Dental Fluoride Treatment: Strengthening Enamel and Preventing Tooth Decay

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Have you ever noticed white spots on your or someone else’s teeth, and wondered what are they?

Dental Fluoride Treatment

The white spots reflect the demineralization of the tooth, meaning the tooth enamel is weaker in that region. 

It is losing its mineral content, which maintains the integrity of the enamel.

Demineralization is generally the first stage of tooth decay before the black cavity arises on your teeth.  These spots are usually seen near the gum line on the anterior tooth surface and the chewing surfaces of the posterior teeth. 

In this case, you should start the fluoride regimen as soon as possible. Flouride helps reverse the signs of tooth demineralization.

However, you can’t expect the white spots to go away completely. Flouride will halt the initial demineralization and will prevent it from turning into a full-blown cavity. 

Below we will discuss the significance of dental fluoride treatment and the options available in the market. 

What is fluoride? 

Fluoride is a naturally occurring mineral that helps build the outer layer of the tooth called enamel.

It forms stronger bonds with tooth calcium and phosphate that are naturally present in the tooth.

This mineral helps resist demineralization of the tooth by building strong internal bonds. However, everything stays good if taken in the desired quantity. Exceeding the dose may cause fluorosis and tooth discoloration. 

What is Dental Fluoride Treatment?

Understanding the role of fluoride in dental care

90% of adults aged between 20 to 64 have caries, and the prevalence exceeds 96% for individuals aged 64+.

Dental caries is a major dental disease that majorly occurs due to two reasons.

role of fluoride in dental care

One improper oral hygiene maintenance and two inadequate access to fluoride. Fluoride is a protective factor that exhibits anti-caries properties through these three basic principles: 

1 – Prevents Demineralization

It inhibits tooth demineralization by forming fluorapatite crystals within the enamel. It prevents the dissolution of minerals in the saliva when the pH of the mouth decreases with the intake of sugary foods. 

Regular topical fluoride application effectively inhibits demineralization by forming internal bonds with minerals like calcium inside the tooth enamel. 

2 – Promotes Remineralization 

It promotes tooth remineralization by attracting calcium ions.

When the saliva neutralizes the acidic pH, the ions that have been leached out from the tooth are forced back into the dental structure. Flouride enhances remineralization by rapidly forming fluorapatite crystals within the tooth. 

#3- Inhibits Plaque Bacteria 

It inhibits plaque bacteria by turning the internal bacterial environment into an acid. Flouride ions cannot cross bacterial cell walls in the neutral state.

However, when the environment of the mouth turns acidic, fluoride diffuses through the bacterial cell wall and inhibits the bacterial enzymes commonly enolase. This causes bacterial death.

What Puts You At A Risk of Developing Caries? 

Here’s a list of why you would develop white spots and caries and why you must need fluoride: 

– inadequate oral hygiene
– multiple active caries
– eating disorders like anorexia
– alcohol and drug abuse
– sugar-rich diet
– existing root restorations
– enamel diseases like amelogenesis imperfecta
– ongoing head and neck radiation therapy

8 Ways to Administer Flouride For Children and Adults 

There are various ways through which fluoride is administered. 

1) Community Water Fluoridation

This method is considered the most effective yet straightforward solution to prevent caries, especially in children with baby teeth. The United States Public Health Service recommends a concentration of 0.7mg of fluoride per liter of water to avoid caries and fluorosis. 

If the primary water source lacks fluoride, fluoride supplements are an alternative. Dentists recommend starting supplementation at six months of age if the water lacks fluoride. 

2) Dietary Flouride Supplements

These supplementation comes in various forms, just like your multivitamins. Tablets contain sodium fluoride as an active ingredient and come in preparation that includes 1.0, 0.5, or 0.25 mg of fluoride.

For infants, liquid fluoride supplementations with the help of the dropper. Children are recommended to chew the tablets or lozenges 1 to 2 minutes before swallowing to improve the topical effect of fluoride.

Here are a few recommended doses of fluoride for children living in areas with less than 0.3 ppm water fluoride content:

  • From six months to three years of age: 0.25 mg of fluoride per day.
  • From three to six years of age: 0.5 mg of fluoride per day.
  • More than six years of age: 1.0 mg of fluoride per day.

3) Flouride Mouthwash 

These mouthwashes improve the amount of fluoride in saliva. Over-the-counter mouthwashes of 230ppm sodium fluoride are recommended to use daily.

However, prescription fluoride mouthwashes with fluoride content exceeding 900ppm must be used once weekly.

Mouthwashes are only recommended for adults and children above six years of age as the swallowing reflexes are not completely developed before the age of 6.

4) Fluoride Varnishes 

The application of fluoride varnish twice a year shows a decline in caries by 37% in primary teeth and 43% in permanent teeth. The varnish is applied in the form of a thin layer on the areas where caries are easy to appear and propagate.

Usually, 22,600ppm fluoride formulations are used. Generally, these varnishes are safe to apply, and these are contraindicated in individuals having an allergy to rosins.

It falls under the category of professional fluoride treatment that takes place in a dental office. 

The American Dental Association recommends 22,600 ppm sodium fluoride varnish for children under six years.

5) Flouride Gel 

One of the common treatments in the dental office is the fluoride gel application.

Fluoride Gel

It is done twice a year with a minimum application time of 1 minute and a maximum of 4 minutes. These are available in multiple formulations ranging between 5000 to 12,300 ppm. These are applied through disposable trays.

The American Dental Association recommends 12,300 ppm fluoride gel application for children above six years.

6) Silver Diamaine Flouride 

To prevent caries in non-affordable areas, silver diamine fluoride works well. It’s a colorless alkaline solution with properties that arrest caries. It is an easy alternative to fluoride varnishes and gels. 

7) Slow-release Flouride Beads

These devices are meant to improve the overall concentration of fluoride in the oral cavity. These beads are budded on the teeth for years to come allowing them to release fluoride gradually for improved oral health. 

8) Flouride Toothpaste

A fluoride toothpaste will help you stay caries-free. Children should use toothpaste with fluoride levels of 1000 ppm up to three years old. Three years older must use toothpaste with fluoride levels up to 1500ppm.

Does Excessive Flouride Pose Risk to Teeth? 

Excessive intake of early childhood fluoride beyond 0.7 ppm I’m drinking water may cause fluorosis. Children under the age of 6 are at risk of fluorosis on permeant front incisors and 1st molars. 

It’s a condition with brown and white discoloration of teeth which gives rise to aesthetic and cosmetic concerns in later lives. 1 in every 4 Americans have fluorosis.

Fluorosis can be classified as mild, moderate, and severe. This is why it is advisable to supervise children with their toothbrushing when aged under six as their swallowing reflexes are immature, and they might swallow fluoride toothpaste.

Excessive Flouride

Too much fluoride can cause:

– white and brown specs on teeth
– staining on teeth 
– pitting on teeth

overdose of fluoride can cause:

– nausea
– diarrhea 
– sweating
– fatigue

Who Can Benefit from Dental Fluoride Treatment?

Anyone can need a supplemental fluoride treatment to meet their needs.

Your dentist will advise you on which treatments suit your situation and how you should move forward with your fluoride applications.

Children and adolescents

Dental caries is one of the most common diseases seen in children and adults. Regular dental visits and frequent fluoride application are advisable in growing ages to prevent them from having caries. 

Adults with a high risk of tooth decay

It is advisable to get fluoride treatment twice a year for adults because, with growing ages and improper lifestyles, teeth need supplemental sources of fluoride to stay in the best health. This goes in hand with proper brushing and an immaculate oral hygiene regimen. 

Individuals with braces

Dental Fluoride

During an orthodontic treatment with braces and wires, demineralization is easy to occur.

Cleaning with toothbrushes gets difficult with braces, so white spots appear over time. It is recommended to get fluoride treatment before the white spots turn into full-blown caries.

How Does an In-Office Flouride Application Process Looks Like? 

Step # 1: Position the Patient

For an adult position the patient in a supine position comfortably.

For an infant or a toddler, place the child on the parent’s lap with the head on the dentist’s knees and legs around the parent’s waist. Hold the hands on the child so that he won’t move during the treatment. 

Step # 2 – Apply the fluoride varnish 

Dry all the teeth with a cotton gauze and apply a thin layer of varnish on all the teeth. Allow it to set. The whole procedure will generally take 2 to 3 minutes only. Repeat the procedure 2 to 4 times a year.

Step #3: Give aftercare instruction

Ask the patient not to eat and drink for 30 minutes following the treatment. Also, ask to maintain oral hygiene and to get fluoride varnishes when next appointed.


How much does fluoride treatment cost? 

Usually, fluoride in-office applications are covered under insurance. It may cost somewhere between $50 to $100. You may enquire about this from your nearest dental clinic.

How long does the effect of fluoride treatment last? 

The treatment can last between 3 to 6 months. It is advisable to get two in-office fluoride application treatments every year.

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