The Health Benefits of Fluoride

Fluoride is an important mineral that helps prevent tooth decay and fortify bones.

In the United States, public water is often fluoridated, as are some bottled water and dental products like toothpaste and mouthwash. You can also purchase fluoride supplements. It is possible to have too much fluoride, however, which is why it's important to understand how to manage your fluoride intake.

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

Uses of Fluoride

Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or doctor. No supplement is intended to treat, cure, or prevent disease.

All across the United States, fluoride is added to public drinking water to reduce cavities, also known as dental caries. The decision to fluoridate public drinking water is made at the local or state level.

Fluoride supplementation has been found to prevent tooth decay in infants, children, and adults. Fluoride exerts this beneficial effect on teeth through direct contact. 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 teeth to form a material called fluorapatite, which mineralizes the teeth. Mineralization is a process of chemical hardening that prevents tooth 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. 

Fluoride Deficiency

In terms of human health and nutrition, fluoride is a trace element that comprises a relatively small percentage of the body’s composition. It is not considered an essential nutrient, however, it does play a role in the development of bones and teeth.

What Causes a Fluoride Deficiency?

Fluoride is naturally present in water, but not all water sources contain a sufficient amount of fluoride. This can be particularly relevant if you only drink bottled water which may not have sufficient fluoride.

Fluoride deficiency usually happens when you don't get enough fluoride from the water you drink or when you use dental products that do not contain fluoride.

Groups At Risk of Fluoride Deficiency

Most people in the United States get enough fluoride from fluoridated water or dental products. People who live in areas where the public water isn't fluoridated or who drink primarily non-fluoridated bottled water may not be getting enough fluoride.

How Do I Know If I Have a Fluoride Deficiency?

Fluoride deficiency is not usually dangerous. However, it can cause dental problems.

The first sign you might not be getting enough fluoride is usually the development of cavities.

What Are the Side Effects of Fluoride?

When ingested in small amounts, such as those found in drinking water and dental products, fluoride does not usually cause side effects. If you take too much fluoride, however, you may experience:

• Stomach discomfort
• Nausea and/or vomiting
• Diarrhea
• An increase in saliva
• Rash
• A soapy or salty taste in your mouth
• Weakness, tremor, or seizures
  

Precautions

Fluoride can be fatal if taken in large doses greater than 40 milligrams (mg) per kilogram (kg) of body weight. It is also possible to experience fluoride toxicity at much lower doses of between 0.4 and 5 mg per kg of body weight.

Dosage: How Much Fluoride Should I Take?

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

What Happens If I Take Too Much Fluoride?

Fluoride intake is not recommended at levels higher than 10 mg per day. Symptoms of toxicity may vary depending on the amount of fluoride exposure and whether it occurs chronically (over a long period of time) or acutely (rapidly).

Chronic Over-Exposure to Fluoride

Dental fluorosis is the most well-documented 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. Don’t use mouthwash more than a few times per day. Be sure to spit out any mouthwash rather than swallowing it.

Bone Fragility

Excessive fluoride ingestion has also been found to cause a rare condition called skeletal fluorosis. This condition 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.

Interactions

Fluoride has not been known to interact with other medications. Still, it is essential to carefully read the ingredient list and nutrition facts panel of products containing fluoride to know which ingredients and how much of each ingredient is included.

Please review the label with your healthcare provider to discuss any potential interactions with foods, other supplements, and medications.

How to Store Fluoride

Products containing fluoride may react with glass and metal. For this reason, it is important to keep fluoride products in their original plastic containers. 

Similar Supplements

Xylitol is a sugar alcohol found naturally in plants. It is sometimes used as a sugar substitute. 

Researchers are looking into xylitol's effectiveness in preventing dental caries, especially when combined with fluoride in toothpaste. Some studies have been promising, but more research is needed before xylitol can be recommended for this purpose.

Sources of Fluoride & What to Look For

It is usually best to obtain important minerals from the foods you eat rather than from supplementation. In foods, however, fluoride is typically only found in very small amounts of less than 100th of a gram. These amounts are too low to have a protective or an adverse effect.

Food Sources of Fluoride

Some food sources of fluoride include:

• Seafood
• Raisins
• Potatoes
• Tea
• Wine
• Grape juice

Fluoride Supplements

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

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.

While you should get most of the nutrients you need from your diet, fluoride dental products 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, however, it is not beneficial in excess amounts.

If you don't have access to supplemented water or can't take fluoride, there's no reason to be concerned. You may miss out on its protective effects, but there are no serious consequences to not getting enough 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.