Fluoride and Water (page 2)
Keeping kids' teeth healthy requires more than just daily brushing. During a routine well-child exam, you may be surprised to find the doctor examining your child's teeth and asking you about your water supply. That's because fluoride, a substance that's found naturally in water, plays an important role in healthy tooth development and cavity prevention.
Fluoride exists naturally in water sources and is derived from fluorine, the thirteenth most common element in the Earth's crust. It is well known that fluoride helps prevent and even reverse the early stages of tooth decay.
Tooth decay occurs when plaque — that sticky film of bacteria that accumulates on teeth — breaks down sugars in food. The bacteria produce damaging acids that dissolve the hard enamel surfaces of teeth.
If the damage is not stopped or treated, the bacteria can penetrate through the enamel and cause tooth decay (also called cavities or caries). Cavities weaken teeth and can lead to pain, tooth loss, or even widespread infection in the most severe cases.
Fluoride combats tooth decay in two ways:
- It is incorporated into the structure of developing teeth when it is ingested.
- It protects teeth when it comes in contact with the surface of the teeth.
Fluoride prevents the acid produced by the bacteria in plaque from dissolving, or demineralizing, tooth enamel, the hard and shiny substance that protects the teeth. Fluoride also allows teeth damaged by acid to repair, or remineralize, themselves. Fluoride cannot repair cavities, but it can reverse low levels of tooth decay and thus prevent new cavities from forming.
Despite the good news about dental health, tooth decay remains one of the most common diseases of childhood. According to the Centers for Disease Control and Prevention (CDC):
- more than 25% of 2- to 5-year-olds have one or more cavities
- half of kids 12 to 15 years old have one or more cavities
- tooth decay affects two thirds of 16- to 19-year-olds
Fluoride and the Water Supply
For over 60 years, water fluoridation has proved to be a safe and cost-effective way to reduce dental caries. Today, water fluoridation is estimated to reduce tooth decay by 20%-40%.
As of 2002, CDC statistics show that almost 60% of the U.S. population receives fluoridated water through the taps in their homes. Some communities have naturally occurring fluoride in their water; others add it at water-processing plants.
Your doctor or dentist may know whether local water supplies contain optimal levels of fluoride, between 0.7 and 1.2 ppm (parts fluoride per million parts of water). If your water comes from a public system, you could also call your local water authority or public health department, or check online at the Environmental Protection Agency's (EPA) database of local water safety reports.
If you use well water or water from a private source, fluoride levels should be checked by a laboratory or public health department.
Some parents purchase bottled water for their kids to drink instead of tap water. Most bottled waters lack fluoride, but fluoridated bottled water is now available. If fluoride is added, the manufacturer is required to list the amount. If fluoride concentration is greater than 0.6 ppm up to 1.0 ppm, you might see the health claim "Drinking fluoridated water may reduce the risk of tooth decay" on the label.
The Controversy Over Fluoride
Opponents of water fluoridation have questioned its safety and effectiveness; however, there has been little evidence to support these concerns.
Scientific research continues to support the benefits of fluoride when it comes to prevention of tooth decay and its safety at current recommended levels of 0.7 to 1.2 ppm. Dramatic reductions in tooth decay in the past 30 years is attributed to fluoridation of the water supply, and parents and health professionals should continue to ensure that kids receive enough fluoride to prevent cavities.
The American Dental Association (ADA), the United States Public Health Service (USPHS), the American Academy of Pediatric (AAP), and the World Health Organization (WHO), among many other national and international organizations, endorse community water fluoridation. The CDC recognized fluoridation of water as one of the 10 greatest public health achievements of the 20th century.
Kids' Fluoride Needs
So how much fluoride do kids need? In general, kids under the age of 6 months do not need fluoride supplements. Your child's 6-month checkup offers a great chance to discuss fluoride supplementation with your doctor. If you live in a nonfluoridated area, your doctor or dentist may prescribe fluoride drops, tablets, or vitamins after your baby is 6 months old.
The AAP recommends that these fluoride supplements be given daily to kids between the ages of 6 months and 16 years. The dosage depends on how much fluoride naturally occurs in the water and the child's age. Only kids living in nonfluoridated areas or those who drink only nonfluoridated bottled water should receive supplements.
What about toothpastes, mouth rinses, and other products that contain fluoride? Here are a few tips:
Parents can brush babies' teeth as they come in with an infant toothbrush, using water with just a smear of toothpaste until about age 2.
- Kids younger than 6 may swallow too much toothpaste while brushing, so should be supervised when brushing and taught to spit, not swallow, toothpaste.
- Kids over age 2 should use a fluoride-containing toothpaste that carries the ADA's seal of acceptance.
- Kids should use only a pea-sized amount of toothpaste.
- Kids under age 6 should never use fluoride-containing mouth rinses. However, older kids at high risk for tooth decay may benefit from using them. Your dentist can talk with you about risk factors such as a family history of dental disease, recent periodontal surgery or disease, or a physical impediment to brushing regularly and thoroughly.
Your family dentist or pediatric dentist (one who specializes in the care of children's teeth) is a great resource for information about dental care and fluoride needs. A dentist can help you understand more about how fluoride affects the teeth, and may even recommend applying a topical fluoride varnish during routine dental visits.
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation. All rights reserved.
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