What is Fluoride, and Who Needs It?

Fluoride is a mineral that enhances tooth and bone health when provided in optimal amounts throughout life. Fluoride increases tooth resistance to tooth decay, primarily through topical effects. Fluoride occurs naturally in groundwater. It is also commonly found in foods such as breads and beverages that are made using fluoridated water and in many public fluoridated water supplies. Tooth decay can be reduced by 50 to 70 percent with exposure to the proper amounts of fluoride.

Water fluoridation is one of the best examples of a public health preventive intervention at the community level. All infants and children who drink fluoridated water benefit from systemic ingestion by incorporating fluoride into their developing teeth, as well as from important topical effects. Unfortunately, many families live in communities without fluoridated water, and many use multiple or alternative sources of water (for example, bottled or processed water), complicating the delivery of fluoride to infants and children.

Topical fluoride is probably the most important method of preventing tooth decay. Topical fluoride reaches the teeth directly, slowing down or preventing the development of tooth decay. Topical fluoride works best when it is ingested in very small amounts many times a day through water, foods containing fluoride, and fluoridated toothpaste.

Almost all toothpaste manufactured provides topical fluoride. Unless a dentist or physician advises otherwise, fluoridated toothpaste should be introduced at around age 2.

Another form of topical fluoride is professionally applied fluoride (including gels, foams, and varnish), which renews the high levels of fluoride in the enamel. Topical fluoride may be especially effective for children at high risk for tooth decay because they lack fluoridated water, have a history of tooth decay, snack frequently on foods high in sugar, or have a medical condition that makes them susceptible to decay. Only a dentist, dental hygienist, physician, or other qualified health professional should apply topical fluoride.

Baby Bottle Tooth Decay

Baby Bottle Tooth Decay (BBTD) is caused by prolonged contact with almost any liquid other than water. This can happen from putting her to bed with a bottle of formula, milk, juice, soft drinks, sugar water, sugared drinks, etc. Allowing her to suck on a bottle or breastfeed for longer than a mealtime, either when awake or asleep, can also cause BBTD.

When liquid from a baby bottle builds up in the mouth, the natural or added sugars found in the liquid are changed to acid by germs in the mouth. This acid then starts to dissolve the teeth (mainly the upper front teeth), causing them to decay.

Baby Bottle Tooth Decay can lead to severe damage to your child’s baby teeth and can also cause dental problems that affect her permanent teeth.
But there are steps you can take to prevent Baby Bottle Tooth Decay.

Keep these pointers in mind as you care for your child’s teeth:

• Never put your child to bed with a bottle. By 7 or 8 months of age, most children no longer need feedings during the night. Children who drink bottles while lying down also may be more prone to getting ear infections.

• Only give your baby a bottle during meals. Do not use the bottle as a pacifier; do not allow your child to walk around with it or to drink it for extended periods. These practices not only may lead to BBTD, but children can suffer tooth injuries if they fall while sucking on a bottle.

• Teach your child to drink from a cup as soon as possible, usually by 1 year of age. Drinking from a cup does not cause the liquid to collect around the teeth, and a cup cannot be taken to bed. If you are concerned that a cup may be messier than a bottle, especially when you are away from home, use one that has a snap-on lid with a straw or a special valve to prevent spilling.

• Keep your baby’s mouth clean. This is an important part of preventing tooth decay. After feedings, gently brush your baby’s gums and any baby teeth with a soft infant toothbrush.

• Use water and a soft child-sized toothbrush for daily cleaning once your child has 7 to 8 teeth.
By the time your toddler is 2 years of age, you should be brushing his teeth once or twice a day, preferably after breakfast and before bedtime. Once you are sure your child will spit, and not swallow, toothpaste, you should begin using a fluoride toothpaste. Use a pea-sized amount of toothpaste to limit the amount he can accidently swallow.