Dental care - fluoride

Fluoride is a mineral found in food, water, plants and toothpaste. Brushing with fluoride toothpaste and drinking fluoridated water helps to protect teeth against decay. Water fluoridation is recommended by leading national and international health organisations.

Fluoride is a natural substance

Fluoride is not a medication. It is a mineral found naturally in rock, air, soil, plants and water. All fresh and sea water contains some fluoride.
Many foods and drinks naturally contain fluoride. It is also added to:

• Drinking water, where fluoride is added to the local water supply
• Fluoride toothpastes, gels and mouth rinses
• Fluoride products painted on the teeth by a dental professional.

Water fluoridation helps protect teeth against decay

Tooth decay occurs when acid attacks the surface of the tooth. Fluoride helps repair any damage before it becomes serious. A constant low-level supply of fluoride is best for this. Fluoride in your drinking water is like a constant ‘repair kit’ for your teeth.
Dental decay affects the community in many ways, including pain, suffering and cost.

Benefits of water fluoridation

Fluoride is helpful because it:

• Helps protect against tooth decay in children and adults
• Repairs weak spots that could become cavities (holes in teeth) on the surface of the tooth
• Reduces the amount of money people need to spend on dental treatment
• Saves the community money and time (away from work and school)
• Reduces discomfort and pain caused by tooth decay
• Provides a benefit to all people, especially individuals from low socioeconomic communities, who have less access to other forms of fluoride treatments.

Adult and baby teeth need protection from decay

Fluoride can help to protect young and old teeth because it:

• Helps protect against surface decay in older adults
• Helps protect against tooth decay in children
• Helps prevent early loss of baby teeth due to decay. Baby teeth are important because they help to guide the adult teeth developing underneath into the right place. Losing baby teeth early may result in the need for orthodontic treatment
• Helps prevent painful and costly dental complications like tooth abscess or other permanent tooth damage.

Other ways to help protect your teeth

Even if your water is fluoridated, it is important that you look after your teeth by:

• Eating a healthy diet
• Brushing and flossing your teeth regularly
• Having regular dental check-ups
• Using a toothpaste with fluoride in it.

Protecting your children’s teeth

Children’s teeth need particular protection as they develop. Suggestions include:

• Brushing teeth without toothpaste until the age of 18 months
• Introducing a low-fluoride toothpaste when a child is approximately 18 months old. Choose a low-fluoride toothpaste designed especially for children
• Using a child-size toothbrush with soft bristles
• Using only a pea-size amount of toothpaste, smeared over the toothbrush
• Encouraging children to spit out toothpaste, not swallow it. Don’t rinse
• Supervising children when they brush their teeth until you are sure they can do it well
• Continuing to use low fluoride toothpaste for children until they are six years old
• Don’t use fluoride supplements in the form of drops or tablets to be chewed or swallowed. They can affect the development of your child’s adult teeth.

If your drinking water is not fluoridated, seek professional dental advice about the use of fluoride toothpaste for children. A dental professional may advise more frequent use of fluoride toothpaste, commencement of toothpaste at a younger age or earlier commencement of use of standard toothpaste.

Dental fluorosis

Too much fluoride at an early age can cause a child’s adult teeth (which form underneath their baby teeth) to stain. This is called dental fluorosis. Dental fluorosis looks like fine, pearly-white mottling, flecking or lines on the surface of the teeth; it is usually very hard to see. It cannot develop after teeth are fully formed and does not affect the function of the teeth. Dental fluorosis can occur in areas with or without water fluoridation.
By following the toothpaste guidelines above, the chance of dental fluorosis occurring can be minimised.
If fluoride is not the cause of staining of the teeth, it is not called dental fluorosis. Mottling of the teeth may be caused by other things including

• Injury to the teeth
• Certain medications
• Childhood infections.

Water quality and fluoride

Water fluoridation does not noticeably change your water. Some facts about fluoride and the quality of your water are:

• Adding fluoride to the water does not change the taste or smell of your drinking water, as fluoride has no taste or smell.
• Your local water authority will be able to tell you if your supply has fluoride added to it.
• All Australian capital cities have fluoride added to the water.
• Boiling the water does not significantly change the levels of fluoride added.
• Most home water filters do not remove fluoride, with the exception of reverse osmosis systems.

Safety and water fluoridation

Water fluoridation is supported by leading Australian and international health, medical and dental organisations due to the following:

• The latest evidence confirms that water fluoridation is a safe and effective way to help protect teeth against decay.
• There is no evidence that fluoride in water fluoridation programs affects bone development or causes hip fractures or cancer.
• Fluoride is added to water in carefully controlled amounts. The total amount of fluoride in the water is monitored on a regular basis.
• Only very small amounts are used.

Water fluoridation is recommended

Many leading local, national and international health organisations endorse water fluoridation, including:

• Arthritis Australia
• Australia’s National Health and Medical Research Council
• Australian Dental Association
• Australian Institute of Health and Welfare
• Australian Medical Association
• Cancer Council Victoria
• Diabetes Victoria
• FDI World Dental Federation
• Osteoporosis Australia
• Public Health Association of Australia
• The Pharmacy Guild of Australia
• World Health Organization

Where to get help

• Water fluoridation, Department of Health
• Your dental professional
• Your local water authority