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What Is Fluoride?

Fluoride is a natural mineral found in soil, water, and some foods. It helps strengthen tooth enamel and prevent cavities by slowing the growth of harmful bacteria. Many communities add it to tap water to help keep teeth strong.

You may have heard a lot about fluoride lately. Is it good or bad?

The short answer: It’s good in the right amount! Fluoride helps protect teeth, but there are a few things parents should know—especially those with young children.

What Is Tooth Decay?

Tooth decay (also called cavities) happens when the enamel (outer layer of the tooth) gets damaged. When bacteria in the mouth mix with food and drinks, cavities can form. Dental cavities are the most common chronic disease in children and can make eating and talking difficult.

What Happens If Tooth Decay Isn’t Treated?

If left untreated, cavities can get worse and cause:

  • Pain and infection
  • Trouble eating
  • Tooth loss
  • Gum disease

Does My Child Need Fluoride?

Yes! Fluoride helps protect teeth from decay.

Kids get it from:

  • ✓ Drinking fluoridated tap water
  • ✓ Using fluoride toothpaste
  • ✓ Getting fluoride treatments at the dentist

Is Fluoride Safe?

Yes, when used in the right amounts. The American Academy of Pediatrics, the American Dental Association, and the American Academy of Pediatric Dentistry all agree that fluoride is safe and important for healthy teeth.

Can a Child Have Too Much Fluoride?

Yes, too much fluoride can cause a condition called dental fluorosis. Mild fluorosis causes white spots on teeth, while severe fluorosis can lead to brown stains and weaker enamel. The risk is highest between 15-30 months of age.

Do Babies Need Fluoride?

  • Babies under 6 months old do not need fluoride.
  • Breastfed and formula-fed babies over 6 months old may need a fluoride supplement if your local drinking water has low fluoride levels (below 0.3 ppm). Ask your doctor or dentist if this applies to you.

Fluoride in Toothpaste, Varnish, and Supplements

The American Academy of Pediatrics recommends:

  • Fluoride varnish applied by a doctor or dentist every 3-6 months after the first tooth appears.
  • Over-the-counter fluoride mouth rinses for kids age 6 years and older if they can swish and spit properly.
  • Fluoride supplements for kids in areas without fluoridated tap water.
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A rice-sized smear of fluoride toothpaste from the first tooth until age 3.

A pea-sized amount of fluoride toothpaste from ages 3-6.

What If My Family Drinks Bottled Water?

Some bottled water contains fluoride, but many do not.

If your child mostly drinks bottled water, talk to your dentist about fluoride supplements. Some brands of bottled water offer both fluoridated and non-fluoridated options.

Other Ways to Prevent Cavities

Fluoride is important, but it’s not the only way to keep your child’s teeth healthy.

Here’s what else you can do:

  • Brush teeth at least twice a day, especially before bed.
  • Floss teeth that touch at least once a day.
  • Don’t put your baby to bed with a bottle.
  • Limit juice, sugary drinks, and sweets.
  • Take your child to the dentist by their first birthday and every 6 months after.
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By using fluoride, brushing regularly, and making healthy food choices, you can help protect your child’s teeth for years to come!

REFERENCES

American Academy of Pediatric Dentistry. (2024). Fluoride therapy. The Reference Manual of Pediatric Dentistry (pp. 351-357). Retrieved from
https://www.aapd.org/media/Policies_Guidelines/BP_FluorideTherapy.pdf

American Academy of Pediatrics. (2022, January 21). Where we stand: Fluoride supplements. Retrieved from
https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Fluoride-Supplements.aspx

American Academy of Pediatrics. (2020, November 30). All about fluoride: Updated clinical report covers caries prevention in primary care. AAP News. Retrieved February 11, 2025, from
https://publications.aap.org/aapnews/news/7429/All-about-fluoride-Updated-clinical-report-covers?searchresult=1

American Dental Association. (n.d.). Fluoridation FAQs. Retrieved February 11, 2025, from
https://www.ada.org/resources/community-initiatives/fluoride-in-water/fluoridation-faqs

Kiritsy, M. C., Levy, S. M., Warren, J. J., Guha-Chowdhury, N., Heilman, J. R., & Marshall, T. (1996). Assessing fluoride concentrations of juices and juice-flavored drinks. Journal of the American Dental Association, 127(7), 895-902.
https://doi.org/10.14219/jada.archive.1996.0347

Author: Bridget Swinney MS, RDN, LD