Understanding Fluoride Treatments

Overview

Fluoride is a mineral that can be found naturally in water, salt, and milk. Fluoride has been seen as a key part of dental health ever since the 1930s. It was first noticed that, in places where fluoride could be found in the water supply, the local population saw fewer cases of dental caries, or tooth decay. The benefits of fluoride against tooth decay are now widely accepted.¹

There are increasing varieties of fluoride treatments that can be used to effectively deliver fluoride to the teeth. You can find a range of fluoride products that help protect and strengthen your teeth. Be sure to read on for a healthy smile!

What do fluoride treatments treat?

We know that fluoride treatments aim to prevent tooth decay. But what is tooth decay and why is it so important to use fluoride routinely?

Tooth decay occurs when the enamel (the surface layers of the tooth) is weakened by dental plaque. Dental plaque is a film of bacteria that sticks to teeth. Whenever we consume sugar-containing food or drinks, this film of bacteria produces acid from the sugars. These acids gradually break down the surface of the tooth, which leads to tooth decay.² You might not be able to see the damage immediately, but it can eventually lead to toothache, sensitive teeth, teeth discolouration, or even infections and loss of teeth.

The good news is that tooth decay is generally preventable. Good oral hygiene consisting of regular, twice-daily brushing with fluoride toothpaste is the best way to prevent tooth decay. It is normal to find bacteria in the mouth, but regular brushing helps to physically disturb the bacterial film and stop dental plaque from building up.

Although routine brushing and proper technique are important in dental health, it is the presence of fluoride in toothpaste that prevents the progression of tooth decay. Fluoride can also help in restoring the tooth surface to keep your teeth happy and strong.³

What kinds of fluoride treatments are there?

Fluoride is available in different strengths and formulations. For easier comparison, manufacturers often list fluoride content in parts per million (ppm). Products with fluoride contents of at least 1,000 ppm fluoride are most effective at preventing tooth decay.

Toothpaste

For most people, toothpaste will be their main source of fluoride. As part of the daily routine, brushing teeth with fluoride toothpaste is the most convenient and accessible method for both adults and children. Teeth should be brushed at least twice daily – once before bedtime and once at any other time of the day.³

In the UK, strengths between 1,000 ppm and 1,500 ppm can be bought at shops and pharmacies. 

Mouthwashes

Mouthwashes are also widely available and can be used in addition to fluoride toothpaste. However, they should NOT be considered a replacement for toothbrushing. It is advised to leave 30 minutes in between tooth brushing and rinsing with mouthwash. Mouthwashes are not recommended for children under 6 years, as they may accidentally swallow the mouthwash.⁴

For daily use, fluoride mouthwashes containing 230 ppm fluoride are available. Mouthwashes containing 900 ppm fluoride can be used on a weekly or fortnightly basis. 

Varnishes

Fluoride can be applied directly to the teeth using a concentrated fluoride varnish. The effects are long-lasting and varnishes can be applied two to four times a year. Varnishes are usually only applied at a dentist.

Water supply

Fluoride can be found naturally in most parts of England and Wales, at very low levels. In some areas of England, local water suppliers may add extra fluoride to the water. 

How much fluoride should I be using?

Adults and children over 7 years are advised to use a pea-sized amount of toothpaste that contains at least 1,350 to 1,500 ppm fluoride. 

It is advised that parents start brushing their children’s teeth as soon as they emerge from the gums. Toothpaste for children should contain no more than 1,000 ppm fluoride. A pea-sized amount will be enough for children between 3 to 6 years, while a smear of toothpaste can be used for children under 3 years.³

Dentists may choose to prescribe higher-strength toothpaste to those found to be at higher risk of tooth decay. There are two higher-strength toothpastes available via prescription. These include 2,800 ppm toothpaste for patients from 10 years of age, and 5,000 ppm toothpaste for patients aged 16 years or over. The usual dose is to use a pea-sized amount twice a day, while making sure to spit out the toothpaste instead of rinsing afterwards.

Can you have too much fluoride?

Taking too large amounts of fluoride may cause faint white streaks or marks to develop on the teeth. This is called fluorosis. Most cases are very mild and barely visible. Since fluoride is not ingested in large amounts, the risk of fluorosis is low.²

Fluorosis tends to be limited to young children who are more likely to accidentally swallow toothpaste. The risk can be reduced further by having a parent supervise the child while they brush their teeth.⁵

Summary

Fluoride has a proven record for protecting against tooth decay and is now added to a range of dental care products, with fluoride toothpaste being the most popular due to availability and convenience.

FAQs

What is the idea behind the saying “Spit, don’t rinse”?

Rinsing the mouth immediately after brushing will dilute the fluoride concentration in the mouth. The effects of brushing with fluoride toothpaste should last for a few hours if allowed to settle into the teeth. This is why it is advised to spit out the toothpaste and to avoid rinsing your mouth immediately after brushing. If you cannot avoid the urge to rinse, try to rinse with only a small amount of liquid.

There are too many different fluoride toothpastes. Which brand should I buy?

Different toothpastes contain different ingredients that change the way they taste or feel in the mouth. When looking for fluoride toothpaste, just be sure to find one containing the appropriate amount of fluoride – 1000 ppm for young children under 6 years of age, and 1,350 to 1,500 ppm for adults and children over 7 years.

After using fluoride treatments, how long should I wait before eating, or drinking?

It is advised to leave at least 30 minutes after brushing teeth with fluoride toothpaste, and 15 minutes after rinsing with fluoride mouthwash.

How else can I avoid tooth decay?

Reduce how much and how often you eat or drink sugar-containing food and drinks. If you take liquid medicines, consider speaking to your prescriber about sugar-free options.