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Fluoride Delivery

Systemic

Systemic delivery refers to fluoride that is ingested into the body by eating or drinking. In the United States, fluoridation of drinking water is the most prominent source of systemic delivery. Fluoride is an important nutrient during tooth development, as having fluoride ions in the tooth creates a tighter crystalline structure, strengthening the tooth and making it more resistant to the demineralization process. Fluoride helps the tooth absorb calcium and phosphate. These two minerals help to reduce acid in the mouth. In turn, this helps saliva be more effective at neutralizing acids from food and drinks.

Sources of Systemic Fluoride

IntentionalUnintentional
Fluoridated waterWell water (in some areas)
Fluoride supplementsFoods containing fluoride
Fluoridated saltHome-use topical fluoride products,
including fluoride toothpaste
Fluoridated milkMedications containing fluoride
Fluoridated foodsHigh fluoride bottled water

Topical

Topical fluoride is another familiar method of delivery to the general public. It prevents demineralization, promotes remineralization, and deters bacteria from growing. Topical fluoride can be applied in high-concentration forms, such as varnish at the dentist office. Or in low-concentration forms, such as fluoride toothpaste.

A high-concentration application creates a fluoride reservoir, which can last for several months in the mouth. A fluoride reservoir is generally harmless and acts to stabilize the pH in the mouth. If the environment becomes too acidic, the fluoride reservoir activates to release calcium, phosphate, and fluoride to start the remineralization process. In a low-concentration application, fluoride is absorbed by the saliva and surrounding oral mucosa (the soft tissues of the mouth). It helps these parts of the mouth stay neutral longer. Thus preventing demineralization after a child consumes acidic foods or drinks.

In addition to the major action of preventing demineralization, fluoride may help prevent cavity-causing bacteria from growing in the mouth.  In theory, fluoride ions interfere with the bacteria’s metabolic processes, making them weaker and less able to reproduce. This reduces the production of acid that leads to cavities.

Sources of Topical Fluoride

At Home (Low Concentration)At the Dentist’s Office (High Concentration)
ToothpasteFluoride Varnish
Fluoride mouth rinses, such as ActFluoride gel/foam
Prescription fluoride gel supplementsFluoride release filling materials
Fluoride released cements

Should a Baby Get Supplemental Fluoride?

  • Since most infant formulas have the appropriate amount of fluoride, Fluoride toothpaste is not recommended until your child is off formula.
  • We also discourage parents from using tap water to mix formula to prevent overexposure to fluoride.
  • If your baby is breastfeeding, they can start using Fluoride toothpaste as soon as they get teeth.
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