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What is fluoride and what is it used for?

What is fluoride?

Fluoride is a compound of the element fluorine that occurs throughout nature in soil and water. Initially discovered by an American dentist researching brown discolouration in teeth, fluoride has been proven to dramatically decrease the incidence of dental decay. Since its discovery in the 1930s, fluoride has been used worldwide in toothpastes and in drinking water to prevent dental decay.

How fluoride works

Tooth decay occurs when the tooth surface experiences repetitive acid attacks. The sugars and other fermentable carbohydrates that we consume (for example, in soft drinks) provide a climate for the oral bacteria that can lead to dental plaque, and this plaque contains harmful acids. Acids are also contained in reflux. Acid attacks will slowly weaken the tooth surface and may eventually cause a hole or cavity.

However, when calcium and phosphate are present, the saliva neutralises the acid attack, and the tooth surface will microscopically repair itself. (Dairy products are high in calcium; and foods such as cereals, rice and pasta are high in phosphate.)

The tooth surface can be made even stronger and even less susceptible to acid attack with the addition of fluoride. When it comes into contact with the tooth surface or is mixed with saliva, this mineral will be taken up by the tooth enamel and further reduce the risk of damage to our teeth from bacteria and acids.

Fluoride has an especially important role to play in children up to the age of 18. When children drink fluoridated water, the fluoride they consume will strengthen their teeth while they are still growing. This means the tooth it is already protected from dental decay before it erupts.

Fluoride in toothpaste

Most toothpastes currently on the market contain fluoride. The amount of fluoride required varies between patient but most often is around 1000 to 1450 ppm. For patients with a high risk of decay (that is, they have had recent fillings, always feel like they need new treatment even though they have regular 6 monthly check-ups, or have been told by their dentist they have areas to be “watched”), I would always recommend a higher strength fluoride toothpaste. Neutrafluor 5000 is the strongest on the market and available only from pharmacies.

Patients considering avoiding fluoride

At the risk of stating the obvious, fluoride is and has always been a hot topic, and without getting deep into politics and, as always, respecting the individual, our job as dental practitioners is to educate the public. What people do with this information is their choice.

There is a wide range of non-fluoride toothpastes on the market; please do your research before using them (and remember trendy lifestyle bloggers aren’t always right).

Here are a few simple hints to consider:

  • Never deliberately expose your teeth to acids.
  • If you choose to avoid fluoride make sure your dental hygiene (and hence plaque control) is impeccable – brushing and flossing!
  • Over-brushing is common and can cause problems with both teeth and gums – steer clear of very abrasive products.
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