Fluoride Treatment

Although most people receive fluoride from food and water, sometimes it is not enough to help prevent decay.  Your dentist or dental hygienist may recommend the use of home and/or professional fluoride treatments for the following reasons:

• Deep pits and fissures on the chewing surfaces of teeth.
• Exposed and sensitive root surfaces.
• Fair to poor oral hygiene habits.
• Frequent sugar and carbohydrate intake.
• Inadequate exposure to fluorides.
• Inadequate saliva flow due to medical conditions, medical treatments or medications.
• Recent history of dental decay.

Custom Fluoride Trays:

Some medical conditions, medical treatments or medications can put a person at high risk for developing dental decay.  Examples are xerostomia (dry mouth), physical impairments making it difficult to brush and floss adequately, Alzheimer's, and other forms of dementia.  In many such cases, we recommend the use of custom fluoride trays to be used at home for the daily application of fluoride.  While daily application of fluoride with custom fluoride trays will not eliminate the risk of tooth decay, it will reduce the risk and slow progression.

Custom fluoride trays are fabricated in our laboratory after making impressions of your teeth.  They adapt perfectly to your teeth, ensuring maximum fluoride exposure to all the tooth surfaces.  Follow these guidelines when using custom fluoride trays at home...

Systemic fluoride strengthens the teeth that have erupted as well as those that are developing under the gums.  We gain systemic fluoride from most foods and our community water supplies.  It is also available as a supplement in drop, tablet or gel form and can be prescribed by our office.  Generally, fluoride drops are recommended for infants, and tablets are best suited for children up through the teen years.  It is very important to monitor the amounts of fluoride a child ingests.  If too much fluoride is consumed while the teeth are developing, a condition called fluorosis (white spots on the teeth) may result.

If you are interested in giving fluoride supplements to your child, or if you currently do and would like more information, the following should help guide you in the proper dosing and administration of fluoride to your child. 

For residents with well water in the Baltimore area, we do recommend fluoride supplementation for your child.  Fluoride addition to municipal drinking water is one of greatest public health improvements of the 20^th century.  Where implemented, it has reduced the incidence of dental caries (cavities, decay) by 50-70%.

Well water in the Baltimore area generally does not contain fluoride.  Approximately 10% of Baltimore County wells have been found to contain low levels of fluoride, in the range of 0.2 - 0.3 parts per million (ppm), which is insignificant and will not contribute to fluorosis of the teeth (brown and white mottled staining of the teeth from over-ingestion of fluoride during tooth development).  Baltimore city water, on the other hand, does contain approximately 1 ppm of fluoride and therefore, fluoride supplementation is not recommended.

Fluorosis can occur due to over-ingestion of fluoride from other sources, such as mouthrinses (ACT and Fluorigard), prescription fluoride gels and toothpastes (Prevident, GelKam, etc.), and normal fluoride-containing toothpastes.  Children under 6 years of age have difficulty eliminating toothpaste from their mouth (spitting) adequately, and should be watched carefully when brushing their teeth to ensure they are using only a pea-sized amount of toothpaste and are not swallowing the toothpaste.  This is not such a concern for children over 6 years of age, but fluoride-containing materials should not be swallowed at any age.

Because of the low levels of fluoride found in area well water, we recommend fluoride supplementation for your children up to the age of 16 to ensure maximum protection against dental decay. 

The following chart summarizes dosages at various ages for the two products we prescribe here.  Follow it carefully to provide maximum cavity protection for your children without risk of them developing dental fluorosis. 

Remember, fluoride alone will not prevent tooth decay!  It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.