Is There Such a Thing as Too Much Fluoride?

Fluoride is a mineral that occurs naturally in water and many foods. It can also be applied to teeth through several dental products. Fluoride helps protect teeth from developing cavities by making the tooth more resistant to acids from plaque bacteria in the mouth. It also helps reverse early stages of tooth decay.

Fluoride intake is critical for infants and children between the ages of 6 months and 16 years, when primary and permanent teeth are developing. It is also beneficial for adults.

Intuitively, it may seem like the more fluoride, the better! However, this is not the case! Too much fluoride, particularly in young children can be damaging to tooth enamel. It can lead to a tooth discoloration called dental fluorosis.

Children 8 years of age and younger, when permanent teeth are forming underneath the gums, are at risk of dental fluorosis. Once permanent teeth have come in fully, fluoride will no longer cause dental fluorosis. Although fluorosis can be cosmetically treated, the stains left by fluorosis are permanent and may darken over time.

But how bad is it really? Dentists have rated the severity of fluorosis using the following degrees:

  • Questionable: The enamel may show a few white spots or lines.
  • Very mild: Less than 25% of the tooth surface is affected by small opaque white spots.
  • Mild: Less than 50% of the tooth surface is affected by white opaque areas . Research suggests that mild cases of fluorosis may actually be beneficial for children. A 2009 study published in The Journal of the American Dental Association suggests that molars with fluorosis are more resistant to cavities than normal molars.
  • Moderate: 50% of the enamel surface is affected by white opaque areas.
  • Severe: All enamel surfaces are affected. Teeth may also have pitting and are at risk of dental erosion.

Common sources of fluoride include tap water, toothpaste, mouth rinses, gels, beverages and foods, and prescription supplements. The Centers for Disease Control and Prevention (CDC) estimates that 75% of individuals' fluoride intake is from drinking water and processed beverages. You can minimize the risk of your child developing dental fluorosis by monitoring their fluoride intake. Find out how much fluoride is in your drinking water at home. Recommendations for adequate fluoride levels in drinking water are 0.7 to 1.2 milligrams per liter. According to the World Health Organization, fluoride levels above 1.5 mg/L can lead to dental fluorosis.

Fluoride in toothpaste is important to protect kids' teeth against tooth decay. However, the CDC recommends avoiding fluoride toothpaste at all until age 2. Only place a pea-sized amount on your child's toothbrush and monitor your child’s brushing to ensure that they are not swallowing the toothpaste. To promote spitting out toothpaste, avoid purchasing toothpastes containing flavors your child is likely to swallow. If a child ingests a large amount of fluoride in a short period of time, it may cause nausea, diarrhea, vomiting or abdominal pain.

If treatment is necessary for your child, most options vary from tooth whitening to veneers or full crowns. Make sure to keep all fluoride-containing products out of the reach of young children.

Feel free to contact Drs. Ali & Ali and the caring team at Wellesley Dental Group if you have any thoughts or concerns; they will be happy to answer your questions! Contact us today at 781-237-9071 or to set up an appointment and consultation.

Your little ones and teens are welcome to visit our pediatric dentist Dr. Van Orenstein. Dr. Emad is happy to help with your orthodontic needs. For wisdom teeth extractions or any other oral surgery needs Dr. Ghazi would be more than willing to help.


2 Responses to Is There Such a Thing as Too Much Fluoride?

Drs. Ali & Ali says:

Yes, Dr. Tagliarini, this is why we believe in educating our patients via our social media, blog and website, and all of our doctors take this responsibility very seriously. It is crucial for every doctor to stay abreast of the latest research in our field, so we may provide the highest quality of care to every individual we treat.

Dr. Joe Tagliarini says:

I had a new patient come in with mild discoloration. When he was younger another dentist had him take fluoride pills. He may have no real cavities, but the discoloration is something he's stuck with.

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