Fluoride Supplements and Treatments


Fluoride is known to strengthen teeth and is an element that occurs in nature. By strengthening the teeth, fluoride is effective in lowering the incidence of decay in teeth. Several sources of fluoride are available to the public, and experts recommend using a variety of sources. Water naturally contains fluoride in very small quantities. Several foods and beverages naturally contain fluoride, for example eggs, fish, meat, and tea. Many communities have added fluoride to their drinking water, and the majority of toothpastes, mouth rinses, and treatments in the dental office contain fluoride. Fluoride tablets are available with a prescription for children who do not live in areas where fluoridated drinking water is available.

Uses of Fluoride:

The outer visible layer of the tooth's crown is made out of hydroxyapatite crystals packed very closely together. On a daily basis, these minerals are lost (also known as demineralisation) and gained (also known as remineralisation) by the teeth. When these processes are balanced, the tooth remains healthy.

Demineralisation is caused when bacteria builds up on your teeth and forms dental plaque. Dietary sugar supplies the energy source for these bacteria, and the end-product of the bacterial metabolism is acids. The tooth enamel crystals are dissolved by these acids. Remineralisation is the process of the enamel being built up again. During remineralisation, several minerals which include phosphate, calcium and fluoride are incorporated into the enamel. When an unbalance occurs and demineralisation dramatically outweighs the remineralisation process, enamel is lost and the decay process begins.

Fluoride replaces the hydroxyl groups in the hydroxyapatite crystals strengthening the teeth by making the crystals less dissolvable and speeding up the remineralisation process. Fluoride also plays a role in inhibiting the bacteria's ability to make acids. Fluoride is absorbed by the teeth by two means. One of these is through children consuming fluoridated foods and beverages and/or supplements. This way, fluoride is absorbed and enters the circulation to become incorporated into the teeth during their development. As a result, the teeth are strengthened, making it more difficult to dissolve the enamel by bacterial acids.

Fluoride enters the mouth and directly enters tooth enamel. This occurs in several ways:

  • During dental office fluoride treatments
  • During teeth brushing with fluoride toothpastes or using fluoride rinses
  • During fluoridated water drinking

In-office fluoride treatments are regularly used during a child's regular check-up, every six months. However, if children are at higher risk of dental decay, they will require extra fluoride. These fluoride treatments help to support tooth remineralisation. The in-office and/or supplemental fluoride serve as additional defence against dental decay, even with the consumption of water that is fluoridated.

In children over 6 years old, who have a history of cavities, mouth rinses containing fluoride can help. They are available over-the-counter. The dentist may also prescribe fluoride gels and rinses that contain increased levels of fluoride in certain cases.

Fluoride supplements are generally prescribed by a dentist or a paediatrician to the 6-16 year old category of patients who have no access to fluoridated drinking water. Either tablets or liquids are available, depending on the age of the patient.

Both primary and adult teeth can be helped with fluoride. Basically, anybody at risk for developing tooth decay should receive fluoride treatments.

The following reasons should be considered when evaluating whether additional fluoride should be used with a patient:

  • Dental caries history
  • Not visiting the dentist regularly
  • Unsatisfactory oral hygiene habits
  • Snacking frequently, especially on sugar-containing snacks.

Several medications can cause dry mouth (i.e., xerostomia), including medications used of hypertension, allergies, depression and anxiety. Xerostomia worsens the decay process.

Fluoride Treatment Preparation

Clean your teeth thoroughly before visiting your dentist for fluoride treatment in the office. Stains on your teeth will be polished away by the dentist or dental hygienist. For home fluoride treatments using gels and/or rinses, and brush and floss your teeth thoroughly prior to using the fluoride-containing product. The best time to use these products are right before bedtime, so that they will stay in the mouth longer, and are less likely to be washed away by foods and beverages.

The Procedure

In-office fluoride treatments contain a higher concentration of fluoride than fluoride-containing products found in stores, and are chemically different; thus allowing the fluoride to stay on the teeth longer. Both children and adults can receive in-office fluoride treatments.

The different types of topically applied fluoride are, acidulated phosphate fluoride (APF) which is acidic as the name implies, and neutral sodium fluoride. People with xerostomia or have white tooth coloured fillings, bonding, veneers, or crowns and bridges, receive neutral sodium fluoride. Fluoride that is acidic can cause mouth irritation when there is mouth dryness, and cause small irregularities in the tooth coloured fillings.

In the dental office, fluoride that is used is either in the form of a varnish, foam, or gel. Prior to the application of the fluoride, the teeth are dried so as not to dilute the fluoride. Trays that resemble mouth guards are used for between 1-4 minutes, to apply the fluoride; or, the dentist can paint the fluoride right onto the teeth surfaces. Fluoride comes in several flavours and should be spit out after application and not swallowed.

Children usually take fluoride supplements in small quantities, from between 0.25-1 mg daily. The strength is dependent on the child's age and level of fluoride in the drinking water. The dentist will not prescribe over 264 mg of fluoride tablets at one time, due to the possibility of overdose. Children that are 2 years old and weigh 22 pounds develop fluoride toxicity at a 320 mg dose. Therefore, do not stock up on fluoride tablets, and call your dentist or paediatrician if you should have any concerns or questions.

When brushing, use toothpaste that contains fluoride, but watch your young children to make sure that they do not swallow the toothpaste. Only place an amount the size of a pea on your child's toothbrush, and make sure that they spit out after they brush. By avoiding flavoured toothpaste, your child will be less likely to swallow it. But, still keep an eye on them. Post Fluoride Treatment

No eating, smoking, or drinking after yours or your child's fluoride treatment for 30 minutes, as this helps the fluoride to stay on the teeth.


If fluoride is used properly, it is very safe. But, parents should be aware of high levels being used by their children. Keep fluoride products and supplements out of reach of small children. The toxic dose of fluoride is essentially based on the weight of the child. Six hundred fifty five (655) mg is toxic for a 45 pound, 8 y.o. child. In contrast, a glass of fluoridated drinking water contains 0.25 mg, and a pea-sized amount of toothpaste contains approximately 0.24 mg of fluoride.

When properly used, fluoride is efficient and safe. Make sure that younger children are supervised in the dental office and at home when fluoride products are being used. They may become nauseous if they have swallowed too much fluoride. When their adult teeth enter the mouth, spots may be visible on the teeth from too much fluoride use at a younger age. Make sure that you call your dentist with any concerns about fluoride, as they will suggest which fluoride-containing products and what amounts to use.

Talk to the Doc

You should make sure that your dentist and/or dental hygienist know and review which fluoride products that are currently being used in your home, both by you and your children. They will make recommendations about which fluoride products are best for you and your family.