Published: 09/19/2023

Ever since you were old enough to hold your own toothbrush, you probably heard your dental team recommending fluoride to keep your teeth strong and healthy. Since then, though, you may have also heard that fluoride isn’t without controversy or side effects. So, what is fluoride, what does it do, and should you keep using fluoride in your toothpaste or oral rinse?

what is fluoride
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What Is Fluoride?

Fluoride is a natural mineral found in water, soil, plants, rocks, and even air. It comes from the abundant element “fluorine,” and it can also be synthetically produced. It’s a key mineral found in teeth and bones. This mineral is often found in dentistry and is suggested for helping strengthen the outer layer of teeth known as the enamel.

Fluoride has been found in research to help prevent cavities or tooth decay, which is why many communities add it to drinking water in a process called fluoridation. For example, the CDC found that after fluoride was added to drinking water starting in the late 1960s, tooth decay dropped by 50 to 70%. However, that’s also partly due to fluoride toothpaste also being readily available. Fluoride is often the active ingredient in toothpastes, oral rinses, and some supplements.

Tooth health isn’t the only use for fluoride, though. It’s also used in medical imaging, to clean, in some pesticides, and as a component in steel, aluminum, and Teflon.

Does Fluoride Really Matter?

Research has found that fluoride has a number of benefits for teeth, including:

  • Remineralizing and rebuilding weakened enamel
  • Reversing tooth decay if applied early
  • Fighting harmful bacteria in the mouth
  • Slowing the loss of minerals in teeth and bones

When we eat, our teeth, along with enzymes and bacteria in the mouth, begin to break down the food to be absorbed in the digestive system. The bacteria break down sugars and carbohydrates, but this process also produces acids in the mouth. If left floating around in the mouth, these acids can begin to eat away at the minerals found in enamel. This, in turn, can weaken the teeth and make them more vulnerable to cavities.

Fluoride is used to help remineralize the enamel, which may help not only prevent cavities but even reverse early tooth decay. Some research indicates regular toothbrushing isn’t nearly as effective without fluoride toothpaste. One study found that brushing without fluoride didn’t reduce cavities at all. 

Does Fluoride Have Risks?

Natural fluoride-free toothpastes are now being marketed to prevent cavities. And some natural health advocates recommend avoiding the use of fluoride toothpaste. Unfortunately, that does leave people who follow this advice at greater risk of developing cavities. According to research, brushing alone can help remove food particles, but it doesn’t appear to be enough to stop tooth decay. That’s why dentists from around the world recommend brushing with fluoride toothpaste.

That said, there are side effects of excess fluoride in the body. These include:

  • Dental fluorosis, which is when you get too much fluoride as the teeth are still forming under the gums. So, it’s most common in young children (under 8) who may swallow toothpaste, which can affect the teeth still coming in.

    Dental fluorosis causes white spots or streaks on the teeth. Fortunately, the issue appears to only be cosmetic—it doesn’t harm the teeth. Plus, it can be avoided by supervising children as they brush to ensure they don’t swallow it. Children under six years old should not use (or have access to) fluoride-containing oral rinses.
  • Skeletal fluorosis, which affects the bones rather than the teeth. Unfortunately, it can lead to joint stiffness and pain and alter bone structure over time. This type of fluorosis only comes from long-term exposure to excessive levels of fluoride. It’s not due to the small amounts added to drinking water. Excess fluoride in the diet is typically a result of contamination, such as from fires, explosions, or chemical contaminants near water supplies, or swallowing toothpaste over years. Fortunately, this condition is extremely rare.

Again, issues caused by excess fluoride aren’t due to adding fluoride to drinking water or brushing with fluorinated toothpaste as directed. And there are hundreds of studies from around the world demonstrating the safety of fluoride.

If, however, you are concerned that excess fluoride has been added to your city or county’s water supply, you can find fluoride filters that remove minerals from drinking water. (In the U.S., the CDC provides a tool to check your local water supply if your community participates.)

It’s important to keep in mind that many substances are beneficial in small, controlled amounts but can become harmful if large quantities are used.

How to Get Enough Fluoride

Fluoride is especially beneficial for children and people who don’t have proper access to dental care. Using fluoride can provide protection for the teeth at a minimal cost. Fluoride can also be useful for folks who snack or eat a lot of sweets and other carbohydrates, practice poor dental hygiene, have had dental work (such as braces, crowns, bridges, or other restorative procedures), or have a history of tooth decay. 

Whether or not your city or county fluorinate your water supply, you can help protect your teeth and prevent cavities by brushing at least two times daily with fluoride toothpaste. You can also speak with your doctor or dentist to see if they recommend using a fluoride mouthwash every day or having a professional fluoride treatment.

What Is Fluoride Takeaway

Fluoride is a mineral that’s found naturally. It’s also used extensively in dental products and treatments to help strengthen the enamel on your teeth and prevent cavities. It’s also often added to water supplies and has been found to significantly decrease the risk of cavities for entire communities.

High levels of fluoride do have negative effects. Fortunately, excess amounts are rarely found in the U.S.

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