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Fluoride: The Supplementation Situation

November, 2011
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There is a wide range of information and opinions on whether we need to supplement our water with fluoride. Here are some basic facts to help you decide what is best for you and your family.

Q: What is fluoride, and what does it do for teeth?
A: Fluoride is a naturally-occurring mineral that has been proven to protect teeth against tooth decay.
Q: How does fluoride work to prevent tooth decay?
A: Bacteria in plaque ferment sugar and other refined carbohydrates and produce acid. The acid causes demineralization of teeth, resulting in “cavities.” Fluoride can stop and sometimes reverse this demineralization process.
Ingested fluoride, present in drinking water or as fluoride supplements, is incorporated into the enamel of teeth and strengthens them as they develop.
Topical fluoride, in toothpastes and mouth rinses, leaves a coating on the surface of teeth that can inhibit the demineralization process.
Q: What are good sources of fluoride?
A: Fluoride is added to the water supply of many communities at a recommended optimal amount of 0.7 milligrams per liter. Fluoride is also added to toothpastes and mouthrinses.Concentrated fluoride gel is available for topical application at your dental clinic.
Q: Is the water in Beijing fluoridated?
A: The water in Beijing has not been fluoridated.If there is any naturally occurring fluoride in the water supply, it is below the optimal amount that would offer protection against dental decay. Most of the bottled water available is also un-fluoridated.
Q: What can I do to improve my family’s dental health without fluoridated water? Are there supplements I could take?
A:Fluoride supplements can be given to children but need to be prescribed by a dentist or doctor. The dosage depends on your child’s age, and you should follow your dentist’s instructions very carefully. Fluoride supplements are not available in China,so you may want to ask your dentist in your home country to assist you.
Q: What do I do if I don’t have access to fluoride supplements?
A: Using toothpaste that contains fluoride and fluoride mouthrinses are good ways to reduce the possibility of tooth decay. 
Q: Which toothpaste should I use?
A: It is important to always use age-appropriate toothpaste.Children under the age of 6 do not have the muscle control to rinse adequately and will swallow some toothpaste when they brush. Since too much ingested fluoride during the development of teeth can cause pitting and mottling of the enamel, the fluoride content of toothpastes for younger children is lower than that for older children and adults.
Using a fluoride mouthrinse (available at some supermarkets) also offers some protection. Again, this is more suited to children 8 years and older who are able to rinse properly without swallowing the mouth rinse.
You can also ask your dentist to apply a topical fluoride gel to your child’s teeth at each checkup.
Q: Is fluoride safe?
A: The main side effect of prolonged excessive fluoride intake in children under the age of 8 is mottling or pitting of the enamel. If consumed atthe recommended optimal levels, evidence-based research over the past 60 years has shown that people living in areas with fluoridated water have a much lower incidence of tooth decay than similar communities without fluoridated water supplies.
Local and central governments and health authorities of most countries regularly monitor for possible adverse effects of fluoride supplementation.
For more information about fluoride or family dental health issues in general, feel free to contact the BJU Dental Clinic at the following numbers:
s     BJU Main Hospital (010) 5927 7058
s     United Family Shunyi Dental Clinic (010) 8046 1102
For additional information, please visit the following Websites:
*     www.ada.org
*     www.bda.org
By Vivian Nazari, BDS (Lond), MSc (Hons)
Dentist, Beijing United Family Hospital and Clinics
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