Preserving teeth comes down to 2 factors… Your dental hygiene habits and your toothpaste. Fluoride-free toothpastes can scrape off bacteria, but there's a reason fluoride is so common in toothpaste, drinking water, and your dentist's office. Fluoride toothpastes are more effective at cavity control, because of fluoride's special properties.
Fluorine is a naturally-occurring mineral found in the earth's crust and is the 13th most abundant element on this planet. It's called fluoride when it combines with another mineral (e.g., calcium fluoride). In its natural state, it's found in rocks, clay, and coal. It also easily floats in the wind and can suspend in water rather than sink as other heavier minerals might.
For this reason, in many parts of the world, fluoride levels are naturally high in the water supply. It occurs to some extent in all natural water sources.
Fluorides also naturally occur inside the human body in the form of calcium fluoride, which resides in your teeth and bones. Research shows that adding fluoride to public water supplies decreased tooth decay by 25 percent. This led to the common practice of adding fluoride to public water in the US.
In small doses, fluoride strengthens tooth enamel against acids created by the bacteria in your mouth. Enamel is a hard substance that protects the softer inner tooth. Dietary acids and those created by bacteria can soften enamel, allowing it to erode.
Hard brushing or eating abrasive foods in the presence of these acids can increase erosion. The American Dental Association now recommends waiting at least one hour to brush after eating/drinking something acidic for this reason.
Once the enamel is gone, it doesn't come back. But weakened enamel can reharden through a process called demineralization if you don't scrape it off.
In the right doses, fluoride slows down the mineralization process and can remineralize the enamel. We say small doses because, like many substances, you can have too much, which can cause discoloration. However, that's hard to do when getting your fluoride, as most of us do -- in toothpaste and drinking water.
For this reason, the Centers for Disease Control and Prevention (CDC) called the public policy to add fluoride to water one of the top 10 health achievements of the 20th Century.
This is why several fluoride-containing toothpastes have been given the American Dental Association (ADA) seal of acceptance. With this said, some people may want to avoid fluoride, so you do have fluoride-free options.
While fluoride toothpaste uses both a mechanical and chemical approach, fluoride-free toothpaste takes a mechanical approach to cleaning. You scrape the teeth to prevent plaque build-up. This gives bacteria and acidic food particles fewer places to hide, so the teeth and gums stay cleaner. They may use alternatives to fluoride like:
These have antimicrobial properties which can keep bacteria levels in the mouth down and antacid properties, but they do not support tooth health enamel as fluoride does.
Some people are allergic to fluoride or hypersensitive to it. They may experience an upset stomach, tiredness, mental sluggishness, muscle pain, and headaches. However, this condition appears to be very rare.
Others believe that because fluoride is in the water supply you don’t need it in your toothpaste. In parts of the country where fluoride is naturally very high in drinking water, you may choose to use fluoride-free toothpaste. Your dentist can assess your teeth for signs of enamel erosion or too much fluoride to help you make this decision for yourself and your family.
If you, your child, or a special needs adult like to swallow toothpaste, this will upset the stomach, so you might want to choose no fluoride.
For most people, the amount of fluoride entering the mouth is both safe and protective. If you’re concerned about fluoride exposure, talk to your dentist about alternatives to preserve your teeth and protect your enamel. If you believe you may be getting too much fluoride, that is certainly something we can assess by inspecting your teeth.
Whether you're a new or returning patient, it's time to schedule your next appointment.