The Importance of Fluoride
By: Amanda Damon CPNP
Whether your child is a toothless infant, a toddler with baby teeth coming in, or a school aged child with adult teeth coming in and cute gaps in their mouth, it is important to pay attention to the Fluoride in your child’s diet!
Fluoride is a naturally occurring mineral that protects teeth from tooth decay. Fluoride works by promoting healthy enamel and inhibiting bacteria and acid production on the teeth. It is important for fluoride ingestion to begin as early as possible. Insufficient fluoride is the main cause of dental caries (cavities) in children. However, too much fluoride can cause staining of the teeth known as fluorosis. Therefore, it is important to maintain a healthy balance of fluoride intake. Teeth continue to develop until the age of 8, so these first few years of life are the most critical for fluoride intake - especially to reach those un-erupted teeth under the gums. The best sources of Fluoride for your child are tap water and toothpaste.
Breast Fed Babies
Babies who are breastfed exclusively will receive fluoride through breastmilk. Therefore, it is important for breastfeeding moms to drink a good source of fluoridated water. Refrigerator dispensed water and water filtered through a relatively inexpensive filter (such as a Brita) does not remove Fluoride, so these are good sources.
Formula Fed Babies
Babies who are formula fed will receive fluoride through the water that is used to reconstitute the formula. If you are consistently making your baby’s bottles with powdered formula, it is important to use a fluoridated source of water. "Nursery" water is also an option, however, not all “Nursery” waters are fluoridated - be sure to check. Liquid concentrated formulas can also be reconstituted with tap water in order to provide fluoride. Ready to feed formulas contain very little fluoride and will not provide an adequate amount of fluoride to form healthy teeth.
2-8 Year Olds
Until your child is 8 years old, their teeth are still forming. Therefore, it is important to make sure they have an adequate source of fluoridated water. They will also ingest fluoride in other areas of the their diet, but the most important source is through tap water. It is also important that they are brushing their teeth twice daily with fluoridated toothpaste.
It is recommended that you begin brushing your child's teeth with toothpaste as soon as their first teeth erupt. Using a "smear" the size of a grain of rice of toothpaste twice daily is ideal. It is safe to use fluoridated toothpaste with the first tooth eruption as long as your child is not swallowing the toothpaste on a regular basis and you are using the recommended small amount of toothpaste. (Please note that this is a change made in 2014). Once your child is 3 years of age, you can increase the amount of toothpaste to the size of a pea. Limiting the amount of toothpaste is important to decrease the chance of swallowing the toothpaste and getting too much fluoride.
Although Fluoride ingestion is important for the health of your child's teeth, there is a risk of developing a condition known as “Fluorosis” if they ingest too much fluoride. This condition causes chalky white as well as brown stains and discoloration of the teeth.
Previously, Chicago tap water contained 1ppm (1 mg/liter) of fluoride. In order to minimize the risk of fluorosis, as of 2015, the new recommendation is lower the recommended amount to 0.7ppm. According to the CDC, Chicago's tap water currently contains 0.7 ppm of Fluoride. If you are not receiving Chicago water in your community, be sure to check on the amount of Fluoride from your local source.
Fluoride Supplements, Rinses, and Varnishes
There is a lot of information on the internet regarding the use of other sources of fluoride to prevent fluorosis and promote healthy teeth, However, these options need to be recommended by your child's provider and/or pediatric dentist as they are used only for high risk children such as those who have no access to fluoridated water.
The main fact to remember is the your child NEEDS Fluoride in order to have healthy teeth. Tap water and toothpaste will be the main sources of this fluoride. Do not hesitate to ask your child's provider if they are getting enough fluoride based on their diet!
Here are some resources for further information: