We see it listed as an ingredient on toothpaste packaging and hear about its presence in our tap water. But what is fluoride, and what do dentists say about its importance for oral health?
Found in the earth's crust and naturally occurring in soil and rocks, fluoride is a mineral that is present at varying levels in water sources from inland groundwater to oceans.
Fluoride has also been found to help prevent tooth decay. The enamel that covers and protects our teeth is under constant attack by bacteria that feed on the carbohydrates and sugars our foods leave behind. These attacks strip important minerals from our teeth, but fluoride strengthens the enamel and protects it from demineralization. In addition, fluoride replenishes any minerals that have been lost, resulting in a more resistant tooth surface.
"These processes occur throughout our lives, so frequent exposure to fluoride is important at all ages," says Aaron Myers, DDS, MPH, a pediatric dentist at Columbia University College of Dental Medicine. He draws on his years of experience treating patients to share the role fluoride plays in our dental health.
What problems could result from getting too little fluoride?
Not getting enough fluoride increases the risk of cavities or tooth decay. Untreated tooth decay can lead to pain, swelling, infection, and, in rare instances, death. Dental pain and swelling from untreated tooth decay and cavities can also lead to emergency room visits, chronic pain, missed days of work and school, and overall lower quality of life-all of which are avoidable.
Is it important to have fluoride in our drinking water?
Water fluoridation is widely considered one of the great public health successes of the 20th century. It provides frequent, low-dose fluoride exposures and has been shown to reduce tooth decay. By optimizing the fluoride level in the water supply, everyone in the community benefits. The largest benefit is for those who don't have regular access to oral health care providers.
What are other ways to get fluoride?
Everyone should be brushing twice a day with a fluoridated toothpaste. Some mouthwashes also contain fluoride. At the dentist's office, fluoride foams, gels, and varnish can be professionally applied to your teeth. For those at higher risk for cavities a prescription for toothpaste, rinse, or gel with a higher level of fluoride may be provided by your dentist. In addition, food that is prepared with fluoridated water also contains fluoride.
In the U.S., dietary fluoride supplements may sometimes be prescribed for children at high risk for tooth decay who live in areas where their main water source doesn't contain enough fluoride.
Is fluoride in drinking water safe?
Yes, there is overwhelming scientific evidence supporting the safety of fluoridation in community water supplies. As is the case with other nutrients, fluoride is effective and safe at recommended levels.
What are the most important things you feel people should understand about fluoride and dental health?
Because fluoride occurs naturally in water, when we say water "fluoridation," we're actually talking about optimizing the amount of fluoride already in the water supply. In some instances, this means reducing the amount of fluoride that would naturally be present.
The bottom line is this: frequent low-dose exposures of fluoride have been shown to be both safe and effective at preventing tooth decay.
References
Aaron Myers, DDS, is an assistant professor of dental medicine in the Division of Pediatric Dentistry and the senior associate dean for clinical affairs at Columbia.
