Not all Fluoride is Created Equal

Did you know that not all fluoride is created equal? There are two types of fluoride, topical and systemic. Below we will discuss topical vs. systemic fluoride, and how it relates to your child’s individual needs.

By definition, topical fluoride is fluoride that is beneficial when used on the surface (of the teeth which are erupted in the mouth). Topical fluorides include toothpaste, rinses, gels, and professional treatments done by the dentist. On the other hand, systemic fluoride is beneficial when swallowed and thus is used in much smaller concentrations. Systemic fluorides include fluoride in drinking water and prescription fluoride supplements (when there is no fluoride in your drinking water). By design, these fluorides help with the teeth which are forming in the jaw.

What types of topical fluoride should my child be using?

When you keep in mind that topical fluorides help strengthen the teeth that are erupted in the mouth, it makes sense that every child should begin using fluoridated toothpaste once they have their first tooth. If your child cannot yet spit, use just a small smear of toothpaste the size of a grain of rice to start. Once your child has learned how to spit, you can start using a larger (pea-sized) amount of toothpaste.

Fluoride rinses are a great adjunct to cavity prevention. You may opt to begin using a fluoride rinse once your child can effectively rinse and spit (usually around age 6), although it is by no means necessary unless your dentist has indicated that it would be beneficial for your child. When choosing a rinse, choose one that is geared toward children. Ensure that it has fluoride in it (not all mouthwashes do!) and that it is alcohol-free, as this ingredient can dry out or burn the gums. The best time to use a rinse is after you’ve just brushed and flossed your child’s teeth so that the plaque layer has been removed and the fluoride can reach the tooth surface. Remember not to rinse with water or drink anything after, as the water will wash away the fluoride, negating its benefits.

If your child is at high risk for cavities, your dentist may recommend a special fluoride gel, which contains a more concentrated amount of fluoride than toothpaste alone.

The last type of topical fluoride is the professional treatment that your dentist will apply at the end of every cleaning appointment. This varnish should stick to their teeth for the remainder of the day, and deliver fluoride to the outermost layer of their teeth until it is brushed off. Remember not to brush or floss them for at least 6 hours after visiting the dentist.

What types of systemic fluoride should my child be using?

When it comes to systemic fluoride, many towns within Massachusetts, and around the country, have opted to add it to the water, as part of a water fluoridation program. This added fluoride helps aid in the development of enamel that is fluoride-rich and thus resistant to cavities. If your child drinks the water, or even if you just use the water when you cook (to boil pasta, rice, etc.) your child is receiving enough fluoride to aid in the development of his or her permanent teeth. If you have well water or your town is not fluoridated, consider whether your child is receiving fluoridated water from another source, school, daycare, etc. If your child is not receiving systemic fluoride, talk to your dentist because he or she may be a candidate for a prescription fluoride supplement.

To check if your town is fluoridated, click here:

I have fluoride in my drinking water. Should my child still be using fluoride toothpaste?

Yes. Remember, the fluoride in your drinking water (or a supplement your child may be taking) is in such a small concentration (as it’s meant to be swallowed) that it doesn’t have much benefit topically. Continue to use a smear of fluoridated toothpaste for children who cannot spit yet, and a pea-sized amount of fluoridated toothpaste for children who can.