Topical Fluoride

The use of topical fluorides may result in a significant reduction in caries as the fluoride gets integrated into the enamel matrix, hardening the structure and making it more resistant to demineralization. Topical application of fluoride is available via:

• Fluoride-containing toothpastes

• Professionally-applied topical fluoride treatment

• Over-the-counter rinses for home use

• Prescription rinses and gels for home application

Over-the-counter fluoride mouthrinses are not recommended for preschool aged children due to risk of swallowing excess. Fluoride mouthrinses or brush-on gels may be recommended for school-aged children with active caries or at high risk for caries. Indicators of increased caries risk may include:

• orthodontic/prosthodontic appliances

• reduced salivary function

• inability to clean teeth properly

• dietary risks

• siblings with caries

• high oral levels of cariogenic bacteria

Over-the-counter rinses are designed for daily use. Higher concentration fluoride prescription rinses and gels are designed for weekly use.

Using small amounts of fluoride on a routine basis can help prevent tooth decay. Too much fluoride could cause fluorosis of developing enamel. Fluorosis usually is mild, with tiny white specks or streaks that often are unnoticeable. Development of fluorosis depends on the amount, duration and timing of excessive fluoride intake.

Toothpaste can be used to deliver fluoride to the tooth surface. The use of a fluoride toothpaste should always be supervised in children. For those under three years old, a smear or rice size amount of fluoride toothpaste twice a day is recommended by the American Academy of Pediatric Dentistry and American Dental Association. An amount equal to the size of a pea should be used twice a day for children ages 3 to 6 years of age. When using these small amounts, rinsing with water is discouraged after brushing to allow the fluoride a maximum topical effect.

Fluoride products should be kept in childproof storage areas. This includes not only supplements but toothpastes, fluoride rinses, and gels.