Safe Fluoride Use and Alternatives

We recommend the use of fluoride for reducing cavities, but some patients are concerned about the use of fluoride. We always respect your personal health decisions and want to support you as best we can.

Here are some ideas and alternatives to consider about fluoride:

#1 Know Your Risk

Not everyone needs extra fluoride. Fluoride is added to many water sources, is naturally occurring in other water sources, and is present in many prepared foods and drinks. Most people use an over the counter fluoride toothpaste. However, some people can benefit from extra fluoride in high strength concentrations applied in the dentist’s office. We can help you decide if you need this kind of fluoride. We can suggest a custom plan to incorporate as many of these ideas and alternatives as you wish.

For example:

Fluoride applied topically is much more important than fluoride swallowed – consider topically applied fluoride instead of supplements.

Newly erupted teeth are more able to take in extra fluoride and are more at risk for decay – consider scheduling fluoride treatments to take advantage of this.

In babies, the upper incisors are at much higher risk for decay than the lower incisors – consider only applying fluoride on the upper incisors.

Decay on chewing surfaces and grooves of the teeth is not influenced by fluoride nearly as much as decay on the smooth surfaces (sides) – consider adding fluoride if you have smooth surface decay.

#2 There are different ways to apply fluoride

If you decide to use professionally applied high strength fluoride there are two commonly used ways to apply it. There are advantages and disadvantages to each one.

Fluoride Foam:

The dentist, hygienist, or assistant places fluoride foam in a soft disposable tray which fits over your teeth. You hold it on your teeth for the recommended length of time (ours is 60 seconds). Then you spit/suction out the rest and don’t rinse, eat or drink for 30 minutes. Some formulations are not recommended for those with white fillings or crowns. Your teeth still feel clean after the treatment. Small children may not be able to control swallowing a small amount of the foam.

Fluoride Varnish:

The dentist, hygienist, or assistant paints a more concentrated sticky gel coating over the teeth. The fluoride varnish sticks to the teeth for several hours, releasing the fluoride over time. You may eat or drink with the varnish on. One positive is that for very small children, only a small amount is applied to the teeth and lower blood levels of fluoride have been reported. One disadvantage is that your nice clean teeth now feel sticky. Some research indicates that the varnish is more effective.

#3 Non-fluoride alternatives

For those who do not want fluoride we can suggest some other options. There is limited evidence that non-sugar sweeteners like xylitol can reduce decay. There are gums, mints, and hard candies containing xylitol. Look for xylitol in the first three ingredients to pick out a good product. You need to use xylitol 4-5 times a day in order to gain any benefit.

There is also some evidence for a varnish containing chlorhexidine and thymol to reduce decay. Chlorhexidine is a widely used prescription product which reduces bacteria, and thymol is the essential oil of thyme. This varnish may be most useful in patients with exposed root surfaces.

Another product called MI paste may help to add minerals back to your teeth. There is little evidence to support it, but might be most beneficial in those who have poor quality saliva without a lot of their own minerals.

A good diet is always important for your health. Having enough quality saliva is critical for the health of your teeth. Absorbing minerals and having enough vitamin D is also important. The most important part of diet and decay is the frequency that you ingest carbohydrates. Dr. Mularczyk can help you figure out your dietary risks and tips to reduce these risks. Read more about the science behind tooth decay and diet.