Fluoride and Children's Dental Health: Benefits, Safety, and Cavity Prevention

February is National Children's Dental Health Month. I'll be honest. Brushing my kid's teeth might be my least favorite daily parental activity. Why are toddlers so squirmy?

It's important to floss and brush your child's teeth properly each day. Proper brushing entails the rule of "2 x 2"—brush at least twice daily for at least two minutes each time. Most dentists agree that parents should brush or assist with brushing until their children are at least seven years old.

That's all well and good, but in the real world, how do we deal with the daily toddler screams of "I DO IT MYSELF!" or "I NO WANT BRUSH!" or the older kid who insists that they brush but on closer inspection, has fuzz growing on their pearly whites? Or the teenager who leaves their expensive toothbrush out on the counter only to have it stolen and eaten by the family dog?

Yes, proper brushing is challenging. Add sugary sweets or a genetic predisposition to poor tooth enamel, and you have a recipe for cavities!

Enter: Fluoride.

What is Fluoride?

Fluoride is a naturally occurring mineral found in the environment. Dirt, water, plants, and food organically contain small amounts of fluoride. As part of a significant initiative to enhance dental health, fluoride is added to dental products, supplements, and public drinking water.

Adults and children regularly consume fluoride through drinking water and foods grown in fluoride-containing soil or water. At these standard amounts, fluoride is safe! It's been added to public drinking water for over 70 years and has been robustly studied.

How Does Fluoride Prevent Cavities?

Fluoride is a tooth enamel repairer! Tooth enamel is the hard protective coating on teeth. Bacteria in the mouth release acids that erode tooth enamel. Fluoride, a mineral, repairs acid damage on the enamel in a process known as remineralization. Topical fluoride (like in toothpaste) and systemic fluoride (consumed from drinking water) help remineralization.

Fluoride also helps promote healthy teeth right from the start of infancy, before teeth even erupt! Fluoride consumed via formula, milk, and foods is used by the body to strengthen enamel while teeth are still in those cute baby gums. This process continues throughout childhood. As adult teeth form and erupt, fluoride from drinking water helps to strengthen tooth enamel before teeth erupt and enter the world of Skittles and juice.

Preventing Cavities is Important

Using fluoride as instructed is very important to help prevent cavities. Fluoride repairs damage and protects the teeth from future damage. Cavities are painful, can lead to infections, and can be traumatic for children to repair.

My daughter has had a few cavities, and despite my best efforts, she agonized for days before her filling appointments! It was very stressful for her. I'm glad that I did everything I could to prevent cavities, including using fluoride products as recommended.

Cavities also have significant effects if left untreated for too long. Besides the risk of infections, big cavities can lead to expensive dental repairs, sometimes even requiring anesthesia in kids to repair damage. Severe dental cavity damage has also been linked to growth impairment, trouble in school, problems with self-image, and many other detrimental effects.

Making Sure Your Child Gets Enough Fluoride

Talk to your dentist or pediatrician! Most kids in the United States get enough fluoride without significant parental effort—unless you count the daily wrestling match parents have with toddlers to get them to brush their teeth.

Use fluoride toothpaste:

• The American Academy of Pediatrics (AAP) and the American Dental Association (ADA) agree that parents should use fluorinated toothpaste on their kids.
• Look for a product with the ADA seal of acceptance.
• Use a tiny grain of rice-sized amount for babies and toddlers and a pea-sized amount for preschoolers and young kids. If they swallow some accidentally, those are safe amounts to ingest occasionally.
• Once your child is older and can reliably spit out toothpaste, you don't have to obsess over how much paste they use. Instead, focus on ensuring they brush well and for at least two minutes twice daily.

Consider fluoride mouthwash:

• If you wish, you can introduce fluorinated mouthwash to older kids. Just make sure they understand the "swish and spit" process.
• Some health professionals recommend using fluoride mouthwash daily if your child is prone to cavities.

Dental cleanings and topical fluoride application:

• See the dentist regularly for cleanings. Bring your child in every six months.
• Dentists use topical fluoride varnish to supplement home products and protect tooth enamel. Today's fluoride varnish is easy to apply and SO MUCH better than the ones we used as kids.

Remember that gross paste in the weird plastic tray thing? And you had to sit there uncomfortably with the tray in your mouth and try to talk to the dentist about your favorite sport or your summer vacation plans? Yup, that's a thing of the past. Today, a quick swipe with a paintbrush dries in seconds.

Kids today... they wouldn't have made it in the 80's!

Is Fluoride Safe for Kids?

Fluoride is safe at standard doses, which means eating and drinking normally and using fluorinated toothpaste, mouthwash, and dental products as directed. However, health risks exist if fluoride is taken excessively at continual high doses well over the standard amounts found in dental products and water.

• Fluoride given in excess can cause dental fluorosis, which is white or brown streaking on the teeth. Mild fluorosis can sometimes occur in childhood and is usually not detectable. Other than cosmetic streaking, there are no other health risks. If it happens, it often disappears by adolescence.
• Moderate or severe dental fluorosis, which is more significant staining, can lead to tooth damage. Severe dental fluorosis is very rare.
• With continual high doses of fluoride, there is also a risk of skeletal fluorosis due to too much fluoride in the bones. This is more serious and can have many effects, such as pain. It's extremely rare and not caused by fluoride in drinking water or dental products.
• Accidental overdose of high-dose concentrated fluoride, such as topical prescription products used at the dentist that are accidentally swallowed, could cause significant side effects like nausea, vomiting, and diarrhea. This is super rare and not likely to happen; pediatric dentists have safeguards to protect children from accidental overdoses.

Conclusion: Why Fluoride is Essential for Kids’ Dental Health

In conclusion, we recommend topical fluoride in dental products for all kids. Dental health is so important and is linked to many other conditions. Fluoride is safe at standard doses and with regular use.

If you have any concerns, talk to your pediatrician or dentist. If you live in an area without fluoridated water, you can also contact your healthcare provider. They may have strategies to ensure your child is getting enough!

Happy dental health month, and good luck with the tooth brushing battles! 😁

The following references were used to compile this information:

Fluoride. (n.d.). Retrieved February 25, 2025, from https://www.mouthhealthy.org/all-topics-a-z/fluoride

Fluoride for Children: Parent FAQs. (2020, November 24). HealthyChildren.Org. https://www.healthychildren.org/English/healthy-living/oral-health/Pages/FAQ-Fluoride-and-Children.aspx?utm_source=chatgpt.com

Office of Dietary Supplements—Fluoride. (n.d.). Retrieved February 25, 2025, from https://ods.od.nih.gov/factsheets/Fluoride-HealthProfessional/

This article has been reviewed by Andrea Morrissey, PharmD, Board Certified Pediatric Pharmacy Specialist, and Chief Content Officer of Kids Med Guide. The content is for educational and entertainment purposes only and does not replace professional medical advice. Always consult your healthcare provider for medical guidance, and call 911 in an emergency.

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