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Cris Gilb, PHN and Executive Director

Think Fluoride 1-2-3

Cris Gilb, RN, PHN, MHA
Executive Director, Minnesota Oral Health Project

It’s as easy as 1-2-3 to protect your child’s teeth and strengthen them with fluoride! When sugars in food and beverages mix with bacteria in the mouth, they create acid.  Acid damages tooth enamel, or the outer covering of the tooth. The enamel loses mineral and breaks down. However, enamel will remineralize when exposed to fluoride. Too much demineralization and not enough remineralization leads to tooth decay. Fluoride plays a very important role in strengthening the enamel and preventing cavities and tooth decay. Make these simple changes in your daily habits and you can crush childhood cavities!

What can you do to protect your child’s teeth?

Drink Fluoridated Water

Drink tap water. Municipal water is a very important source of fluoride. Most communities have added fluoride to their public water. Drink fluoridated public tap water! It is one of the top 10 most effective public health measures of the 20th century.

If you have a private well, it is important to test the water for fluoride content. You can get water test kits from your local Department of Health or Public Health agency.  Your well may not have sufficient amounts of fluoride or it may have too much fluoride depending on the ground water supply.  In either case, you should consult with your family doctor or dentist.

Don’t drink bottled water. Do not give your child bottled water unless you know it is enriched with fluoride. Most bottled water does not have fluoride. Fluoride is removed from water as part of the bottling process. Read the label of the bottle to know for sure. Some families choose to filter their tap water before drinking it. It is important to know if the filtration system removes the water’s fluoride. For example, reverse osmosis filtration systems removes fluoride but filters that use activated carbon, like a Brita Filter, does not. Check with the manufacturer of the system you have to know for sure. Know if the water your child drinks regularly is fluoridated and change to fluoridated water if possible!

Eat vegetables. The best way to get fluoride from food is to eat a variety of vegetables. Some foods contain fluoride but have a lot of acid that is not good for your teeth, like tea and fruit juices.  Protect your child’s teeth by serving healthy foods and limiting sugary foods and beverages.

Brush and Rinse with Fluoride

AgeToothpaste AmountRinsing after brushing
1 – 2Size of grain of riceWipe out mouth with gauze
3 – 6Size of a peaAssist child with rinse and spit
7 and olderSmall smearInstruct child to rinse and spit
Toothpaste size of grain of rice and pea

Use fluoridated toothpaste. One of the best ways to protect your child’s teeth is by using a fluoride toothpaste. Fluoridated toothpaste can and should be used for everyone, beginning with the eruption of the first tooth. When using fluoridated toothpaste, caregivers of young children need to be aware of the amount of toothpaste to use. Parents should assist the child with rinsing the mouth after brushing.

Children are not skilled enough to brush or to rinse adequately to brush their own teeth without parental assistance until they are 7 – 8 years old. Swallowing some toothpaste after brushing is not dangerous because it is very difficult to swallow high levels of fluoride from toothpaste.

Your dentist or doctor can provide other sources of fluoride.  Your child’s dentist or doctor may prescribe fluoride supplements or stronger fluoridated toothpaste if the child’s diet or water does not contain enough fluoride to protect teeth.

Use a fluoride rinse. Use of fluoride mouthwashes can be started at the age of 6 with parental supervision to ensure that the child spits the mouthwash out instead of accidentally swallowing it. There are many over the counter fluoride mouthwashes available on the market. Fluoride mouthwashes act as a boost to brushing and flossing, helping to protect the teeth against decay. Children should use fluoride mouthwashes at night after they have brushed and flossed, and are done eating for the night.

Apply Fluoride Varnish

Your child’s dentist or doctor may apply fluoride varnish to the teeth.   Fluoride varnish is applied to the surface of all teeth and dries on contact.  It prevents further demineralization, remineralizes the enamel and reduces the bacteria on the teeth that causes cavities.  Fluoride varnish is safe and effective according to the American Dental Association and the American Academy of Pediatric Dentistry.

When fluoride varnish is applied, a minimal amount of the fluoride is ingested into the body.  The small amount of fluoride that is swallowed is important for teeth that have not erupted yet.  Children should have fluoride varnish at least every 3 months, or four times per year.  Fluoride can also be applied via gel or rinses but is most common in the form of varnish.  The varnish is applied with a tiny brush and is as simple as polishing your fingernails.

Fluoride varnish is not the same as sealants.  Children should also have sealants which coat the permanent molars. Dentists apply the sealants.

Fluoride is safe. Some people have questioned the safety of fluoride. Fluoride in any form is safe and effective and is recommended by The American Dental Association (ADA), the American Academy of Pediatric Dentistry (AAPD), the American Academy of Pediatrics (AAP) and the American Academy of Family Medicine (AAFM). You can start using fluoride when the first baby tooth comes in. Studies have repeatedly demonstrated that fluoride is safe and effective to prevent cavities.

Be Fluoride Smart.  Know the sources of fluoride that you and your children receive.  Assure yourself that fluoride is safe and effective for you and your children.
Above all, you can help your child have healthy teeth.  Cavities can be prevented.

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