Family Dentist Files: Managing Fluoride Fears

Parents are fearing fluoridated toothpaste at an increasing rate. I am commonly asked about fluoride safety. I also encounter many parents who note that they don't agree with their child using fluoridated toothpaste. Fluoride consumption is one of the most contentious topics in all of Pediatric Dentistry. In this blog post I would like to provide facts about fluoride and fluoride safety. I would also like to propose strategies for use of fluoride while minimizing related fears. Before I begin, I would like to say that I respect everybody's opinion and the article is not meant to pressure or convince anybody with respect to fluoride use.

There are some very useful supplementary articles on fluoride provided by the Canadian Dental Association (CDA). You can access the here.

Why is my Kitchener Family Dentist recommending fluoridated toothpaste?

So, what does fluoride do for teeth anyway? It plays a few key roles in the mouth:

• A Stronger Shield. Think of your tooth enamel as a shield. It is the hardest most decay-resistant part of your tooth. Fluoride soaks into enamel and makes it even more resistant to acids that cause tooth decay and cavities.
• A Bacteria "Blaster". Harmful bacteria consume left over food and dental plaque and then produce acids which harm your teeth. Fluoride inhibits bacterial metabolism and activity. Thus, bacteria harm your teeth less in the presence of even small amounts of fluoride.
• A Re-mineralization Maximizer. There is evidence showing that fluoride helps calcium and phosphate in your saliva soak into your enamel more readily. This result in re-mineralization and strengthening of your tooth enamel.

Is Fluoride safe for my little one?

There is currently no research to prove that fluoridated toothpaste and community-fluoridated water has adverse health effects. The only documented effect is "fluorosis" which occurs when too much fluoride is ingested during early childhood. Fluorosis causes white spots on teeth. This is merely an esthetic change to the teeth. Importantly, fluorosis does not affect tooth quality or function.

Fluoride has a very high therapeutic index. This means that it takes only very small amounts to have massive benefits to teeth while much larger concentrations may cause fluorosis. Simply put, there is tons of "buffer" or "safety" room with administering fluoride.

A Family Dentist's top tips for controlling Fluoride exposure

I have seen Dentists lecture parents about fluoride. If somebody has a belief against (or fear of) doing something, a rigid explanation almost never works. One thing that I find very helpful is to work with parents on a compromise. Sometimes they still go against my recommendation - I respect it and we keep on being pals. Below are some common parent concerns and my suggestions for minimizing fears about your child's fluoride intake:

I have seen Dentists lecture parents about fluoride. If somebody has a belief against (or fear of) doing something, a rigid explanation almost never works. One thing that I find very helpful is to work with my patients and work with parents on a compromise. Sometimes they still go against my recommendation - I respect it and we keep on being pals. Here are some suggestions for minimizing fears about your child's fluoride intake:

• "My Child Doesn't Spit the Toothpaste Out". The Canadian Dental Association recommends children aged 3-6 brush with a "green pea" sized amount of fluoridated toothpaste. If you have discontinued use of the fluoridated toothpaste, consider re-introducing it. Use 1/4 the recommended amount. A green pea-sized amount is the gold standard. However, a smaller amount is still more helpful than not using fluoride at all. Once your child develops the habit of spitting out the froth, go up to the recommended amount.
• "My Child Won't Tolerate the Taste". There are strong-tasting fluoridated and non-fluoridated toothpastes. There are fruit-flavoured fluoridated and non-fluoridated toothpastes. Just because a toothpaste is fluoridated, doesn't mean it has to taste minty, strong, or bad. You have alternatives! Specifically, you can switch to a fruit-flavoured fluoridated toothpaste and then monitor their brushing. Sometimes, if the toothpaste tastes good, they use too much. I always recommend parents brush with their kids to build the habit and monitor their fluoride intake and brushing technique.
• "My Child is Using Too Much Toothpaste". If your little gem is really overdoing it with the toothpaste, the best thing you can do is be in the bathroom with them. Dispense the toothpaste for them so you know how much they're brushing with. If it gives you piece of mind, keep the toothpaste out of reach where only you can get to it.

• "Are There Other Fluoridated Products I Can Use?". Fluoride rinses and varnishes are available. Some are over-the-counter and some are by prescription. Some of these products can be used less frequently compared to everyday toothpaste use. Now, again, I still recommend the daily use of a fluoridated toothpaste. However, if you have your child brushing with a non-fluoridated toothpaste, any additional exposure will only help. Ask your Family Dentist about other fluoridated products requiring less frequent administration.

The "New Kid on The Block": Hydroxyapatite Toothpaste

Hydroxyapatite (high-drox-ee-ap-ah-tight) toothpaste helps to remineralize or strengthen your teeth. In fact, Hydroxyapatite is the main building block for both enamel and dentin (the 2 hard layers over your nerve)! Proponents of these toothpastes point out that they strengthen your teeth while not exerting a negative effect on the bacteria in your mouth (much of which is good bacteria).

Hydroxyapatite toothpastes have not been shown to have any negative health effects and may provide a suitable alternative for families would prefer to avoid Fluoride.

If you have concerns about whether fluoride is safe for your child, or about how much exposure is safe, have a chat with your Kitchener Family Dentist.

If you would like to have a consult with Dr. Kyle Hornby regarding your child's oral health, please feel free to request a consult here.

By Dr. Kyle Hornby, Kitchener Family Dentist

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your Kitchener Dentist or other qualified healthcare provider with any questions you may have regarding a dental condition or treatment.