Fluorides help prevent tooth decay by expediting remineralization while impeding demineralization of enamel.
Despite its effectiveness and safety, some parents refuse fluoride treatments for their children during preventive dental or medical visits, with others having unresolved concerns that make them fluoride hesitant.
This is a worrying trend, since fluoride is one of the few treatments available for caries prevention. So dental professionals have to find better ways to communicate with parents about fluoride to ensure that they can make informed preventive care decisions for their children.
History of Fluoride treatments
In the early Twentieth Century, Frederick McKay discovered that people exposed to naturally fluoridated drinking water in Colorado Springs had fewer instances of tooth decay.
This discovery resulted in the adoption of fluoride as a cornerstone of dental prevention, with varying concentrations available in drinking water, over-the-counter toothpastes and mouthwashes, foams, gels, and varnishes provided by health providers, and prescription-strength toothpastes, drops, or tablets.
What is involved in Fluoride Treatment?
Fluoride treatment is a dental procedure that involves the application of a high concentration of fluoride to the teeth to help prevent tooth decay and cavities, usually for children under the age of 14 years. The fluoride is applied in the form of a gel, foam, or varnish, and it’s typically left on the teeth for several minutes. You will also have to avoid eating or drinking for about 30 to 60 minutes after the procedure. The treatment can be done by a dentist, hygienist, or other dental professional.
Pros and cons of Fluoride Treatment
The primary benefit of fluoride treatment is its ability to strengthen tooth enamel, making it more resistant to acid attacks that can cause decay. Fluoride can also help slow down and reverse the early stages of tooth decay owing to acid erosion and demineralization, before cavities form on them. In addition, it enhances the ability of teeth to reabsorb calcium and phosphate to repair enamel.
These benefits translate to:
- Lower risk of cavities
- Slow development of cavities
- Delay or eliminate the need for dental work
- Retention of baby teeth until they fall out naturally – prevent premature tooth loss
- Lower risk of gum disease
- Lower risk of tooth pain
However, there are some potential downsides to fluoride treatment. Some people may experience symptoms such as sensitivity or discomfort during or after the treatment.
Additionally, excessive fluoride exposure can lead to teeth discoloration associated with dental fluorosis, a condition that causes white or brown spots to form on the teeth. In rare cases, high levels of fluoride can also lead to skeletal fluorosis, a condition that affects the bones and joints.
Other concerns with topical fluoride treatments
There are several reasons why some people refuse to have topical fluoride treatments:
Firstly, the historical opposition to water fluoridation by the John Birch Society during the Soviet era has contributed to limited knowledge and risk-benefit misperceptions regarding fluoride.
Secondly, some parents of children with special needs such as autism spectrum disorders are more likely to refuse topical fluoride. Additionally, fluoride refusal is associated with vaccination refusal, and more common among parents under 35 years of age and those with a college degree.
Other reasons for fluoride refusal include:
- Low health literacy
- Religious beliefs
- A desire for autonomy
- Concerns about the true intent of vaccines
Finally, some people may refuse fluoride treatments due to perceptions that dental offices discriminate against lower-income families, or because they feel recommendations for fluoride treatment are indiscriminate.
Verdict: Should I say yes or no?
It is for these reasons that some people may choose to decline fluoride treatment, or simply because they prefer to avoid unnecessary procedures for their children.
Moreover, refusal of topical fluoride treatment can affect children from low-income families more than those from high-income families, since the former are often at a higher risk of developing tooth decay. Conversely, children from high-income families who do not receive fluoride treatment may still have other protective factors, such as healthier diets.
It seems like socioeconomic factors play a big role in influencing the decision to accept or refuse fluoride treatment. However, it’s important to note that the benefits of fluoride treatment generally outweigh the risks, particularly when it is done in moderation and under the guidance of a dental professional.
Fluoride treatment recommendations
Although fluoride can be toxic, this should only be a concern if it is applied incorrectly and ingested (swallowed) in extremely high doses. Considering that cavities are the most common chronic childhood disease, it’s best to use fluoride for prevention.
According to the CDC and ADA, fluoride is safe in small amounts and can help prevent dental cavities. The recommended ways to get fluoride are by drinking tap water with optimal fluoride levels and using fluoridated toothpaste while brushing teeth twice a day.
For those at a higher risk of cavities, fluoride treatments can be beneficial.
- Children under six years old should receive professional fluoride varnish treatment, as they may swallow other forms of fluoride, which can cause nausea, vomiting, and other symptoms of excess fluoride.
- The AAP recommends fluoride treatment for all children as soon as their teeth begin to grow, at 3 to 6 months intervals depending on their risk of cavities.
- Adults at high risk of cavities can also get professional fluoride treatments twice a year.
People living in areas without fluoride in the water may benefit more from regular fluoride treatments.
It is essential to discuss the risks and benefits of fluoride treatment with a dentist, considering all sources of fluoride, including fluoridated toothpaste and mouthwash.
Ultimately, the decision to undergo fluoride treatment should be based on individual risk factors, such as a history of cavities or other dental problems, as well as personal preferences and concerns. Patients should discuss their options with their dentist and weigh the potential benefits and risks before making a decision.