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Fluoride is a compound that contains fluorine, a natural element. Using small amounts of fluoride on a routine basis can help prevent tooth decay. In areas where fluoride does not occur naturally, it may be added to community water supplies. Research shows that community water fluoridation has lowered decay rates by over 50 percent, which means that fewer children grow up with cavities. Fluoride can be found as an active ingredient in many dental products such as toothpaste, mouth rinses, gels and varnish.

Fluoride inhibits lots of minerals from tooth enamel and encourages remineralization (strengthening areas that are weakened and beginning to develop cavities). Fluoride also affects bacteria that cause cavities, discouraging acid attacks that break down the tooth. Risk for decay is reduced even more when fluoride is combined with a healthy diet and good oral hygiene.

Fluoride should be considered for all children between 6 months and 16 years of age who drink fluoride-deficit water. The pediatric dentist takes into account many factors before recommending a fluoride supplement. Your child’s risk of developing dental decay and other dietary sources of fluoride are important considerations. Infant formulas contain different amounts of fluoride. Bottled, filtered and well waters also vary in the amount of fluoride they contain. Your pediatric dentist can help determine if your child is receiving -- and not exceeding -- the recommended amount.

Using fluoride for the prevention and control of decay is proven to be both safe and effective. Nevertheless, products containing fluoride should be stored out of the reach of young children. Too much fluoride could cause fluorosis of developing permanent teeth. Fluorosis usually is mild, with tiny white specks or streaks that are often unnoticeable. In severe cases of fluorosis, the enamel may be pitted with brown discoloration. Development of fluorosis depends on the amount, duration and timing of excessive fluoride intake. The appearance of teeth affected by fluorosis can be greatly improved by a variety of treatments in esthetic dentistry.

When determining the risk-benefit of fluoridated toothpaste for very young children, the key issue is mild fluorosis versus preventing devastating dental disease. Talk with the pediatric dentist about your child’s risk for developing cavities. Fluoridated toothpaste is recommended for children under two-years-old at moderate or high caries risk. All children ages 2 and above should use toothpaste with fluoride and the American Dental Association Seal of Acceptance.

Parents should dispense the toothpaste to prevent their young children from swallowing too much fluoride. Brushing twice a day (after breakfast and before bedtime) provides greater benefits than brushing once daily. For children under two-years-old, use a smear of toothpaste. For those aged 2 to 5 years, a pea-sized amount to decrease the risk of fluorosis. Rinsing after brushing, however, should be kept to a minimum to increase the beneficial effects of fluoride.

Topical fluoride is a preventive agent applied to tooth enamel. It comes in a number of different forms. A dental professional places gels or foams in trays that are held against the teeth for up to 4 minutes. Fluoride varnish is brushed or “painted” on the enamel. Varnish is especially useful for young patients and those with special needs who may not tolerate fluoride trays.

Children who benefit the most from fluoride are those at highest risk for decay. Risk factors include a history of previous cavities, a diet high in sugar or carbohydrates, orthodontic appliances, and certain medical condition such as dry mouth. If your school-age child is at high risk for decay, the pediatric dentist may recommend an at-home fluoride rinse or brush-on gel.