Tooth decay is more prevalent now than ever before, affecting 60 – 90% of children and a vast majority of adults. Since 2011, when fluoride was removed from Calgary's public water system, pediatric dentists have noticed a large increase in the rate of tooth decay among children in our community. This increased rate of tooth decay can be caused by many factors such as poor oral habits, the increased consumption of processed foods, overconsumption of fruit juice and soda pop, and the constant snacking that many children have grown accustomed.
Most foods that we eat contain sugars – fruits, vegetables and dairy products all have naturally occurring sugars. Processed foods such as breads and pastas contain high levels of carbohydrates that are broken down into sugar during the digestion process. When bacteria found in the dental plaque contact sugars in our food, an acid is formed. This acid attacks the hard outer layer of the tooth, known as enamel. If dental plaque is not removed daily with regular brushing and flossing, over time the enamel softens and a cavity forms. The amount of damage that is caused to the teeth depends on how often sugar is consumed and how long it stays there.
Nature’s Defense Against Tooth Decay
Fluoride is a mineral found in our soil, water, and various foods. It is important to understand how fluoride helps prevent tooth decay. Fluoride has a positive effect on oral health by making teeth more resistant to decay. Fluoride in small, frequent quantities aides in the prevention or even reversal of tooth decay. It also inhibits the metabolic processes of bacteria, reducing the number of bacteria in the mouth.
Fluoride sources recommended by your dentist include fluoridated tap water, toothpaste, mouth rinses, and fluoride applications provided by your dentist. At your dental office, fluoride is applied to the teeth as a rinse, gel, or foam in trays, or as a varnish that is painted on the teeth. When fluoride is applied topically, it is absorbed into the enamel, making teeth more decay-resistant.
Systemically occurring fluoride is acquired when we consume fluoride containing food, water, and fluoride supplements. As the teeth form, systemic fluoride is included in the tooth structure as the teeth develop. Fluoride taken regularly during the time of tooth development creates stronger and harder tooth enamel.
Pediatric dentists in the Calgary area are largely in agreement that without fluoride being present in our drinking water, the use of a fluoridated toothpaste is recommended as soon as teeth start to appear in the mouth. It is important to limit the amount of toothpaste used when brushing our children's teeth since they will likely swallow whatever toothpaste is placed on the toothbrush. More is not better. The risks associated with swallowing a controlled amount of fluoride on a daily basis is outweighed by the benefits of fluoride. Children under the age of three should use only a smear of toothpaste (about the size of a grain of rice) on their toothbrush, twice daily. Children over the age of three should brush with a pea-sized amount twice daily.
The risk of overexposure to fluoride is primarily dental fluorosis. Fluorosis occurs in children who consume fluoride in a high concentration over a long period of time. Children over the age of eight are at a much lower risk for dental fluorosis because the enamel in the remaining developing teeth has all ready begun to calcify. In its mild form, fluorosis appears as tiny white specks on the permanent teeth and is often unnoticeable. In its most severe form, it appears as black or brown stains, as well as cracking and pitting of the teeth. Dental fluorosis can be caused from the misuse of fluoridated toothpaste or from unregulated water that contains high levels of naturally occurring fluoride, typically in well water. It is important to understand that not all white, brown, or black markings on the teeth are fluorosis. There are many reasons for colour variations in teeth. This can include a disruption of the tooth during its development likely from a fever or dehydration, injury to the baby teeth, untreated abscessed baby teeth, genetics, or it can be the beginning stages of a cavity. In short, fluorosis is not the sole cause of enamel discolouration.
Protecting your child’s teeth is important for not only their oral health but for their overall health and wellness. If you have questions about fluoride, please contact your dentist to learn more about fluoride supplementation.
