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Why do I need fluoride?

Fluoride helps to prevent tooth decay.

During tooth decay, the action of the bacteria in your mouth (that live in dental plaque) together with sugar and other carbohydrates in the diet produce acid.

This acid causes demineralisation (softening) of the tooth enamel so that eventually a cavity can form. This is more likely in inaccessible areas where plaque is left undisturbed.

If there has been no sugar eaten recently, the demineralisation stops and some remineralisation starts (hardening). This process of softening and hardening of enamel happens continuously throughout the day but there are certain ways we can promote more hardening and decrease the amount of softening.

One of these ways is to try to reduce the amount of bacterial plaque in our mouths by thorough brushing.

Another way is to decrease the amount and frequency of sugar intake throughout the day.

The other way is to increase our intake of fluoride so that there is a higher concentration of fluoride in our mouths. If there is plenty of fluoride around our teeth then the softening during the decay process is less severe and hardening is more likely.

How can I get more fluoride?

Fluoride is contained naturally in certain foods and drinks, for example tea and fish. It is also present in some tap and mineral water.

However these sources are usually insufficient for the ideal amounts of fluoride needed to protect teeth so other ways are required.

The main way that we can get enough fluoride is by using fluoride toothpaste. Most toothpaste contains fluoride but there are different strengths of fluoride in different toothpastes. You need to look for the strength by looking for a number followed by "ppm" on the packet. The ideal strengths are given below.

Other ways of getting more fluoride include mouth rinses and varnishes and you should discuss with your dentist as to whether this is necessary.

Current guidelines for prevention of decay and fluoride use

For all adults, the Department of Health guidelines on prevention state that you should:
  • Brush twice daily with fluoridated toothpaste.
  • Use fluoridated toothpaste with at least 1350ppm fluoride.
  • Brush last thing at night and on one other occasion
  • Spit out after brushing and do not rinse.
  • The frequency and amount of sugary food and drinks should be reduced and when consumed, limited to mealtimes.
  • Sugars should not be consumed more than four times per day.
The guidelines also state that for those people giving particular concern to their dentist about their risk of decay, the dentist may recommend you to:
  • Use a fluoride mouthrinse daily (0.05% NaF) at a different time to brushing.
  • Consider using an oscillating/rotating power toothbrush.
  • Use extra-strength fluoride tooth paste (2800 or 5000ppm)
  • Have fluoride varnish applied to the teeth twice yearly.
Your dentist will tell you if these extra measures are necessary.

Risk factors for getting decay

Older adults may have a higher risk of getting decay due to factors such as:
  • Wearing dentures (which tend to trap plaque).
  • Having more exposed root surfaces (which decay more easily than the rest of the tooth).
  • Brushing less well (due to less manual dexterity with age).
  • Lower saliva flow causing dry mouth (due to taking certain medication).
Because of these factors, your dentist may recommend the extra measures as described above.



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