Chronic Fluoride Toxicity: Dental Fluorosis
Although dentists espouse the benefits of fluoride for the prevention of gingivitis and tooth decay, regular consumption of fluoride can be dangerous for young children. Chronic fluoride toxicity in this age group can lead to dental fluorosis, a condition that affects tooth enamel. Children up to eight years of age are susceptible to dental fluorosis if they ingest too much fluoride during the time their teeth are forming underneath the gums.
Dental fluorosis can change the appearance of tooth enamel in a variety of ways. Mild forms can produce white flecks or spots, chalk-like lines, or white edges on the surface of the teeth, and more severe forms of dental fluorosis can cause larger spots and stained or pitted surfaces.
The most common sources of fluoride in the United States are fluoridated water and processed beverages like soda and fruit juices. Other sources include:
- Toothpaste and mouth wash (if swallowed)
- Foods manufactured with fluoridated water
- Fluoride tablets, drops, or rinses
To prevent the development of dental fluorosis, the Centers for Disease Control (CDC) recommends that parents do not give fluoride toothpaste to children ages two and under. Brushing teeth with water after meals (or use non-fluoridated natural toothpaste for children) works best for this age group. Children from two to six years of age should be given a pea-sized amount of toothpaste. Tooth brushing should be supervised and kids should be reminded to spit out toothpaste when finished.
Kids should not be given fluoride rinses until all permanent teeth have come in. Once permanent teeth have emerged completely through the gums, dental fluorosis is no longer a concern. Because statistics show that mouth rinses have limited success for the prevention of tooth decay in children, use should be aimed at those youngsters with high risks for tooth decay.
Parents should learn whether their public water supply or private well contains fluoride and know the concentration levels. They can find this information by calling their local water utility company or check for the information online in the case of state-wide water fluoridation. If the primary source of drinking water at home contains levels of fluoride greater than 2 mg/L, parents should provide children younger than eight years of age with alternative water sources.
Although studies show that fluoride helps to prevent tooth decay in older children and adults, it can cause dental fluorosis in young children. Fortunately, parents who learn about their personal water supply and limit their children’s consumption of fluoride through dental products, beverages, and foods can thwart the development of this unsightly condition.