Fluoride-containing toothpaste is the only proven way to prevent tooth decay. But dental experts warn that some consumers are substituting fluoride toothpaste for fluoride-free toothpaste.
Those consumers may be turning to alternatives available online or in the stores they sell "natural" products.
But Professor of Restorative Dentistry at the University of California, Los Angeles School of Dentistry, Edmond Hewlett, says he is concerned that individuals choosing fluoride-free toothpastes are missing out on the proven benefits of fluoride for caries prevention.
What is fluoride?
It's fluoride a natural mineral that can be found in most water sources such as lakes, rivers and oceans. People add this natural mineral to water, food and other products.
Fluoride also plays a role in mineralizing your bones and teeth, a process necessary to keep them firm and strong. In fact, about 99% of body fluoride is stored in bones and teeth.
What is fluoride used for?
Many toothpastes contain fluoride because it has benefits for protecting dental health.
Fluoride is common used in dentistry to strengthen enamel, which is the outer layer of your teeth and helps prevent caries. Too much fluoride can pose a health risk, but the amounts contained in toothpaste are generally safe if a person uses toothpaste as advised.
Research has shown that fluoride in public water systems has prevented tooth decay in children and adults by at least 25%.
Fluoride can be found in the local water supply and in many over-the-counter (OTC) products, including:
- dietary supplements
If you tend to get a lot of tooth decay, your dentist may suggest using a fluoride mouthwash with a prescription. These rinse aids typically have higher fluoride concentrations than OTC options.
Fluoride is also used:
- in medical imaging scans, such as PET scans
- as a cleaning agent
- in pesticides
- for the manufacture of Teflon, steel and aluminum products
Fluoride can be ingested or applied topically to the teeth. The main sources of fluoride include:
Fluorinated water or salt
Countries like the United States, the United Kingdom and Australia add fluoride to their public water supplies. In the United States, fluoridated water should ideally contain approximately 0.7 mg per liter. Some countries may also fluoride salt or milk (source: 1, 2, 3).
Groundwater naturally contains fluoride, but the concentration varies. For example, some areas of India have dangerously high levels of fluoride in their water supply. This can lead to serious health problems.
Fluoride food supplements
They are available in the form of drops or tablets. Fluoride supplements are recommended for children older than 6 months who are at high risk of developing tooth decay and live in areas with non-fluoridated water.
Certain foods can be processed using fluoridated water or they can absorb fluoride from the soil. Tea leaves, especially old ones, may contain fluoride in larger quantities than other foods.
Dental care products. Fluoride is added to a number of dental care products on the market, such as toothpaste and mouthwashes.
What are the benefits of fluoride?
Fluoride can greatly help dental health strengthening tooth enamel, making it more resistant to caries. It also reduces the amount of acid produced by bacteria on your teeth.
Children who have fluoride when their teeth develop usually have shallower furrows in their teeth, so plaque can be removed more easily. Plaque is a thin, sticky film of bacteria that constantly builds up on your teeth.
In addition, fluoride promotes remineralization. This process brings calcium and phosphate ions into the tooth to create a new acid-resistant surface.
Fluoride is good for teeth because it helps:
- restore (remineralize) weakened tooth enamel
- slow down the loss of minerals from tooth enamel
- reverse the early signs of caries
- prevent the growth of harmful oral bacteria
When bacteria in the mouth break down sugar and carbohydrates, they produce acids that eat away at the minerals in tooth enamel. This loss of minerals is called demineralization. Weakened tooth enamel makes your teeth susceptible to caries-causing bacteria.
Fluoride helps remineralize tooth enamel, which can prevent tooth decay and reverse early signs of tooth decay.
According to a reliable source from the Centers for Disease Control and Prevention (CDC), the average number of teeth missing or decaying in 12-year-olds in the United States fell by 68% from the late 1960s to the early 1990s. This followed the introduction and spread of fluoridated water in communities, and the addition of fluoride to toothpastes and other dental products.
Are there any potential side effects from fluoride?
Although fluoride is a natural compound, it still is can cause side effects when consumed in large doses. In the United States, the amount of fluoride added to water is typically about 0.7 parts per million (ppm), which is the maximum allowed since 2015.
Dental fluorosis occurs when you consume too much fluoride while your teeth are still forming under your gums. This results in white spots on the surface of your teeth. Apart from the appearance of white spots, dental fluorosis does not cause any symptoms or damage.
It tends to affect only children under the age of 8 whose permanent teeth are still growing. Children also more often swallow toothpaste, which contains significantly more fluoride than fluoridated water.
You can reduce the risk of developing dental fluorosis in a child by taking it monitor while brushing your teeth to make sure it does not swallow large amounts toothpaste.
Skeletal fluorosis is similar to dental fluorosis, but it affects the bones instead of the teeth. Early symptoms include joint pain and stiffness. Over time, it can change bone structure and cause ligament calcification.
It occurs as a result of long-term exposure high levels of fluoride, often in drinking water. Several things can cause excessive amounts of fluoride in water, including accidental contamination from fire or explosion.
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What about fluoride toothpaste?
Most toothpastes now contain fluoride, and most people get fluoride this way. Fluoride toothpaste is very effective in preventing caries. The amount of fluoride in toothpaste is usually enough to reduce caries.
In areas where fluoride has been added to the water supply, fluoride toothpaste provides extra protection.
Thorough brushing your teeth with fluoride toothpaste is one of the most effective ways to prevent tooth decay. To keep fluoride on your teeth longer, spit it out after brushing your teeth and do not rinse.
A range of toothpastes are available that contain different levels of fluoride. The amount of fluoride in toothpaste can be found on the side of the tube and is measured in parts per million (ppm).
Toothpastes containing 1,350 to 1,500 ppm of fluoride are the most effective. Your dentist may advise you to use a higher-strength toothpaste if you or your child are particularly at risk for tooth decay.
Children under 3 years they should brush their teeth twice a day, with a smear of paste containing at least 1000 ppm of fluoride.
Children between 3 and 6 years they should brush their teeth at least twice a day with a pea-sized amount of toothpaste that contains more than 1000 ppm of fluoride.
Adults you should brush your teeth at least twice a day with a toothpaste that contains 1,350-1,500 ppm of fluoride.
Parents should supervise their children’s brushing and use only a pea-sized fluoride paste smear until they are about 7 years old.
Do not use mouthwash at the same time as brushing. Use it at alternate times as it flushes fluoride into toothpaste.
Is fluoride safe?
While fluoride in toothpastes in general considered safe, there is a larger, constant debate about the total intake of fluoride from water, food, mouthwash and other sources.
International Association for Oral Medicine and Toxicology (IAOMT), which advocates the use of added fluoride in water and products, states the following health problems associated with fluoride consumption:
- cardiovascular problems, including high blood pressure, heart failure and myocardial damage
- low fertility rates and early puberty in girls
- osteoarthritis, temporomandibular joint disorder and bone cancer
- immune system complications
- niži IQ
- cognitive deficits, attention deficit hyperactivity disorder (ADHD) and neurological deficits
- thyroid dysfunction
Despite strong evidence to support the benefits of fluoride for oral health, some consumers choose options that are advertised as effective despite not containing fluoride.
A search on the popular Amazon shopping website revealed a variety of fluoride-free toothpastes with advertising descriptions such as “don’t choose between natural and effective”. Consumer reviews listed under some of the products reveal that some customers are afraid of fluoride.
“Most bacteria-eliminating toothpastes contain harmful ingredients such as fluoride and triclosan, as well as calcium chloride. "Every year we ingest a lot of toxins just by brushing our teeth," wrote one customer.
But Edmond Hewlett, a DDS professor, says not only that fluoride in toothpaste is safe, but it is also a natural ingredient.
Experts say that some consumers have a misconception about the safety of fluoride, and this may be a factor in choosing a product without fluoride.
While fluoride-free toothpastes are advertised as a safe and effective way to maintain healthy teeth, Hewlett says no other ingredient is close to the benefits of fluoride, adding that there is no other toothpaste ingredient with such results. For this reason, dentists have been recommending fluoride toothpaste to their patients for decades.
How to choose the best toothpaste?
The first question you need set if you want a toothpaste that contains fluoride. If so, most major brands have a variety of fluoride products available. If not, look for a natural toothpaste, which is more likely to be fluoride-free.
When it comes to choosing the right toothpaste, dentists have a simple recommendation.
“I am telling all my patients to look for a toothpaste that has earned the ADA a stamp of acceptance. If a product has an ADA seal, it means it has been tested and proven to be safe and effective, ”Matthew Messina, DDS, a Ohio dentist and spokesman for the American Dental Association (ADA), told Healthline.
In the United States, toothpastes that have been shown to be safe and effective in preventing caries and maintaining optimal oral health have the ADA seal of acceptance.
With any fluoride toothpaste, look for the seal of approval of the American Dental Association. Indicates that toothpaste:
- contains fluoride
- has active ingredients to improve dental health such as reducing tooth sensitivity, preventing enamel erosion or reducing gingivitis
- there is no sugar in the aromas
- provide scientific evidence demonstrating safety and efficacy
According to the ADA, only fluoride-containing toothpastes will have such a label, and only after providing scientific evidence showing the safety and effectiveness of the product.
In addition, choose toothpaste based on personal preferences or specific dental needs. Teeth whitening, resolving tooth sensitivity, controlling tartar and choosing different flavors are all options.
In addition to containing fluoride, ADA-accepted toothpastes should also not contain odors that would cause tooth decay such as sugar, and may contain active ingredients that help whiten teeth, reduce tooth sensitivity, prevent enamel erosion and reduce gingivitis and gum plaque. dental plaque.
Messina said that even if you brush your teeth well twice a day, using a fluoride-free toothpaste is not a good idea, even if it is sold as natural or safe. “Just because something is ‘natural’ doesn’t mean it can help prevent tooth decay. Brushing your teeth with fluoride-free toothpaste will not help prevent tooth decay, ”he said.
Fluoride dental treatments
Fluoride mouthwashes can be prescribed to adults and children aged 8 and over who have tooth decay. They should be used every day, brushing your teeth twice a day with a paste containing at least 1350 ppm of fluoride.
Rinsing agents should be used at different times than brushing your teeth to avoid rinsing toothpaste from your teeth, as this reduces the beneficial effects of fluoride in the paste.
Fluoride varnish can be applied by a dentist on both deciduous and adult teeth. The process involves applying a varnish containing high levels of fluoride to the tooth surface every 6 months to prevent decay. It works by strengthening tooth enamel, making it more resistant to caries.
From the age of 3, children should be offered fluoride varnish treatment at least twice a year. Children of all ages with caries or those at high risk of developing caries should be offered fluoride varnish 2 or more times a year.