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Dental health and fluoride treatment

Fluoride treatment may be recommended by a dentist to help protect teeth and their enamel from decay.

Fluoride may be added to drinking water supplies in some areas, and is often found in toothpastes and mouthwashes.

Fluoride can help reduce dental decay by at least 40%.

A dentist may also suggest applying a fluoride varnish to the surfaces of the teeth.

In what forms is fluoride available?

Not all public water supplies in the UK are fluoridated. The decision to add fluoride is made by local health authorities in England and the Welsh Assembly in Wales. Scottish Water does not add fluoride to drinking water supplies.

Fluoridation of water for dental health is supported by the British Dental Association.

As well as being absorbed from drinking water, fluoride can also be directly applied to the teeth through fluoridated toothpastes and mouth rinses. Mouth rinses containing fluoride in lower strengths are available over-the-counter; stronger concentrations require a prescription. A dentist can also apply fluoride to the teeth as a gel, foam or varnish. These treatments contain a much higher level of fluoride than the amount found in toothpastes and mouth rinses. Varnishes are painted on the teeth; foams are put into a mouth guard, which is applied to the teeth for 1 to 4 minutes; gels can be painted on or applied via a mouth guard, but care is required in children to ensure the gel is not swallowed.

Fluoride supplements are also available as liquids and tablets. These are available over-the-counter or may be prescribed by your dentist or doctor, in particular to children who live in non-fluorinated water areas. It is important to make enquiries before use about what is a safe dose, especially for children. Supplements should only be used where the water supply contains less than 0.7 parts per million of fluoride, and not in children below the age of 6 months.

When is fluoride intake most critical?

It is certainly important for infants and children between the ages of six months and 16 years to be exposed to fluoride. This is the timeframe during which the primary and permanent teeth appear. However, adults benefit from fluoride too. Research indicates that topical fluoride, from toothpastes, mouth rinses and fluoride treatments, is as important in fighting tooth decay as in strengthening developing teeth.

In addition, people with certain conditions may be at increased risk of tooth decay and would therefore benefit from additional fluoride treatment. They include people with:

  • Dry mouth conditions: Dry mouth caused by diseases such as Sjögren's syndrome, certain medications (such as allergy medications, antihistamines, anti- anxiety drugs, and high blood pressure drugs), and head and neck radiation treatment makes an individual more prone to tooth decay. The lack of saliva makes it harder for food particles to be washed away and acids to be neutralised.
  • Gum disease: Also called gingivitis, gum disease can expose more of your tooth and tooth roots to bacteria, increasing the chance of tooth decay.
  • History of frequent cavities: If you develop a cavity frequently, you might benefit from additional fluoride.
  • Presence of crowns and/or bridges or braces: These treatments can put teeth at risk of decay at the point where the crown meets the underlying tooth structure or around the brackets of orthodontic appliances.

Ask your dentist if you could benefit from additional fluoride.

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