Fluoride; Who Needs It?

     Some doctors prescribe fluoride supplementation for their young patients and some don’t. Dentists warn against both too much and too little fluoride. What should a parent do?

      Fluoride decreases the growth of bacteria in the mouth that cause tooth decay. In the 1930’s and 40’s, studies showed that fluoride in public water supplies reduced dental decay. In 1945, fluoride was first added to the water supply in Grand Rapids, Michigan and, since that time, it has been estimated that water fluoridation has reduced dental cavities in the American population by about 60%. That means a significant decrease in both the discomfort and the cost of dental problems in American children.

     Even though most water supplies have fluoride, some children may not have an adequate amount. Well water may have some natural fluoride but it may not have enough. There are still some areas in the country that do not have fluoridated water and some home water purification systems remove fluoride. Breast milk does not contain fluoride, even if the mother is drinking water with fluoride.  Powdered or concentrated formulas do not contain fluoride, but the water used to reconstitute them may have fluoride. Bottled water may or may not have fluoride. Children with inadequate fluoride are at risk for increased dental problems. Other children at risk for tooth decay are children who snack on sugary snacks and drinks (including milk) or who go to bed with bottles that contain liquids with sugar.

     On the other hand, the American Dental Association warns against too much fluoride. Too much fluoride over a long period of time can cause staining of tooth enamel and weakening of the tooth enamel. Because there are many sources of fluoride in today’s society, parents need to be aware of how much fluoride their child is getting.  Along with water, fluoride is in toothpaste, mouthwash and in fluoride dental applications. Doctors also prescribe fluoride supplementation, especially to breast-fed infants. At the American Academy of Pediatric Dentistry web site (www.aapd.org) parents can find a risk assessment tool to help determine how much fluoride their child may need. Parents then need to speak with their child’s caregiver or dentist about supplementation.