Fluoride is a common ingredient found in dental care products like toothpaste and mouthwash and is generally good for oral care. But is it safe for everyone to use? Read on to learn more about fluoride, its uses, and its pros and cons.

What Is Fluoride?

Fluoride is a naturally occurring element added to toothpaste, mouthwash, and other dental products to help prevent tooth decay. As it has been shown to reduce the incidence of tooth decay, some countries even add fluoride to their public water supplies.

A 2015 review found that fluoridated water led to 35% fewer decayed, missing, or filled baby teeth in children, a 15% increase in children with no decay in their baby teeth, and a 14% increase in children with no decay in their permanent teeth. Fluorine in water has made such an impact that the U.S. Centers for Disease Control and Prevention has proclaimed fluoridated water as one of the 10 great public health achievements of the 20th century.

Tooth decay (a.k.a. dental carries or cavities) happens when tooth tissue or enamel is destroyed by bacteria from dental plaque, a sticky film that forms on teeth when you eat or drink anything sugary. These sugary substances lead to the production of acid that can damage your teeth. (Read more about tooth decay and proper tooth care here.)

In Scientific American, Mary Hayes of the American Dental Association explains that fluoride may be effective against tooth decay due to the combination of demineralization (converting harmful acids on enamel into less harmful ones), the reduction of the ability of plaque organisms to produce acid, and remineralization (strengthening enamel that has been damaged by acids).

Pros and Cons of Fluoride Use

It seems like fluoride is a magic ingredient, but along with its benefits come some possible side effects, so you might be considering going fluoride-free.

“Fluoride, much like calcium, has the ability to strengthen and fortify the hard tissue structures of the teeth. Most toothpastes and mouthwash contain fluoride because it promotes stronger teeth,” says Crickette Inserto, DMD of You and Your Teeth Dental Clinic.

However, Dr. Inserto adds, “For young individuals, especially those who cannot spit, we prohibit the use of toothpaste with fluoride because it’s toxic. Increased consumption of fluoride leads to fluorosis and this gives the teeth an unsightly mottled appearance. The tissues appear chalky, brittle, and severely weakened. In sever cases it can lead to skeletal fluorosis.”

Thus, products with fluoride are not safe for children who are unable to spit as well as those already suffering from fluorosis. If you’re allergic to fluoride, it makes sense to steer clear of products that have it.

The American Dental Association has some guidelines on fluoride toothpaste use for children younger than three years: Use no more than a smear or the size of a grain of rice; brush teeth thoroughly twice a day or as directed by a dentist; and supervise children’s brushing to make sure they use the right amount of toothpaste.

Children three to six years old can use a pea-sized amount of fluoride-toothpaste; supervise their pressure to minimize the amount of toothpaste they swallow.  

“Children with developing teeth, around the ages of one to fifteen, may receive topical fluoride applications. Younger patients who cannot spit will need the varnish method so that it is easy to wipe off the teeth,” says Dr. Inserto. “Teeth of patients between one to fifteen are developing and will develop from fluoride applications. Teeth of older patients may still receive fluoride but they no longer imbibe fluoride as effectively as growing teeth do.”

Other individuals who may benefit from fluoride treatments are those who have braces or crowns, as these make teeth more susceptible to tooth decay.

Improving Dental Health, the Natural Way

Dr. Inserto says that you can strengthen your teeth by increasing your Vitamin D and calcium intake. She cites anecdotal evidence from her medical missions to far-flung places. “I am fascinated with patients who live on islands because their teeth and bones are strong,” she says. “The bones and teeth of patients with high seafood diets are so strong that we have to be extra careful when we pull teeth.” She also observed that those on a diet high in seafood also tend to have less cavities.

If you’re thinking of going fluoride-free, consult your dentist and your physician about adjustments you can make to your diet to ensure that your teeth remain strong.