Should my child get a fluoride treatment at the dentist?
With the use of Fluoride literally on trial, many parents want to know what is best for their family in regards to fluoride and whether fluoride treatments at the dentist for kids are safe.
Hopefully this guide can help answer some of those big questions and leave you feeling more empowered to make the best choice for your child and family circumstances.
What is fluoride?
Fluoride is a combination of the element fluorine and minerals in soil or rocks. It is found naturally in water, soils, and plants, but can also be released into the environment as a byproduct of industrial fertilizer.
Fluoride is added to toothpaste, mouthwashes, and drinking water to prevent cavities.
Does fluoride prevent cavities?
Yes, but also… maybe not.
According to this study performed on extracted teeth- when applied directly to the teeth, sodium fluoride can help to prevent cavities by incorporating itself into the enamel and remineralizing it.
This study did note that the amount of remineralization depended on the levels of calcium and phosphate available and admitted that their solution may have more than would be found in saliva.
According to this study, which follows the effects of sodium fluoride varnish treatments on live teeth of children ages 3-7 years old over a 5-year period, there was no association found between the application of fluoride varnish and prevention of fillings placed.
But what they did find was that it depends more on who your dentist is than how much fluoride is placed and whether your child will get a filling placed or not.
So, does fluoride really prevent cavities?
It’s up for debate.
According to the first study, the effectiveness of fluoride depends on your child’s diet and the subsequent makeup of their saliva. And in the second study, it really depends on how conservative your dentist is.
So maybe those are better places to start for your child in preventing cavities? A tooth-friendly diet and a dentist that focuses on preventative dentistry practices and then add fluoride in as a safety net if that feels right for you.
Risks of Fluoride
When too much fluoride is ingested, fluoride poisoning (toxicity) can occur.
The maximum amount of fluoride for children to ingest really depends on their size. You should stay below 5mg/kg of body weight to avoid toxicity.
That’s 77mg for the average 34-pound, 4-year-old child.
But just because that is the maximum dose doesn’t mean you should aim for that. It’s best to stay well below to account for differences in each child as far as how their body responds to fluoride.
There are two types of fluoride toxicity. Acute toxicity- a more immediate and short-term poisoning effect. And Chronic toxicity- a long-term effect due to the cumulative effects of fluoride over time.
Acute (immediate) Toxicity
- Nausea
- Vomiting
- Abdominal pain
- Diarrhea
- Weakness
- Hypocalcemia
- Tetany
- Low blood pressure
- Coma
- Convulsions
- And in very rare cases- death
Chronic (long-term) Toxicity
- Dental fluorosis- especially in children 8 years old or younger. (FYI- fluoride is not even recommended to be used before the age of 3 because of the high risk of dental fluorosis)
- Skeletal fluorosis
- Kidney problems
- Numbness and muscle spasms
- Dermatitis, eczema
- Indigestion
- Endocrine disruption– including insulin resistance and male fertility
- Lowered IQ
- ADHD
- Birth defects
- Cancer
For a complete list and more in-depth look at the effects of fluoride toxicity, both acute and chronic check out FluorideAlert.org.
Sources of fluoride
- Fluoride toothpaste 500-1000 ppm: This is your everyday over-the-counter toothpaste. It probably has a sparkly fun flavor that is likely to be swallowed by your little one… which is why it’s not advised for children who don’t know how to spit yet.
- Fluoride varnish 12,300 ppm: (you may be offered a rinse or foam trays instead depending on your dentist) this is clearly a very concentrated dose of fluoride. It is a gel that is painted onto your child’s teeth and left to sit until it is brushed or washed away. Your child will most likely swallow globs of this as it rubs off the teeth and into the saliva.
- Fluoridated water 0.7 ppm: the purpose of this is for your child to drink it under the premise that it will either topically harden the teeth or do so from the inside out- but there are no reliable sources proving that ingesting fluoride prevents decay. It seems like a low dose, but this is your child’s water source and so it adds up quickly between drinking, cooking, and bathing.
As a side note, the fluoride that is used to fluoridate drinking water is not always the same sodium fluoride that we have been talking about. The fluorosilicic acid that is used is not pharmaceutical-grade quality like you find in toothpaste. It has been shown to contain contaminants such as arsenic and lead.
- Prescription Fluoride Toothpaste 5000 ppm: This high-dose fluoride supplement is for special cases of high cavity rates or high vulnerability to cavities such as cancer patients, dry mouth, or inability to perform proper oral hygiene care.
Cost of fluoride treatments at the dentist
Insurance companies will usually cover the full cost of fluoride treatments for children as a preventative treatment, but not for adults.
If you don’t have insurance or are last your plan’s age limit, fluoride treatments at the dentist are fairly inexpensive and range from $20-50.
How is a fluoride treatment performed?
The fluoride treatment will either be a highly concentrated varnish, gel, foam, or rinse that will be applied with a brush, swab, tray, or mouthwash.
It is usually placed directly after a cleaning to increase the absorption into the teeth as plaque or tartar buildup won’t be in the way.
Your child will be asked to avoid food or water for 30 minutes to allow for the fluoride to be fully absorbed.
Benefits of fluoride treatments at the dentist for kids
- Potential for preventing cavities and remineralizing teeth
- Can help to protect teeth of:
- children with special needs that don’t have the dexterity needed for proper oral hygiene
- children who mouth breathe leading to dry mouth
- Children undergoing chemotherapy treatment
- children from lower-income households that can’t afford a healthier diet
Risks of fluoride treatments at the dentist for kids
- High potential for the child to swallow the varnish leading to ingestion of high doses of fluoride
- Even if your child does not ingest any varnish, the fluoride may be absorbed through the oral mucosa anyways leading to high blood serum levels of fluoride
Fluoride during pregnancy or breastfeeding
Excess fluoride should be avoided during pregnancy or while breastfeeding because the fetus and infants are especially susceptible to the effects of fluoride.
Fluoride is found in the blood serum, urine, and amniotic fluid of pregnant women after ingestion.
According to this study, fluoride can cross the placental barrier and be incorporated into fetal tissues causing disturbances in bone, neurological, and brain development.
High fluoride levels in the mother have been shown to negatively impact the child’s IQ by 5-6 points at 4 and 6-12 years of age.
How to prevent cavities without fluoride
Just a gentle reminder that cavities do not form because of a fluoride deficiency.
Fluoride is not a nutrient that our bodies need.
There is no recommended daily intake of fluoride, but there is an upper limit of toxicity. Check your fluoride toothpaste tube… there will be a poison warning against swallowing too much.
The best way to prevent cavities is to balance the oral microbiome. (Fluoride actually has an antibacterial effect that kills both the good and the bad bacteria… leading to imbalance)
It may seem counterintuitive, but Bacteria is your friend… the friendly bacteria that is.
When the oral Microbiome is balanced, the mouth will be a less acidic environment- leading to stronger teeth and fewer cavities.
So instead of focusing on sterilizing your mouth, focus on feeding the good bacteria.
- Eat the rainbow! Think nutrient-dense foods like fruits and veggies. Bonus points if they are crunchy!
- Avoid snacking all day long… especially on over-processed foods (crackers, chips, pretzels), sticky foods (cereal bars, dried fruit, fruit snacks), or sweet treats (candy).
- Opt for water and limit juice, sports drinks, and soda
- Use Hydroxyapatite toothpaste to strengthen and remineralize the teeth
- Ditch the mouthwash- as I said, we want to avoid sterilizing our mouth
- Breathe through your nose all day and night. Mouth breathing can cause dry mouth and an imbalanced Microbiome.
- Regular dental check-ups. Twice a year.
Conclusion
Fluoride treatments at the dentist can be beneficial for cases where it is more difficult to prevent decay such as a child with limited dexterity, who can’t perform proper oral hygiene, or for children in low-income families that can’t afford the expense of ”healthy” foods or hydroxyapatite toothpaste.
But be aware that cavities are not caused by a fluoride deficiency.
Fluoride does not address the root cause of decay.
Fluoride use has risks.
And it’s important to note that high-dose fluoride treatments at the dentist are not the only source of fluoride your little one may be exposed to. They may be swallowing over-the-counter fluoride toothpaste or fluoridated community water.
So take all of that into account when determining your child’s fluoride intake and overall risk for toxicity.
But it is not all doom and gloom!
There is an alternative option available to your child. Hydroxyapatite toothpaste and eventually (fingers crossed) hydroxyapatite varnishes are both non-toxic and just as effective as fluoride at preventing decay (cavities).
And remember, you CAN prevent cavities without fluoride.
In the end, you know your little one’s situation best. And the use of fluoride in your family is up to you. Talk to your child’s dentist about their risk of decay and their individual need for fluoride.
You’re doing a great job! Your little one’s smile is in good hands.
