags: fluoride  
BeAwareofYourFamilysFluorideIntaketoAvoidStaining

It’s indisputable that fluoride has revolutionized dental care. Decades of research have overwhelming shown this natural, enamel-strengthening chemical has decreased tooth decay.

Too much fluoride, though, can cause enamel fluorosis, a permanent staining of tooth enamel. In its mildest form, the teeth develop faint whitish streaks; in more severe cases, the staining is noticeably darker and the teeth appear pitted. The teeth themselves aren’t damaged, but the unsightly staining could require cosmetic treatment. Children under age 9 (when permanent teeth enamel matures) are especially at risk of fluorosis due to over-fluoridation.

Because of fluoride’s prevalence in hygiene products and many drinking water supplies, it’s not always easy to know if your child is receiving too much. There are two areas, though, that bear watching.

First, you should limit the serving quantity of fluoride hygiene products, particularly toothpaste. Children tend to swallow rather than spit out toothpaste after brushing, so they ingest more fluoride. We recommend a small “smear” of toothpaste on the brush for children under two, and a pea-sized amount for children two to four.

The other concern is your drinking water. Three-quarters of America’s water systems add fluoride, usually to a recommended level of 0.70 PPM (parts per million). To know if your water supply adds fluoride and at what levels, you can contact your local water utility or health department, or check the Center for Disease Control’s website for their “My Water’s Fluoride” program (http://apps.nccd.cdc.gov/MWF/Index.asp). This site will have information if your water system participates in the program.

If your area exceeds recommended levels or is at high risk for fluorosis, we recommend reducing the use of tap water in infant formula. Besides breast-feeding (human breast milk is low in fluoride), you can use either ready-to-feed formula, or mix powdered formula with water specifically labeled “de-ionized,” “purified,” “de-mineralized,” or “distilled.”

One thing you should not do is eliminate your use of products containing fluoride — this may increase your child’s risk of tooth decay. The consequences of decay can be serious and have a life-long effect — and far outweigh the risks of fluorosis staining.

If you would like more information on fluoride and your infant, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Development and Infant Formula.”

By Gallery Dental
August 21, 2011
Category: Oral Health
Tags: oral health   fluoride  

The CDC (Centers for Disease Control and Prevention) calls fluoridation of drinking water one of the ten most important public health measures of the 20th century, along with such measures as vaccination and motor-vehicle safety.

A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The connection between fluoride and oral health was confirmed in the first half of the 20th century, and by 1955 the first clinically proven fluoride toothpaste was launched. Fluoride-containing toothpastes are common today, along with other fluoride-containing products.

Protective Effects of Fluoride
Ongoing studies have shown that fluoride has both a systemic (through the body) effect and a local effect at the tooth surfaces. Tooth decay takes place as part of a kind of active war between de-mineralization and re-mineralization, in which acids produced by bacteria in plaque (a biofilm in your mouth) soften and dissolve the minerals (de-mineralization) in the tooth's surface. At the same time, the saliva bathing the tooth acts to re-harden the tooth's surface by adding minerals back (re-mineralization). If fluoride is present in the biofilm and in the saliva, it protects against de-mineralization.

The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface. The fluoride in toothpastes and products like rinses is delivered directly to the tooth surface. Fluorides can also be eaten in foods with high fluoride content such as teas, dry infant cereals and processed chicken, fish and seafood products.

Problems with Over-use
Eating or swallowing too much fluoride can contribute to a discoloration of teeth called dental fluorosis, which varies in appearance from small white striations to stained pitting and severe brown mottling of the enamel. To avoid this effect, monitor children's tooth brushing to make sure they use only a small amount of fluoride toothpaste and do not swallow it.

Adding fluoride to water has been controversial because some people believe that it may cause other harmful effects. However, most health experts believe that fluoridated water carries no significant health risks and significantly contributes to public health by preventing tooth decay.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can also learn more by reading the Dear Doctor magazine article “Fluoride & Fluoridation in Dentistry.”