How does fluoride work?

Fluoride therapy can be effective in remineralizing early stage cavities, where the structure of the tooth has not yet been irreversibly compromised.  It is a great way to strengthen enamel, but not always prevent cavities.  It has been used to treat decay in increasing concentrations for decades.

Date Introduced	Fluoride Concentration
Fluoridated water introduced 1945	1 ppm
Fluoride toothpaste introduced 1955	1,100 ppm
Fluoride gel introduced 1986	5,000 ppm
Fluoride varnish introduced 1991	25,000 - 50,000 ppm

One major issue we face is that the rate of decay has been steadily increasing despite the increase in fluoride use and availability.

CDC Trends in Oral Health Status United States

Data from National Health & Examination Survey

• Ages 2-5 years old
  • 1988-1994 caries increased 24%
  • 1999-2004 caries increased 28%

While fluoride interferes with the metabolism of cavity-causing bacteria, and may interfere with their acid production, it's primary benefit is to remineralize tooth structure (enamel and dentin) and make the teeth stronger and more resistant to acid attack.  Fluoride by itself may not eliminate the cavity causing bacterial infection.

Expert Advice

• Check with your local water supply and/or bottled water company to find out if there is fluoride in your water.
• See your dentist to find out if you would benefit from fluoride therapy to treat sensitivity or remineralize existing damage to the teeth.
• Research has shown that the best daily fluoride application is a .05% neutral sodium fluoride rinse, used twice daily.
• The ADA suggests patients at risk for cavities receive a professionally applied 5% sodium fluoride varnish up to every 3 months.
• If you have cavities, using products with xylitol, alkaline pH, and antimocrobials, in conjunction with fluoride treatment, may be more effective than fluoride alone.