The Health Benefits of Fluoride

You can't see fluoride, but it's there: In the fluoridated water you drink from the tap and some bottled water, in dental products like toothpaste and mouthwash, and in supplements. No matter the source, this powerhouse mineral helps prevent tooth decay and fortify your bones.

Since it's possible to have too much of a good thing, it makes sense to learn how to strike the right balance with your fluoride intake.

This article describes the health benefits of fluoride as well as the side effects of ingesting too much. It also points out the recommended daily intakes of fluoride and how you may supplement the fluoride you normally get from food and beverages.

Health Benefits

All across the United States, fluoride is added to public supplies of drinking water as a public health measure to reduce cavities, also known as dental caries. Decisions about adding fluoride to public drinking water are made at the local or state level.

Fluoride supplementation has been found to prevent the process of tooth decay in infants, children, and adults. Fluoride exerts this beneficial effect on teeth through direct contact, and it also protects developing teeth that are still underneath the gums from the eventual development of cavities.

Fluoride is believed to help prevent tooth decay in two ways: By preventing bacterial overgrowth and mineralizing the teeth.

Preventing Bacterial Overgrowth

Fluoride has been shown to reduce the overgrowth of certain bacteria that may play a role in causing tooth decay. Fluoride lowers the pH level in the mouth, making the oral environment more acidic and less hospitable to bacteria.

Fluoride has been found to inhibit the growth of three types of oral bacteria: Streptococcus mutans, Streptococcus sanguinis, and Porphyromonas gingivalis.

Mineralization of Teeth

Fluoride interacts with the teeth to form a material called fluorapatite, which mineralizes the teeth. Mineralization is a process of chemical hardening, an effect that prevents tooth demineralization (breakdown). Interestingly, while fluorapatite is not a natural component of teeth, it is beneficial and has not been found to cause any harm to teeth.

The fluorapatite mineralization caused by fluoride supplementation also helps the teeth resist damage that can be caused by food, drinks, and bacteria. 

In terms of human health and nutrition, fluoride is a trace element, which comprises a relatively small percentage of the body’s composition.

Possible Side Effects

Fluoride intake is not recommended at levels higher than 10 mg per day. Excess fluoride can produce varying effects, depending on the amount of fluoride exposure and whether it occurs chronically (again and again), over a long period of time, or acutely (rapidly).

Chronic Over-Exposure to Fluoride

Dental fluorosis is the most well-documented side effect of excess fluoride. It is often caused by ingesting too much fluoride during infancy and childhood, while teeth are being formed. It can lead to the formation of white lines or white or brown flecks on the teeth. Severe dental fluorosis can lead to pitted tooth enamel.

Fluorosis is mainly a cosmetic concern and is not believed to be harmful to teeth. Fluorosis does not improve on its own, and it is very difficult to repair. If you develop this condition, be cautious of at-home cosmetic treatments, such as tooth whitening gels or creams. They can cause further discoloration of the teeth.

To stem these risks, brush your teeth no more than three times per day and don’t use mouthwash more than a few times per day. Be sure to spit out any mouthwash from your mouth, too.

Bone Fragility

Excessive fluoride ingestion has also been found to cause a rare condition called skeletal fluorosis, which is characterized by fragile bones and hardening or stiffness of the joints. Skeletal fluorosis can increase the risk of bone fractures.

This condition is rare, but its effects can range from occasional joint pain or stiffness to osteoporosis and muscle wasting.

Acute Fluoride Toxicity 

Acute fluoride toxicity can cause stomach upset, nausea, vomiting, and diarrhea. In some cases, especially with young children, the effects can become life-threatening.

Acute toxicity is uncommon because the concentrations of fluoride in water, toothpaste, and mouthwash are too low to cause an overdose of fluoride.

Dosage and Preparation

According to the U.S. Environmental Protection Agency, the typical daily fluoride intake in the United States from food and beverages (including fluoridated drinking water) are:

• Children 4 and under: 1.2 mg to 1.6 mg
• Children ages 4 to 11: 2.0 to 2.2 mg
• Children ages ages 11 to 14: 2.4 mg
• Adults: 2.9 mg

These numbers are fairly close to what the daily adequate intakes of fluoride should be, or:

• Birth to 6 months: 0.01 mg/males, 0.01 mg/females
• 7 to 12 months: 0.5 mg/males, 0.5 mg/females
• 1 to 3 years: 0.7 mg/males, 0.7 mg/females
• 4 to 8 years: 1 mg/males, 1 mg/females
• 9 to 13 years: 2 mg/males, 2 mg/females
• 14 to 18 years: 3 mg/males, 3 mg/females
• 19+ years: 4 mg/males, 3 mg/females
  

What to Look For

In addition to supplemented sources of fluoride, fluoride is also found in food and beverages. Notable selections include seafood, raisins, and potatoes as well as tea, wine, and grape juice.

However, the amount of fluoride in these products is less than one-hundredth of a gram, which is too low to have a protective or an adverse effect.

Fluoride Supplements

If you or your child cannot consume water that comes from the regular public water supply, you may not be getting the protection against tooth decay that fluoride can provide. To compensate, use over-the-counter, fluoride-containing toothpaste and mouthwash to get fluoride protection against tooth decay.

In addition, according to the American Dental Association, your healthcare provider or dentist can prescribe oral or topical (meaning, placed directly on your teeth) fluoride. You can also have fluoride professionally applied to your teeth. Your healthcare professional will be able to advise you if these steps are necessary.

Summary

Fluoride is a much-needed mineral that helps prevent tooth decay and builds strong bones. It can stop tooth decay by performing two essential functions: Preventing bacterial overgrowth and mineralizing the teeth. Too much fluoride can cause dental fluorosis, which is the most well-documented side effect of excess fluoride. It most often strikes during infancy and childhood, while teeth are being formed. But it can happen to people of any age. While you should get most of the nutrients you need from your diet, a fluoride supplement can help fill any gaps.

A Word From Verywell

Fluoride supplementation of the water supply is considered among the most cost-effective advances in public health. While fluoride has been found to reduce the incidence and severity of dental caries, it is not beneficial in excess amounts. If you do not have access to fluoride supplementation, or if you cannot take it for any reason, you should rest assured that while you may miss out on its protective effects, there is no serious consequence to a lack of fluoride. However, you'll need to be diligent about keeping up with dental hygiene at home and making sure you have regular check-ups at your dentist's office.