Flouride and Tooth Decay
Tooth decay, also called dental caries or dental cavities, is the destruction of the enamel (outer surface) of a tooth. It is a common health problem, second in prevalence only to the common cold. We have all heard at sometime or the other that fluoride helps prevent tooth decay. Yes, it does, but only when used in moderation.
Fluoride is an important mineral in human health. It occurs naturally in all water sources, even the oceans. The fluoride ion comes from the element fluorine. Fluorine is never encountered in its free state in nature, but exists only in combination with other elements as a fluoride compound. It is an essential element, a minimum amount being required for prevention of dental caries.
Preventing Tooth Decay
There are three principle ways in which fluoride prevents tooth decay:
- Tooth mineralisation: Fluoride promotes the tooth mineralisation process. In other words, fluoride will be absorbed onto the surface of a decaying tooth. This fluoride, in turn, actually attracts other minerals, such as calcium, and speeds up reformation of the tooth enamel.
- Making a tooth more decay resistant: Fluoride helps to create a tooth surface that is more resistant to the formation of tooth decay. The new tooth mineral that is formed when fluoride is present is actually a “harder” mineral compound than what was originally present.
- Inhibition of oral bacteria’s ability to create acids: Tooth decay occurs when it is acted upon by acids formed by the bacteria in the mouth. Fluoride helps by decreasing the rate at which bacteria can produce acids, thereby preventing tooth decay.
Community Water Fluoridation
Community water fluoridation is the addition of fluoride to adjust the natural fluoride concentration of a community’s water supply to the level recommended for optimal dental health. It is an effective, safe and inexpensive way to prevent tooth decay and has a far reaching effect. Fluoridation of community water has been credited with reducing tooth decay by 50 per cent to 60 per cent in the United States since World War II.
The presence of fluoride in high concentration in the environment, particularly in water, leads to a condition called fluorosis. Fluorosis results in hardening of bone and is characterised by the appearance of chalky-white lines or yellow or brown discolouration. For dental fluorosis to occur, the fluoride must be swallowed during that time period when a child’s tooth enamel is forming. The most critical years associated with formation of dental fluorosis lie between birth and ages six or seven.
In India, fluorosis occurs as an endemic disease in parts of Andhra Pradesh and Punjab. One important strategy to control fluorosis in these areas is to supply low-fluoride water. A common source of ingested fluoride is toothpaste. Small children may not be able to spit out toothpaste while brushing, resulting in swallowing of fluoride toothpaste. This swallowed toothpaste can lead to causation of dental fluorosis.
Suggestions to Minimise Ingestion of Fluoride Toothpaste
- Good brushing and rinsing habits should be inculcated in children.
- An unfluoridated baby tooth cleaner should be used with children two years and under.
- Typically, only a small dab of toothpaste is needed, one the size of a green pea.
Fluoride not only benefits children, but also adults in preventing tooth decay. It decreases the risk of cavities at the root surface as well as the enamel. Use of fluoridated water and fluoride dental products will help people maintain oral health and keep more permanent teeth.