used to be a fact of life. But over the past few
decades, tooth decay has been reduced dramatically.
The key reason: fluoride. Research has shown that
fluoride reduces cavities in both children and
adults. It also helps repair the early stages of
tooth decay even before the decay becomes visible.
Unfortunately, many people continue to be
misinformed about fluoride and fluoridation.
Fluoride is like any other nutrient; it is safe and
effective when used appropriately. This article will
help you learn more about the important oral health
benefits of fluoride.
Nature's Cavity Fighter
Fluoride Supplement Dosage Schedule - 1994
Fluoride: Nature's Cavity Fighter
Fluoride is a mineral that occurs
naturally in all water sources, even the oceans. The
fluoride ion comes from the element fluorine.
Fluorine, the 13th most abundant element in the
earth's crust, is never encountered in its free
state in nature. It exists only in combination with
other elements as a fluoride compound.
Fluoride is effective in
preventing and reversing the early signs of dental
caries (tooth decay). Researchers have shown that
there are several ways through which fluoride
achieves its decay-preventive effects. It makes the
tooth structure stronger, so teeth are more
resistant to acid attacks. Acid is formed when the
bacteria in plaque break down sugars and
carbohydrates from the diet. Repeated acid attacks
break down the tooth, which causes cavities.
Fluoride also acts to repair, or remineralize, areas
in which acid attacks have already begun. The
remineralization effect of fluoride is important
because it reverses the early decay process as well
as creating a tooth surface that is more resistant
Fluoride is obtained in two forms:
topical and systemic. Topical fluorides strengthen
teeth already present in the mouth making them more
decay-resistant. Topical fluorides include
toothpastes, mouth rinses and professionally applied
Systemic fluorides are those that
are ingested into the body and become incorporated
into forming tooth structures. Systemic fluorides
can also give topical protection because fluoride is
present in saliva, which continually bathes the
teeth. Systemic fluorides include water fluoridation
or dietary fluoride supplements in the form of
tablets, drops or lozenges.
As a result of the widespread
availability of these various sources of fluoride,
the decay rates in both the U.S. and other countries
have greatly diminished.
The proper mix is key
It is important to note that the
effective prevention of dental decay requires that
the proper mix of both forms of fluoride (topical
and systemic) be made available to individuals. Your
dentist can help you assess whether you are
receiving adequate levels of fluoride for all family
members from the two forms (topical and systemic).
One method of self-applied topical
fluoride that is responsible for a significant drop
in the level of cavities since 1960 is use of a
fluoride-containing toothpaste. The American Dental
Association recommends that everyone use a fluoride
toothpaste displaying the
ADA Seal of Acceptance. Other sources of
self-applied fluoride are mouth rinses designed to
be rinsed and spit out, either prescribed by your
dentist or an over-the-counter variety. The ADA
recommends the use of fluoride mouth rinses, but not
for children under six years of age because they may
swallow the rinse.
are in the form of a gel, foam or rinse, and are
applied by a dentist or dental hygienist during
dental visits. These fluorides are more concentrated
than the self-applied fluorides, and therefore are
not needed as frequently. The ADA recommends that
dental professionals use any of the professional
strength, tray-applied gels or foam products
carrying the ADA Seal of Acceptance. There are no
ADA-accepted fluoride professional rinses for use in
Systemic fluorides such as
community water fluoridation and dietary fluoride
supplements are effective in reducing tooth decay.
These fluorides provide topical as well as systemic
protection because fluoride is present in the
Community Water Fluoridation
Fluoride is present naturally in
all water sources. Community water fluoridation,
which has been around for over 50 years, is simply
the process of adjusting the fluoride content of
fluoride-deficient water to the recommended level
for optimal dental health. That recommended level is
0.7 - 1.2 parts fluoride per million parts water.
Water fluoridation has been proven to reduce decay
in both children and adults. While water
fluoridation is an extremely effective and
inexpensive means of obtaining the fluoride
necessary for optimal tooth decay prevention, not
everyone lives in a community with a centralized,
public or private water source that can be
fluoridated. For those individuals, fluoride is
available in other forms.
Dietary Fluoride Supplements
Dietary fluoride supplements
(tablets, drops or lozenges) are available only by
prescription and are intended for use by children
ages six months to 16 years living in nonfluoridated
areas. Your dentist or physician can prescribe the
correct dosage. It is based on the natural fluoride
concentration of the child's drinking water and the
age of the child.
For optimum benefits, use of dietary fluoride
supplements should begin when a child is six months
old and be continued daily until the child is 16
years old. The need for taking dietary fluoride
supplements over an extended period of time makes
dietary fluoride supplements less cost-effective
than water fluoridation; therefore, dietary fluoride
supplements are considerably less practical as a
wide-spread alternative to water fluoridation as a
public health measure. Fluoride supplements are
recommended only for children living in
It is important to note that
fluoridated water may be consumed from sources other
than the home water supply, such as the workplace,
school and/or day care, bottled water, filtered
water and from processed beverages and foods
prepared with fluoridated water. For this reason,
dietary fluoride supplements should be prescribed by
carefully following the recommended dosage schedule.
Dietary fluoride supplements are not recommended for
children residing in a fluoridated community.
No matter how you get the fluoride
you need—whether it be through your drinking
water, supplements, toothpaste, mouth rinse or
professionally applied fluoride—you can be
confident that fluoride is silently at work fighting
decay. Safe, convenient, effective...however you
describe it, fluoride fits naturally into any dental
care program. For more information about the oral
health benefits of fluoride, just ask your dentist.
Fluoride Supplement Dosage
Schedule - 1994
Approved by the American Dental
Association, American Academy of Pediatrics and
American Academy of Pediatric Dentistry
Fluoride Ion Level in Drinking Water (ppm)*
ppm = 1 mg/liter
** 2.2 mg sodium fluoride contains 1 mg
Important Considerations When
Using Dosage Schedule:
- If fluoride level is unknown,
drinking water should be tested for fluoride
content before supplements are prescribed. For
testing of fluoride content, contact the local
or state health department.
- All sources of fluoride
should be evaluated with a thorough fluoride
- Patient exposure to multiple
water sources can make proper prescribing
- Ingestion of higher than
recommended levels of fluoride by children has
been associated with an increase in mild dental
fluorosis in developing, unerupted teeth.
- Fluoride supplements require
long-term compliance on a daily basis.