Fluoride Preventative Therapy

What is fluoride and how does it work?

Fluoride is nature’s cavity fighter, it occurs naturally in varying levels in rivers, lakes, oceans and certain food and beverages. Fluoride is also added to toothpaste and drinking water, which can increase the level of fluoride obtained to the recommended levels for tooth protection. Per the American Dental Association, when obtained in the correct dosages, fluoride poses no risk of toxicity or harmful effects. Because of this, fluoride is beneficial to both adults and children. Teeth become weakened by bacterial plaque, sugary and acidic food and beverages, clenching or grinding teeth, and acid reflux or sleep apnea due to erosion and/or wear. When the outer layer of the tooth (enamel) is weakened, fluoride helps to rebuild and remineralize this weakened layer. Fluoride also acts to inhibit bacterial metabolism, the by-products of which breakdown enamel. 

What are the different types of topical fluoride available to me? 

Over-the-counter toothpastes include a low level of fluoride (1,000-1,500 ppm) that is taken up by the bacterial plaque and into demineralized lesions. It will increase the fluoride levels in saliva for about 1-2 hours after application.

Prescription toothpastes (ClinPro, Prevident) contain 5,000 ppm of fluoride, offering higher levels of fluoride in the 1-2 hours after application. This toothpaste is recommended in patients who have a higher risk of cavities, have generalized initial breakdown of enamel noted radiographically or during an exam, have root exposure from gum recession, tooth sensitivity and more. Prescription toothpaste can be used morning and/or night time, but its instructions for use are different than OTC toothpaste. With prescription toothpaste, you should spit out the excess, do NOT rinse and ideally do not eat or drink for a minimum of 30 minutes after application. 

Professionally applied fluoride (a varnish application in our office), has 22,600 ppm fluoride and therefore does not need as frequent of application. Once painted on the teeth, saliva helps set the fluoride so that it has a sustained application for several hours. Per the ADA, fluoride varnishes must be applied twice a year (the common frequency of routine cleanings) to have a sustained benefit.