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| |    Fluoride by Amy A. Napierala, D.D.S. reviewed by Laura Jana, M.D., F.A.A.P. There's a very good reason why toothpaste and many water supplies contain fluoride: It's a proven cavity fighter. This naturally occurring substance strengthens the outer surface of teeth (enamel), making it more resistant to the destructive effects of the acidic reaction that takes place after eating. A small amount in the diet of the mother while she is pregnant and then in the child's own diet greatly decreases the possibility of tooth decay. There are two ways fluoride can be used to keep your child's teeth healthy: by swallowing (or ingesting) it, or by applying it directly to the tooth's surface (topical application). Ingested fluoride Before he even cuts his first tooth, your child needs to ingest fluoride to ensure the proper development of his enamel. The most common (and easiest) way to accomplish this is by drinking fluoridated tap water. Your water company should be able to tell you whether your community's water supply contains fluoride and if so, how much. Keep in mind that adequate fluoridation is 0.7 to 1.0 parts per million. If you use well water, ask your dentist or local health department to measure its fluoride content. Also, think about your child's access to other water sources. His school or daycare water may supply an adequate amount of fluoride even if your tap water at home is not fluoridated. If it appears that your child isn't getting enough fluoride, his dentist can prescribe supplements in the form of little chewable pills or special vitamins. Most babies do not need fluoride until after six months of age. Some clinicians recommend supplemental fluoride for breastfed babies, depending on whether or not the baby gets fluoride in water. If you use fluoridated tap water to mix your baby's formula, he's probably getting a sufficient amount. Topical fluoride Once your child's teeth come in, it's important to maintain the strength of his tooth enamel, and that's where topical fluoride is helpful. Toothpaste, fluoride treatments given at routine dental visits, over-the-counter rinses, and concentrated gels are all common forms of topical fluoride. Often, toothpaste is the product of choice, since swallowing topical fluoride can be harmful. If your child is old enough to avoid inadvertently swallowing a rinse or a gel (generally age six years or older), he can use one of these products in addition to brushing and flossing. Ideally, your child should avoid eating or drinking for 30 minutes following a fluoride treatment to allow for maximum absorption of the fluoride. Some children are more at risk for developing cavities because their saliva has a higher level of the bacteria that cause cavities or because they wear an orthodontic appliance. You can combat this higher risk, however, with additional topical fluoride. Too much fluoride Be sure to monitor your child's fluoride consumption carefully. The substance is key to the healthy formation and maintenance of teeth, but if taken in excess, it can actually interfere with the proper formation of enamel. It also can cause unattractive white and brown specks on the teeth or change the tooth surface from smooth to bumpy or pitted. Unfortunately, most young children will attempt at one time or another to eat toothpaste, putting them at risk of getting too much fluoride. Make sure that your child uses very small amounts--pea size is good--and keep the toothpaste, and any fluoride supplements, out of a little one's reach.
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