What are Sealants?

Sealants are thin plastic coatings that seal crevices in permanent teeth and act as a physical barrier to prevent oral bacteria from collecting and creating the acid environment that allows tooth decay to develop. There is no pain involved in applying dental sealants. The cost of preventing tooth decay by placing dental sealants is much less than treating oral disease once it has developed.

What are Fluorides?

Tooth decay rates in U.S. children have decreased dramatically. Much is due to the widespread use of fluoride in both systemic and topical forms, which provide the most effective decay prevention measures. Fluoridated water, fluoride drops and tablets are systemic fluorides, which means they are taken internally. Water fluoridation is the most effective and inexpensive way to reduce dental decay in a community.

Topical fluorides are placed directly on the teeth in the form of toothpastes and mouth rinses, and are professionally applied by dental hygienists. Topical fluoride reverses early decay by helping tooth enamel rebuild itself. Topical fluorides are still very important because there are still communities whose water is not fluoridated.

While research to develop a vaccine against dental caries (tooth decay) continues, it is important to guard against tooth decay — an infectious transmissible disease — with the combined use of dental sealants and fluoride. These services protect children against tooth decay just as vaccines immunize against certain medical diseases.

The American Dental Hygiene Association urges that any childrens health initiative improve access to preventive oral health care services by including dental sealants and fluoride in any definition of childhood immunizations.

What is fluoride?

Fluoride is a substance that strengthens tooth enamel. This helps to prevent dental cavities.

Fluoride is used as a medication to prevent tooth decay in people that have a low level of fluoride in their drinking water.

Fluoride is also used to prevent tooth decay in people who undergo radiation of the head and/or neck, which may cause dryness of the mouth and an increased incidence of tooth decay.

Fluoride may also be used for other purposes not listed in this medication guide.

Dental Health and Fluoride Treatment

Fluoride is a mineral that occurs naturally in many foods and water. Every day, minerals are added to and lost from a tooth’s enamel layer through two processes, demineralization and remineralization. Minerals are lost (demineralization) from a tooth’s enamel layer when acids — formed from plaque bacteria and sugars in the mouth — attack the enamel. Minerals such as fluoride, calcium, and phosphate are redeposited (remineralization) to the enamel layer from the foods and waters consumed. Too much demineralization without enough remineralization to repair the enamel layer leads to tooth decay.

Fluoride helps prevent tooth decay by making the tooth more resistant to acid attacks from plaque bacteria and sugars in the mouth. It also reverses early decay. In children under six years of age, fluoride becomes incorporated into the development of permanent teeth, making it difficult for acids to demineralize the teeth. Fluoride also helps speed remineralization as well as disrupts acid production in already erupted teeth of both children and adults.

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In what forms Is Fluoride available?

As mentioned, fluoride is found in foods and in water. It can also be directly applied to the teeth through fluoridated toothpastes and mouth rinses. Mouth rinses containing fluoride in lower strengths are available over-the-counter; stronger concentrations require a doctor’s prescription.

A dentist in his or her office can also apply fluoride to the teeth as a gel, foam, or varnish. These treatments contain a much higher level of fluoride than the amount found in toothpastes and mouth rinses. Varnishes are painted on the teeth; foams are put into a mouth guard, which is applied to the teeth for 1 to 4 minutes; gels can be painted on or applied via a mouth guard.

Fluoride supplements are also available as liquids and tablets and must be prescribed by your dentist, pediatrician, or family doctor.

When is Flouride use most critical?

It is certainly important for infants and children between the ages of 6 months and 16 years to be exposed to fluoride. This is the timeframe during which the primary and permanent teeth come in. However, adults benefit from fluoride too. New research indicates that topical fluoride — from toothpastes, mouth rinses, and fluoride treatments — are as important in fighting tooth decay as in strengthening developing teeth.

In addition, people with certain conditions may be at increased risk of tooth decay and would therefore benefit from additional fluoride treatment. They include people with:

Dry mouth conditions : Dry mouth caused by diseases such as Sjgren’s syndrome, certain medications (such as allergy medications, antihistamines, anti-anxiety drugs, and high blood pressure drugs), and head and neck radiation treatment makes an individual more prone to tooth decay. The lack of saliva makes it harder for food particles to be washed away and acids to be neutralized.

Gum disease : Also called gingivitis, gum disease can expose more of your tooth and tooth roots to bacteria increasing the chance of tooth decay.

History of frequent cavities : If you have one cavity every year or every other year, you might benefit from additional fluoride.

Presence of crowns and/or bridges or braces : These treatments can put teeth at risk for decay at the point where the crown meets the underlying tooth structure or around the brackets of orthodontic appliances.

Ask your dentist if you could benefit from additional fluoride.

Are there risks associated with fluoride use?

Fluoride is safe and effective when used as directed but can be hazardous at high doses (the “toxic” dosage level varies based on an individual’s weight). For this reason, it’s important for parents to carefully supervise their children’s use of fluoride-containing products and to keep fluoride products out of reach of children, especially children under the age of 6.

In addition, excess fluoride can cause defects in the tooth’s enamel that range from barely noticeable white specks or streaks to cosmetically objectionable brown discoloration. These defects are known as fluorosis and occur when the teeth are forming — usually in children under 6 years. Fluorosis, when it occurs, is usually associated with naturally occurring fluoride, such as that found in well water. If you use well water and are uncertain about the mineral (especially fluoride) content, a water sample should be tested. Although tooth staining from fluorosis cannot be removed with normal hygiene, your dentist may be able to lighten or remove these stains with professional-strength abrasives or bleaches.

Keep in mind, however, that it’s very difficult to reach hazardous levels given the low levels of fluoride in home-based fluoride-containing products. Nonetheless, if you do have concerns or questions about the amount of fluoride you or your child may be receiving, talk to your child’s dentist, pediatrician, or family doctor.

A few useful reminders about fluoride include:

Store fluoride supplements away from young children.

Avoid flavored toothpastes because these tend to encourage toothpaste to be swallowed.

Use only a pea-sized amount of fluoridated toothpaste on a child’s toothbrush.

Be cautious about using fluoridated toothpaste in children under age 6. Children under 6 years of age are more likely to swallow toothpaste instead of spitting it out.

Frequently Asked Questions

Does bottled water contain fluoride?

Even though there’s no scientific studies to suggest that people who drink bottled water are at increased risk of tooth decay, the American Dental Association (ADA) says that such people could be missing out on the decay-preventing effects of optimally fluoridated water available from their community water source. The ADA adds that most bottled waters do not contain optimal levels of fluoride, which is 0.7 to 1.2 parts per million (this is the amount that is in public water supplies, in the communities that have fluoridated water). To find out if your brand of bottled water contains any fluoride, check the label on the bottle or contact the bottle water manufacturer.

Does a home water treatment system affect the level of fluoride in my drinking water?

The amount of fluoride you receive in your drinking water depends on the type of home water treatment system used. Steam distillation systems remove 100% of fluoride content. Reverse osmosis systems remove between 65% and 95% of the fluoride. On the other hand, water softeners and charcoal/carbon filters generally do not remove fluoride. One exception: some activated carbon filters contain activated alumina that may remove over 80% of the fluoride.

If you use a home water treatment system, have your water tested at least annually to establish the fluoride level your family is receiving in the treated water. Testing is available through local and state public health departments as well as private laboratories. Also, check with the manufacturer of the product you purchased or read the information that came with the water treatment system to determine the product’s effects on fluoride in your home water.

How much fluoride is in my tap water?

To find out how much fluoride is in your tap water, ask your local dentist, contact your local or state health department, or contact your local water supplier. Information for contacting your local water supplier should be on your water bill or see the “local government” section of your phone book.

Approximately 62% of the U.S. population served by public water supplies has access to adequate levels of fluoride in their water, and 43 of the 50 largest U.S. cities have water fluoridation systems.

What should I know about fluoride use?

You should not use fluoride if the level of fluoride in your drinking water is greater than 0.7 parts per million (ppm).

Before using fluoride, tell your dentist and doctor if you are on a low salt or a salt free diet. You may not be able to use fluoride, or you may need special tests while you are using it.

Before using fluoride, tell your dentist and doctor if you are on a low salt or a salt free diet. You may not be able to use fluoride, or you may need special tests while you are using it.

Avoid using antacids without your doctor’s advice. Use only the specific type of antacid your doctor recommends. Many antacids contain calcium, which can interfere with fluoride absorption.

How should I take fluoride?

Use this medication exactly as directed on the label, or as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended.

Take this medicine with a full glass of water.

Do not take fluoride with milk or other dairy products. Calcium can make it harder for your body to absorb fluoride.

The chewable forms of fluoride can be chewed, swallowed, dissolved in the mouth, added to drinking water or fruit juice, or added to water for use in infant formula or other food.

The fluoride drops can be taken by mouth undiluted, or mixed with fluid or food.

If you mix fluoride with food or water, drink or eat this mixture right away. Do not save it for later use.

It is important to take fluoride regularly to get the most benefit.

Store fluoride at room temperature away from moisture and heat.

What if I dont take fluoride regularly?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What if I take too much fluoride?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, stomach pain, diarrhea, drooling, numbness or tingling, loss of feeling anywhere in your body, muscle stiffness, or seizure (convulsions).

What should I avoid while taking fluoride?

Do not take fluoride with milk, other dairy products, or calcium supplements. Calcium can make it harder for your body to absorb fluoride.

Avoid using antacids without your doctor’s advice. Use only the specific type of antacid your doctor recommends. Many antacids contain calcium, which can interfere with fluoride absorption.

What other drugs will affect fluoride use?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor if you have any of the following side effects:

  • discolored teeth
  • weakened tooth enamel; or
  • any changes in the appearance of your teeth.

Less serious side effects may include:

  • stomach upset;
  • headache; or
  • weakness.

This is not a complete list of side effects and others may occur. Tell your dentist or doctor about any unusual or bothersome side effect.

What other drugs will affect fluoride use?

There may be other drugs that can interact with fluoride. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.