Sources (part 1)

How is it Best to have Fluoride?

It’s best to have frequent low concentrated applications- below 1ppm- this is the aim of brushing twice daily with a fluoride toothpaste.

Where extra fluoride is needed, try to take it away from tooth-brushing for the maximum benefit i.e. use the mouthwash mid morning and afternoon so you get four small fluoride doses throughout the day. This isn’t always convenient or possible, but as long as you understand the way to get the maximum benefit, just do the best that you can.

The best type of fluoride and how much you need (if you need it), will depend on your age, your teeth, your susceptibility to dental caries, what sources you are currently getting and many other factors. Your dentist will advise you what is most suitable for your particular situation.

In what Ways do we Absorb Fluoride?

We can get fluoride either ‘systemically’ or ‘topically’ (sometimes called ‘locally’) – that is, either we take the fluoride fully into our bodies, or just into our mouth.

Topical fluoride treatments have the best effect on developing teeth and are particularly important from 6-17 years old, as the adult teeth enter the mouth and continue to mature.. Younger children will also benefit (after the age of 3), but compliance can often be a little tricky, so fluoride from systemic sources tends to be more valuable at this stage.

What are the Systemic Sources of Fluoride?

  • Water fluoridation

Fluoride can be added to both our tap water at source and to bottled water. The United States Food and Drug Administration (FDA) has set regulations for the fluoride content of bottled water and other drinks at 1.4-2.4 ppm (Department of Health and Human Services. Bottled water. 2006. (codified at 21CFR165.110).

  • Fluoride tablets

These can be used as a supplement in areas where water isn’t fluoridated- if the water contains less than 0.3ppm and the child is high risk for dental caries. They should be continued daily until adolescence. These are most effective when given as far away from the child’s brushing as possible. If you forget to take it one day, do not double the dose the next day- just take one tablet. Allow the tablet to dissolve slowly in the mouth.

  • Fluoride drops

Fluoride drops come in a small bottle with a little pipette for acuurately dispensing the right amount. They can be taken with or without food and some can be mixed with juice or water before taking them. Your pharmacist will be able to advise you on the specifics of taking them; always follow the directions you are given. If you miss a dose, as with the tablets don’t double up, just carry on the next day as per usual.

  • Diet

(i) Tea

Both black and green tea are a significant dietary source of fluoride. The older a tea plant gets, the more fluoride that is absorbed from the soil into the leaves and the more that is released into your water when you drink your cup of tea. So if you are a big tea drinker like most Brits I know, you are probably getting a good dose of fluoride from this. Just think about how much sugar you are adding and consider sugar free alternatives for sweetness.

(ii) Salt

Fluoride can be added to salt and this can help where fluoridation is not possible. The downside of a diet high in salt, must also be considered.

(iii) Fluoridated Milk

Fluoridated milk schemes have been tried successfully- it smells, looks, and tastes like ordinary milk- that’s because it is- just with a tad of fluoride added for its benefits. This scheme is supported by the WHO (World Health Organisation), and has proved effective at reducing dental caries. It is often necessary for parents/guardians to sign a consent form if they wish their child to be able to drink dental milk at school.

To stop mottling or mild fluososis, only one systemic intake of fluoride should be used at a time for children under 9 years of age.