General, Cosmetic, And Implant Dentistry
Fluoride is the most effective agent available to help prevent tooth decay. It is a mineral that is naturally present in varying amounts in almost all foods and water supplies. The benefits of fluoride have been well known for over 50 years and are supported by many health and professional organizations.
Fluoride works in two ways:
Topical fluoride strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay. We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels. We recommend that children have a professional application of fluoride twice a year during dental check-ups.
Although most people receive fluoride from food and water, sometimes it is not enough to help prevent decay. Your dentist or dental hygienist may recommend the use of home and/or professional fluoride treatments for the following reasons:
Custom Fluoride Trays:
Some medical conditions, medical treatments or medications can put a person at high risk for developing dental decay. Examples are xerostomia (dry mouth), physical impairments making it difficult to brush and floss adequately, Alzheimer's, and other forms of dementia. In many such cases, we recommend the use of custom fluoride trays to be used at home for the daily application of fluoride. While daily application of fluoride with custom fluoride trays will not eliminate the risk of tooth decay, it will reduce the risk and slow progression.
Custom fluoride trays are fabricated in our laboratory after making impressions of your teeth. They adapt perfectly to your teeth, ensuring maximum fluoride exposure to all the tooth surfaces. Follow these guidelines when using custom fluoride trays at home...
1 x per day for 5 minutes do the following
Apply a small bead of fluoride gel (Prevident or Take Home Care) to each fluoride tray (upper/lower) and place in mouth for 5 minutes. Do not swallow fluoride
Remove trays and spit fluoride out. Do not eat, drink or rinse for 30 minutes after application.
If a significant amount of fluoride is swallowed, drink a large glass of milk to bind the fluoride in your stomach and prevent side effects.
Remember, this is only an adjunct to regular brushing and flossing, so continue to brush and floss on a regular daily basis to ensure maximum protection against tooth decay.</o:p>
Systemic fluoride strengthens the teeth that have erupted as well as those that are developing under the gums. We gain systemic fluoride from most foods and our community water supplies. It is also available as a supplement in drop, tablet or gel form and can be prescribed by our office. Generally, fluoride drops are recommended for infants, and tablets are best suited for children up through the teen years. It is very important to monitor the amounts of fluoride a child ingests. If too much fluoride is consumed while the teeth are developing, a condition called fluorosis (white spots on the teeth) may result.
If you are interested in giving fluoride supplements to your child, or if you currently do and would like more information, the following should help guide you in the proper dosing and administration of fluoride to your child.
For residents with well water in the Baltimore area, we do recommend fluoride supplementation for your child. Fluoride addition to municipal drinking water is one of greatest public health improvements of the 20th century. Where implemented, it has reduced the incidence of dental caries (cavities, decay) by 50-70%.
Well water in the Baltimore area generally does not contain fluoride. Approximately 10% of Baltimore County wells have been found to contain low levels of fluoride, in the range of 0.2 - 0.3 parts per million (ppm), which is insignificant and will not contribute to fluorosis of the teeth (brown and white mottled staining of the teeth from over-ingestion of fluoride during tooth development). Baltimore city water, on the other hand, does contain approximately 1 ppm of fluoride and therefore, fluoride supplementation is not recommended.
Fluorosis can occur due to over-ingestion of fluoride from other sources, such as mouthrinses (ACT and Fluorigard), prescription fluoride gels and toothpastes (Prevident, GelKam, etc.), and normal fluoride-containing toothpastes. Children under 6 years of age have difficulty eliminating toothpaste from their mouth (spitting) adequately, and should be watched carefully when brushing their teeth to ensure they are using only a pea-sized amount of toothpaste and are not swallowing the toothpaste. This is not such a concern for children over 6 years of age, but fluoride-containing materials should not be swallowed at any age.
Because of the low levels of fluoride found in area well water, we recommend fluoride supplementation for your children up to the age of 16 to ensure maximum protection against dental decay.
The following chart summarizes dosages at various ages for the two products we prescribe here. Follow it carefully to provide maximum cavity protection for your children without risk of them developing dental fluorosis.
Age Group (<0.3 ppm Fluoride in water)
Daily Oral Dose,
Birth to 6 months
6 months to 3 years
One 0.25 mg tablet
3 to 6 years
One 0.5 mg tablet
6 to 16 years
One 1.0 mg tablet
Do not eat or drink any dairy products within one hour of taking the fluoride, as it will inactivate the fluoride.
If you are concerned about the level of fluoride in your drinking water, the following labs can provide fluoride level testing for your home:
Remember, fluoride alone will not prevent tooth decay! It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.