Is my child receiving enough Fluoride?
Fluoride has been shown to dramatically decrease a person’s chances of getting cavities by making teeth stronger. Fluoride in the drinking water is the best and easiest way to get it, but many water districts do not automatically fluoridate the water supply. To inquire about the status of the drinking water in your area, contact your local municipal water supply district. Your pediatric dentist or pediatrician can prescribe fluoride supplements if necessary.

Should fluoride be given to children before the teeth erupt (come into the mouth) because it incorporates into developing teeth making them stronger and prevents cavities later on when the teeth do erupt?
More recent information suggests that swallowing fluoride (systemic administration) does not help prevent tooth decay in teeth that have not yet erupted into the mouth. It is agreed that the vast majority of the effect of fluoride occurs due to the topical effect (fluoride directly touching the tooth in the mouth).

Should pregnant mothers take fluoride because it will cause the baby teeth that are forming in the un-born child to be more resistant to cavity formation?
It has been shown through careful study that there is no benefit to prenatal fluoride supplements in preventing dental decay in the offspring. It is probable that not much, if any, of the fluoride the mother ingests reaches the fetus.

Is a fluoridated water supply the best method for administering fluoride to the teeth and thus preventing tooth decay?
It is an un-disputed fact, in the scientific community, that a fluoridated water supply helps both the primary (baby) and permanent teeth with a reduction of cavities of approximately 50%.

Is it true that using too much fluoride will stain the teeth after they have formed and erupted (come into the mouth)?
Staining of the teeth from too much fluoride, called fluorosis, only occurs while the teeth are forming and before they erupt into the oral cavity (come into the mouth). Taking too much supplemental fluoride will not cause permanent staining of the teeth already in the mouth but ingestion of excessive fluoride while the tooth is forming and not yet in the mouth can result in fluorosis.

Is it true that children should not take fluoride during the first 3 years of life because of the risk of developing staining (fluorosis) of the front teeth?
Not true, but only in my opinion – there is much debate. It has been shown that permanent teeth are the most susceptible to developing cavities immediately after they erupt into the oral cavity (come into the mouth) and so it is not un-reasonable to assume the same holds true for the baby teeth as well. On average the baby teeth erupt into the oral cavity between the ages of 6 months and 2  years  but this can vary significantly with some children getting their first tooth at 1 year and their last baby tooth at age 3.

Forgoing fluoride supplement in a non-water fluoridated community between the ages of 6 months (or when the first tooth erupts into the oral cavity) and 3 years means that the baby teeth are not benefiting at all from anti-cavity effect of fluoride when they are most susceptible to getting a cavity.
But – the development of the front permanent teeth also is occurring during this critical period of time, generally from between 15 and 30 months or between 1.5 years and 2.5 years of age.

There is concern that taking fluoride by mouth may result in levels of fluoride in the developing teeth to cause fluorosis (staining of the teeth). For example, taking of 1 mg of fluoride all at one time will raise the level of fluoride in body fluids (area where teeth are forming) to a much greater extent then taking the same dose of fluoride dissolved in water over a period of the day, thus one can avoid the potential for over-fluoridation and the risk of developing fluorosis but still also give the teeth erupting the needed fluoride to help reduce the susceptibility to cavities. One mg of Fluoride dissolved in 1 liter of water is the same concentration of fluoride that fluoridated waters supply levels are adjusted to.

Can I fluoridate my personal water supply without difficulty and expense?
It is easy and inexpensive to do and takes just a few moments of your day. The most difficult part is simply remembering to do it. Here is how: Take a 1 liter or ¼ gallon size container and fill it with non-fluoridated water. Mix 1 mg of fluoride obtained by a prescription from your physician or dentist and mix it with the water. Use the now fluoridated water for drinking and mixing with formula, concentrated juice and cooking if you wish. You now have all the benefits of a community fluoridated water supply at your home. Of course, water and drinks consumed out side of your home will probably not be fluoridated, i.e. school, sporting events, etc.

Is fluoride, since it is found in nature, basically harmless except for causing staining of the teeth?
Answer. Fluoride, administered in large doses can be fatal and should be kept with all other medication – out of the reach of children. This includes fluoridated toothpaste, gels and mouth rinse.  The generally excepted toxic amount of fluoride that needs to be consumed at one time is 5mg/kg of body weight. This means that a child who weighs 25lbs would need to consume the equivalent of 56, one mg tablets of fluoride, not a difficult task to accomplish for most 2 year olds. At least one death has been reported in a 27 months old child that is estimated to have consumed less then 5mg/kg of fluoride. The take home message is that parents and care givers should error on the side of caution – just as one should with prescription and over the counter medications.

Is it true fluoride will only benefit children?
People of any age will benefit from fluoride use. The benefit of fluoride use is cumulative. This means that the longer a tooth is exposed to fluoride in the mouth, the greater the protection it will receive. One study has shown that the effects of fluoride administered from birth was more than twice as effective when started past age 4.

All I need to do is have my young child use a toothpaste containing fluoride and no other fluoride product is necessary?
Answer. It would depend on how much toothpaste the child used and more importantly how much they consumed. A study found that preschoolers swallowed between 55% – 79% of the toothpaste used. For example, 8.2 once tube of Aim®, Aquafresh® and Close Up® toothpaste contain 232 mg of fluoride or 28mg per once. Simple math confirms that a child would need to consume only 1/232 (HARDLY ANY) of the tube in order to reach 1 mg of fluoride. If even 1/232 of the tube was consumed it would be the same as giving them a 1 mg tablet of fluoride and this leads to the concern about the possibility of flourosis in the permanent front teeth. TAKE HOME MESSAGE, IT WOULD BE MUCH BETTER TO JUST FLUORIDATE YOUR OWN WATER IF YOU NEED TO AND NOT USE FLUORIDATED TOOTH PASTE. IF YOU ARE GOING TO USE FLUORIDATED TOOTH PASTE, DON’T USE MUCH! JUST A SMEAR ON THE BRUSH IS ALL YOU NEED. Over use of toothpaste and other over the counter products containing fluoride, especially when the drinking water is optimally fluoridated, is probably the leading risk factor for staining of the permanent front teeth. Great tasting children’s toothpastes are associated with use of much greater amounts of toothpaste than what is needed.

Is taking fluoride tablets a good way to replace the amount of fluoride that my child would have received if they lived in a fluoridated community?
It is not the best method. The best method is fluoridating your own water supply. Fluoride tablets may be the next best way (especially in children over age of 3 years) if the tablets are chewed and then swished around the mouth for awhile (to get topical effect on the teeth) then swallowed. If the tablet is not chewed and then swished and swallowed, but just swallowed, it will increase the amount of fluoride that the tooth is in contact with in the mouth because the tablet is digested and a little fluoride finds its way to the saliva and gives the teeth some mild dose of fluoride topically and this will last for only a relatively short time but may be enough to make a difference. However, drinking an optimally fluoridated water supply will provide 20 times the amount of fluoride to the tooth every time the water or things mixed with water is consumed.