Fluoride treatments are fairly well know by most people. You probably had them when you were a kid, or may still have them at your dental appointments. Not all fluorides need to be applied in office. Here are the main types of fluorides and how they are applied.
In Office Treatments
- fluoride foams are placed in a tray and worn in the mouth for 4 minutes- no rinsing, food or drinks for 30 min.
- fluoride gels are placed in a tray and worn for 4 minutes- no rinsing, food or drinks for 30 min.
- fluoride varnish is painted onto the teeth and sticks until it is removed by brushing-no super hot drinks, do not brush for 4-6 hours, eating or drinking after is ok
- fluoride rinses are mixed in office and you rinse with it- no rinsing, food or drinks for 30 min.
Prescription Strength Fluorides
- 1.1% neutral sodium fluoride gel is applied to the teeth at bedtime or more often if recommended- no rinsing, food or drinks for 30 min. Leave it on when you go to bed if you can. This is a long-term maintenance medication
- Stannous Fluoride 0.63% Rinse is used once at least once a day. It must be mixed with water and the patient swishes with it for a total of two minutes- no rinsing, food or drinks for half and hour. This is recommended for short-term use.
- Fluoride pills are usually prescribed for young children that live in communities without water fluoridation. They are usually prescribed by a child’s Pediatrician not by a dentist
- MI Paste Plus. Although not a fluoride treatment like the previously mentioned ones it does contain fluoride and is available through your dentist. This product is contains fluoride, calcium and phosphates. Together these minerals work to remineralize tooth structure. The amount of fluoride in MI Paste Plus is equivalent to the amount of fluoride in over the counter fluoridated toothpastes. MI Paste does not contain fluoride so it is a good option if you oppose fluoride or for very young children who may not spit well or in pregnant women. It is applied to the teeth, left in place for at least 5 minutes and spit out. Rinsing after is not recommended.
How do you get these? Your dental office may carry them so that you can purchase the products directly through your dentist, or your dentist may write you a prescription. Not all dentists will write an prescription though. If these fluorides have been recommended to you you can find most of them in my store as well.
Over The Counter Fluorides
Over the counter fluorides are not as strong as in office fluoride treatments or prescription fluorides. They are good options for people that are generally healthy and want to prevent problems before they start.
- Fluoride Toothpaste- most over the counter toothpastes contain fluoride. Toddler and Baby toothpastes do not because of the risk of swallowing too much. It is harder to find a toothpaste without fluoride than one with fluoride. Some contain more than others though. Generally toothpastes that have a claim to aid in the reduction of sensitivity have more fluoride and also have other active ingredients. Some of the types I recommend to patients are Colgate Total, Crest Pro Health, and Toms of Maine which has many types and is a natural toothpaste.
- Mouthwashes- not all mouthwashes have fluoride. The ones that do tend advertise as anticavity mouthwashes. The most common ones are Act, Listerine Total Care and Crest Complete Care. If the label claims to protect against tooth decay or stop cavities from forming it is a fluoride rinse. With any fluoride rinse you should not eat, drink or rinse for 30 minutes.
What these toothpastes have in common is that they are fluoride pastes. Many of them have different active ingredients and I recommend different ones to different patients. Keep an eye out for more information about the differences between over the counter products.
There are a wide variety of fluoride mouthwashes available over the counter. Take a look in the store section to see a variety of options available.
Who Needs Fluoride
Just about everyone! Fluoride has many uses depending on the type.
- Fluoride strengthens teeth, it is a great preventative measure
- Fluoride can stop early cavities in their tracks if caught early enough, saving you from invasive dental treatment.
- Prescription Strength Fluorides are antimicrobial and can be used in treatment and maintenance of periodontal disease (Gingivitis or more Advance Periodontal Disease)
- Fluoride reduces sensitivity
Now everybody should be using at least the over the counter fluoride toothpaste and rinses. If you fall into any of these categories you should in office treatments or prescription strength fluorides are for you
- You have had a cavity in the last 3 years
- Your diet is full of sugars or other simple carbohydrates, carbonated beverages, energy drinks, sour candies, or you are a frequent snacker.
- You have dry mouth
- Your teeth are sensitive to hot and cold and over the counter sensitivity tooth pastes have not helped.
- You have root surfaces showing, called recession
- You are undergoing cancer treatment, radiation and chemotherapy can do a lot of damage to the teeth
- You have poor home care
- You have acid reflux
- You have eating disorders
- You have Gingivitis or Periodontal Disease
- You have braces or a permanent retainer
- You do not floss
As you can see the list is long. I could go on but I think the picture is pretty clear. Everybody should be using fluoride in some form. There are few people that I would not recommend at least an in office fluoride treatment at their cleaning or periodontal maintenance appointments. Prevention is always easier than treatment. If you do an in office fluoride treatment twice a year and use a fluoride at home and it saves you from having to get fillings and root canals what would you choose.
The Fluoride Controversy
You can probably tell that I am pro-fluoride. There are people out there that are very anti-fluoride. If you google fluoride you will find websites that make fluoride sound evil. The most common anti-fluoride remark that I hear is that it is a toxic substance. In large doses fluoride can be toxic, but so can just about anything. The key to remember when you are looking up information online is to consider the source and look at the date of publish on articles. You are free to make up your own mind. I would never force someone to do something that they are uncomfortable with. There are options to strengthen and remineralize teeth that do not contain fluoride. If you do your research and still decide that fluoride is not for you ask your dental provider about MI Paste. The original, not MI Paste Plus does not contain fluoride.
I have been asked why, if fluoride is so great, do toddler toothpastes not have it. The reason is that little kids tend to swallow or even eat their toothpaste. Too much fluoride ingested when teeth are developing can cause fluorosis, a mottled appearance of the teeth. The teeth that are developing when a child is a toddler are adult teeth. Fluorosis is not visually appealing. Teeth with fluorosis are actually extremely strong and very resistant to decay.