Is Fluoride Toothpaste Good for You?

Do I really need to use Fluoride toothpaste?

This is a hot debate and a topic I am frequently asked about. Let’s debunk the myths on Fluoride in toothpaste.

What is fluoride?

Fluoride is good for your teeth. It is known as the natural mineral which is nature’s cavity fighter. It occurs naturally in your bones and teeth. Science has proven that people who use fluoride toothpastes have stronger teeth and as a result will have less decay on their teeth. According to Oral Health Foundation UK, it has also been scientifically proven that If you have teeth with early signs of decay, the decay will reduce after repeated use of Fluoride toothpaste over a long period of time.

Fluoride can be found in toothpaste, tap water, mouth rinses, fluoride varnishes applied by your dentist, and vitamin supplements. Fluoride can also be found in black teas, black coffees and some shellfish.

How does Fluoride work?

Fluoride works by making the structure of the dental enamel more resistant to the acids that eat away at the enamel. It forms a special bond with the calcium and phosphate in your enamel making the enamel stronger. This process is called remineralisation.

Why do I need fluoride in my toothpaste?

This is a question I get asked a lot, especially as my patients become more health conscious.  I have noticed that my patients who don’t use fluoride have a higher chance of having decay on their teeth. If they are in a medium or high caries risk category, I will suggest they use a fluoride toothpaste in conjunction with their fluoride free toothpaste – so maybe every night before bed they use fluoride toothpaste and the fluoride free toothpaste for the morning brushes. This is a nice compromise that does help to bring my patients back into a low caries risk category.

Is Fluoride bad for me?

If fluoride is ingested in very large quantities, it is toxic. The amount you would need to ingest in one go to make it toxic is roughly 5-10g in an adult and 500mg in a child. People ask – what will excess fluoride do to my body? It would lead to kidney failure, or gastrointestinal issues, neurological problems or heart problems, and if untreated could then result in death.

Fluoride in large amounts in water or toothpaste over a long period of time can also result in fluoride induced fluorosis, which is when the enamel becomes discoloured in a very specific way that makes it easy for the dentist to diagnose fluorosis. It can present as white streaks in the enamel or in very severe cases, pitting and discoloration. In very extreme cases, exposure to high levels of fluoride over a long period of time can lead to skeletal fluorosis, meaning the fluoride has affected the bones and can result in fracture of the bones in older adults. Fluorosis is more prevalent in countries where the tap water has very high levels of fluoride – these are levels in excess of 1.5ppm (parts per million) of fluoride in the water.

What levels of fluoride are in toothpaste?

Children’s toothpaste usually contains anything from 500-1000ppm of fluoride. Adult toothpastes have anything from 1000-1500ppm. There are also some toothpastes which have very strong levels of fluoride, and these tend to be prescription only, such as Colgate Duraphat toothpaste which has 5000ppm. People worry that this level of fluoride in toothpaste is too high and so it could be bad for you. The reason why it is prescription only is because of the exceptionally high levels of fluoride which is not great for everyone and can have potentially adverse effects if not used correctly or excess amounts are swallowed.

Do my kids need fluoride in their toothpaste?

It is a good idea for children to use a toothpaste with fluoride. The fluoride will reduce the chances of decay and strengthen the teeth. It is important to make sure you are using a children’s toothpaste which has the correct amount of fluoride for the correct age group. They should only use a small smear or pea sized amount of toothpaste. If your child swallows their toothpaste while brushing, this is not harmful, as the amount of fluoride in the toothpaste is not enough to become toxic. It is good to supervise toothbrushing as some kids find toothpaste very yummy and you don’t want them to swallow the whole tube of toothpaste. If this does happen, it is best to take them to A&E. Your child may show signs of vomiting, nausea and other unpleasant symptoms. If you are really concerned about fluoride, there are also some fluoride free alternative toothpastes which are available for children.

Is there Fluoride in my tap water?

Almost all tap water will contain fluoride, but this is usually in very low doses. Some areas will adjust the levels of water so that there is fluoride occurring in water, this ensures communities have the correct amount of fluoride to avoid decay.  If fluoride is added to the water, it will be in the range of 0.7-1.2 ppm so that means there is 0.7-1.2 part of fluoride for every million litres of water. In London we have 0.7ppm of fluoride in the water. The decision on whether or not to add fluoride to water is dependent on each local authority.  It is important to find out how many parts per million of fluoride are in the tap water in your area. This will also help you decide if you need to supplement with fluoride in your toothpaste. You local water supplier can provide this information for you.

Why did Europe ban Fluoride in the water?

Some European countries banned fluoridation after their governments found insufficient evidence of safety of adding fluoride to the water. There was also a group of practitioners in Netherlands who provided proof that fluoride in the water had a negative effect on a small percentage of the population. In America, activists have rebelled against fluoridated water as they believe they have the right to consent to medical treatment.

What are the best Fluoride free toothpastes?

There are so many different options available. For children, the Green People have fun flavoured toothpastes such as organic mandarin and aloe vera toothpaste. They also have adult toothpastes such as fennel and propolis, mandarin and aloe vera, minty cool toothpaste and peppermint and aloe vera.

If you have any questions about whether or not you should be using a fluoride based toothpaste, you would need a consultation with the dentist for a full assessment and depending on which caries risk category you fit in, they will advise you accordingly. Contact us to book your consultation with one of our dentists.