Fluoride therapy is the medical use of fluoride, recommended to prevent tooth decay. Especially in locations where municipal drinking water is low in fluoride, fluoride therapy may be provided to children in the form of a pill, a mouth rinse, or a topically applied fluoride paste. Fluoride has been shown to increase the remineralization of tooth enamel, as well as aiding in cavity prevention by decreasing bacterial activity and protecting the teeth from the acids that cause tooth decay.
Fluoride has been in use for the prevention of tooth decay since the 1940s; sodium fluoride is the most widely used form. Fluoride is a generally inexpensive medical treatment that is recognized by the World Health Organization as one of the safest and most effective and necessary medicines in the world.
Fluoride toothpaste is an effective protector for the teeth, and, in younger children, dentists may recommend the additional ingestion of fluoride as the baby teeth are forming. Beginning in the 1940s, the U.S. Surgeon General sponsored a study to investigate the effects of fluoridated water on tooth decay; based on the results of this study, Grand Rapids, MI, began fluoridating its drinking water in 1945, and many cities and towns soon followed suit. It is now estimated that about two-thirds of the U.S. population gets water from a fluoridated municipal water supply. Although water fluoridation is supported by all major public health organizations, skeptics who fear fluoride overdose remain. The fact remains that water fluoridation is the most affordable way to introduce fluoride to the greatest number of people, and water fluoridation has proven effective at reducing tooth decay, contributing to public health and reducing the overall costs of dental care.
Introducing fluoride to children under the age of 6 is not recommended, as it may lead to dental fluorosis, which is defined as hypopigmentation of the teeth that occurs as enamel is being formed. In extremely high concentrations, fluoride can cause fluoride poisoning, which can be fatal; it is highly unlikely, however, that any person would have access to such high concentrations of fluoride.
The topical introduction of fluoride repairs the enamel of the teeth by introducing a mineral, fluorapatite, to damaged enamel. Teeth and their enamel constantly experience an ebb and flow of mineralization as acids react with saliva and plaque; fluoride simply helps this process, especially at the early stage of cavity formation. While it is proven that fluoride can affect remineralization of the teeth, there is some controversy about whether fluoride affects the bacteria in the mouth, though many studies have indicated that fluoride has antimicrobial properties. Fluoride is also more beneficial when topically applied; once swallowed, it has little to no effect on remineralization. Therefore, the most common delivery methods for fluoride are water fluoridation, fluoride toothpaste, mouth rinses, topically applied gels and pastes, fluoride varnish, lozenges, and time-release devices that can be implanted onto the teeth. Depending on the level of fluoride present in these treatments, they are either used at home or applied professionally, during a dental office visit.