Pediatric Dentistry
Too Much Fluoride
While fluoride is very beneficial in strengthening teeth and preventing tooth decay, parents need to be concerned about the levels of fluoride their children are ingesting. Too much fluoride from fluoride supplements, toothpaste and other sources can lead to a condition in young children called fluorosis.
The difficulty in evaluating the level of fluoride that your child is getting comes from the lack of knowledge of the fluoride content of not only your municipal water source, which can easily be obtained, but also from the fluoride content of the drinks your children consume. Often time's fluoride is not added as an ingredient to the beverage so its concentration is not listed on the package. However the municipal water sources that are used at the manufacturing site or the reconstitution site often have their own intrinsic and or manipulated fluoride content.
Fluorosis causes discolored teeth and in some cases will cause pitting in the enamel surface of the teeth. While fluorosis damage tends to be cosmetic in most cases, excessive fluoride intake can be harmful. The teeth can develop white decalcified spots and dark brown areas due to an excessive amount of fluoride ingestion. This can leave teeth unsightly and cause a cosmetic catastrophe for anyone concerned with their or their child's aesthetic appearance. If excessive pitting and demineralization take place the strength of the teeth can be compromised. This can be a more severe and extensive problem than just a cosmetic concern and may require extensive restorative treatment to remedy.
Fluorosis appears more often in young children whose developing teeth are more vulnerable. Children are also the most numerous recipients of the "halo effect" - well intentioned over exposure to fluoride from a multitude of sources. Fluoride is in toothpaste, fluoride supplements, and fluoride mouth rinses and, in some areas, fluoride is added to the municipal water supply. Fluorosis is not caused by fluoride in the municipal or city water systems but by over-exposure through an accumulation of sources. Since most beverages are made with water that contains fluoride and the amount is not specified on the package it becomes very difficult to know exactly how much fluoride your child is consuming.
The good news is that the fluoride in most municipal water supplies are very well controlled if it is added so that it should not become a problem unless your child is taking a fluoride supplement because your local water supply has less than the recommended optimal level of fluoride. In rare cases a water supply can naturally contain more than the optimal level of fluoride, so if you live in such a an area or a beverage is manufactured in such an area then your child is going to be exposed to levels of fluoride that are more than optimal.
The best way to prevent childhood fluorosis is know if your public water supply contains fluoride and to then monitor your children's intake accordingly. If your children use toothpaste that contains fluoride, be sure they are using only a pea size amount of toothpaste and not covering all the bristles as on a TV commercial. Be sure they try not to swallow toothpaste-containing fluoride since the level of fluoride in toothpaste is intended to be used topically and not ingested it is many many times greater than is recommended for consumption.
Before giving your child fluoride supplements, confirm with Dr. Preziosi whether or not additional fluoride is needed. Exposure to normal levels of fluoride is definitely beneficial, but too much fluoride can be harmful.
