Fluoride Toothpaste: How It Works

    Fluoride Toothpaste: How It Works
    Published 18 March 2020
    Fact Checked
    Eugenia Tikhonovich, MD
    Reviewed by Eugenia Tikhonovich, MD, Obstetrician-Gynecologist, Medical Consultant
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    Toothpaste with fluoride helps prevent enamel breakdown. Read on to learn more about fluoride and its benefits, and to make sure you’re using fluoride toothpaste correctly.

    What is fluoride?

    Fluoride is naturally present in different water sources including lakes, rivers, and oceans. Fluoride is also naturally found in different levels in some foods and beverages. Fluoride is added to dental products including toothpaste to help protect your teeth from developing cavities.

    Tooth decay (leading to cavities) is a common disease that affects millions of people all over the world. Fluoride helps prevent tooth decay, and many toothpaste brands add it to their products. Fluoride has been used in toothpaste for a long time to prevent tooth decay. Dental experts recommend regular toothbrushing to prevent the occurrence of dental decay, cavities, and other types of oral diseases. They generally recommend brushing your teeth for two minutes twice a day using fluoride toothpaste.

    In some areas, fluoride is added to the drinking water to help further prevent cavities. In 2012, about 75 percent of the population of the United States had access to fluoridated water.

    The importance of fluoride

    Fluoride is nature’s cavity fighter. It is beneficial for both adults and children. Before babies have teeth, the fluoride in dietary supplements, foods, and beverages makes the enamel (the hard outer surface of your tooth) stronger, making it easier to fight dental decay. This is what is called the “systemic benefit” of fluoride.

    After babies’ teeth erupt, fluoride helps rebuild weakened enamel and reverses initial signs of dental decay. When you brush your teeth using fluoride toothpaste or other dental products with fluoride, you apply fluoride to the surface of your teeth. This is what is called the “topical benefit” of fluoride.

    Some of the foods and beverages you consume also produce a topical benefit if they contain fluoride, which helps rebuild weakened and diminished tooth enamel.

    Fluoride is used to help prevent tooth decay in a wide variety of products such as:

    • Fluoride toothpaste
    • Milk
    • Water
    • Varnish
    • Tooth gels
    • Mouth rinses

    Brushing your teeth regularly with fluoride toothpaste is one of the most effective ways to prevent dental decay.

    Benefits of using fluoride toothpaste

    All kinds of toothpaste help remove plaque, which is a bacterial covering that forms on your gums and teeth every day. Plaque can lead to tooth decay and gum disease. In addition to removing plaque, fluoride toothpaste helps prevent dental decay by strengthening the tooth enamel.

    The amount of fluoride in toothpaste is usually printed on the label in parts per million (ppm). There are lots of different brands with differing levels of fluoride available. The typical strength of family or regular toothpaste is about 1,000 to 1,500 parts ppm fluoride.

    Higher-concentration fluoride toothpaste is usually only available as a prescription. Toothpaste with a stronger concentration of fluoride may provide greater protection from dental decay, but it may also increase the risk of fluorosis (defects of enamel) in children who are still developing their teeth.

    After babies’ teeth erupt, fluoride helps rebuild weakened enamel and reverses initial signs of dental decay. When you brush your teeth using fluoride toothpaste or other dental products with fluoride, you apply fluoride to the surface of your teeth.

    Research states that toothpaste with 1,000 to 1,250 ppm fluoride is more effective at preventing tooth decay than fluoride-free toothpaste. The stronger the concentration of fluoride in a toothpaste, the more it prevents tooth decay. If you have any concerns about the strength of your toothpaste, your doctor or dentist can suggest the concentration that’s best for you and your children. 

    In general, toothpaste that contains 1,350 to 1,500 ppm fluoride is among the most beneficial and effective. Your dentist may recommend using a higher-strength fluoride toothpaste if you or your child are at a higher risk of developing dental decay.

    Recommendations and tips for teeth brushing

    • For children under three, you should start brushing their teeth as soon as they start erupting by using a smear of toothpaste with fluoride (about the size of a grain of rice is enough). Brush their teeth twice a day in the morning and at night, or as recommended by your doctor or dentist. The toothpaste should have at least 1,000 ppm fluoride.
    • For children between three and six, help them brush with a pea-sized amount of toothpaste with fluoride. They should brush their teeth twice a day in the morning and at night, or as recommended by your doctor or dentist. The toothpaste should have more than 1,000 ppm fluoride.
    • It’s a good idea to supervise your children while they brush to make sure that they are being thorough and using the right amount of toothpaste.
    • Adults should brush their teeth at least twice a day with a fluoride toothpaste that contains 1,350 to 1,500 ppm fluoride.
    • Avoid using mouthwash simultaneously with brushing your teeth. Instead, use it alternatively, because using a mouthwash after brushing can wash away the fluoride from the toothpaste.

    Some people have voiced concerns about the association of fluoride with various health conditions. There has not been any evidence to support these claims, and there’s no evidence that using fluoride in normal amounts causes any health problems. 

    Excessive fluoride exposure when a child is developing their teeth can lead to a dental condition called dental fluorosis.

    What is fluorosis of dental enamel?

    Dental fluorosis changes the appearance of dental enamel. It only happens when young children consume an excessive amount of fluoride over a long period of time while their teeth are still developing. Dental fluorosis isn’t easily visible to a casual observer or the affected person, and usually only the dentist or a trained professional can detect it.

    Mild dental fluorosis looks like very fine white pearly lines or flecking on the tooth. Severe dental fluorosis may cause the enamel to become discolored or pitted.

    Your doctor or dentist can help you determine the amount of fluoride and brushing frequency that are best for you and your children. 

    How much fluoride is there in toothpaste?

    There are lots of different fluoride toothpastes with different fluoride levels available. A fluoride toothpaste with 1,350 to 1,500 ppm of fluoride is the most effective at preventing dental decay. Your dentist or doctor may recommend using a higher-strength fluoride toothpaste if you or your child’s teeth are more prone to decay. Toothpaste with fluoride is a safe and effective way to keep your teeth healthy and clean.

    History of updates

    Current version (18 March 2020)
    Reviewed by Eugenia Tikhonovich, MD, Obstetrician-Gynecologist, Medical Consultant
    Published (18 March 2020)

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