Dental Health The Health Benefits of Fluoride By Heidi Moawad, MD Heidi Moawad, MD Facebook LinkedIn Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications. Learn about our editorial process Updated on March 24, 2022 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Edmund Khoo, DDS Medically reviewed by Edmund Khoo, DDS Edmund Khoo, DDS, is board-certified in orthodontics and is a Diplomate of the American Board of Orthodontics. Learn about our Medical Expert Board Print Pixabay Table of Contents View All Table of Contents Health Benefits Possible Side Effects Dosage and Preparation What to Look For Frequently Asked Questions 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. Verywell / Emily Roberts 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. Fluoride to the Rescue It's largely preventable, but tooth decay is the most common chronic disease in both children and adults in the United States. Still, the number of cases has declined over the last 40 years, and many people credit the infusion of fluoride in public drinking water as one contributing factor. 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. The Telltale Signs That You're Dealing With Tooth Erosion 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. Small but Mighty Fluoride is considered a trace element, meaning that it exists in bodily tissues only in small (or trace) amounts, or about 0.1% by volume. 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). Excess Can Lead to Danger Chronically high levels of fluoride intake can affect teeth and bones, while acute ingestion of large amounts of fluoride can cause more dangerous side effects. It may even be life-threatening in rare cases. 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. Prevent Fluorosis To prevent fluorosis, do not expose your teeth to excess fluoride, either with supplements or through excessive exposure to toothpaste or mouthwash. 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. How Is Osteoporosis Treated? 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. The Hard Facts About Fluoride Toothpaste 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 mgChildren ages 4 to 11: 2.0 to 2.2 mgChildren ages ages 11 to 14: 2.4 mgAdults: 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/females7 to 12 months: 0.5 mg/males, 0.5 mg/females1 to 3 years: 0.7 mg/males, 0.7 mg/females4 to 8 years: 1 mg/males, 1 mg/females9 to 13 years: 2 mg/males, 2 mg/females14 to 18 years: 3 mg/males, 3 mg/females19+ years: 4 mg/males, 3 mg/females Don't Overdo Fluoride Swallowing extremely large amounts of fluoride from dental products or dietary supplements can trigger unpleasant side effects, including abdominal pain, diarrhea, nausea, and vomiting. 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. Good News for Tea, Coffee Lovers Tea and coffee drinkers might be glad to know that these beverages tend to be high in fluoride. One cup of brewed black tea contains between 0.07 and 1.5 mg of fluoride while 1 cup of brewed coffee contains about 0.22 mg. The exact amounts may vary depending on the water (and fluoride content) used to make these drinks. 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. Frequently Asked Questions Is fluoride approved as a safe supplementation? At the current time, the U.S. Public Health Organization and the American Dental Association consider fluoride supplementation to be safe and beneficial. If my family drinks mostly bottled water and not tap, are we getting enough fluoride? According to the CDC, bottled water may not have a sufficientamount of fluoride. If you have questions about whether yourbottled water contains fluoride, contact the manufacturer of the bottled water and ask for details. How do I learn about the fluoride in my drinking water? Your water bill or local water utility customer service department is a good place to start. The EPA requires all municipal water systems and other water suppliers to prepare and deliver an annual consumer confidence report (sometimes called a CCR, or water quality report) for residential customers by July 1 of each year. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institutes of Health. Office of Dietary Supplements. Fact sheet for consumers. Fluoride. Centers for Disease Control and Prevention. About fluoride. National Institute of Dental and Craniofacial Research. Dental caries. National Research Council (US) Committee on Diet and Health. Diet and health: Implications for reducing chronic disease risk. Washington (DC): National Academies Press (US); 1989. 14, Trace Elements. Available from: www.ncbi.nlm.nih.gov/books/NBK218751/ National Institutes of Health. Office of Dietary Supplements. Fact sheet for health professionals. Fluoride. American Dental Association. Fluoride: Topical and systemic supplements. ChemistrySafetyFacts.org. Fluoride. Additional Reading Aoun A, Darwiche F, Al Hayek S, Doumit J. The fluoride debate: The pros and cons of fluoridation. Prev Nutr Food Sci. 2018;3(3):171-180. doi:10.3746/pnf.2018.23.3.171. Cheng X, Liu J, Li J, Zhou X, Wang L, Liu J, Xu X. Comparative effect of a stannous fluoride toothpaste and a sodium fluoride toothpaste on a multispecies biofilm. Arch Oral Biol. 2017;74:5-11. doi:10.1016./j.archoralbio.2016.10.030.