Babies need fluoride before their teeth start to form to help make them stronger as their development begins. How does it work? Fluoride, which is a naturally-occurring mineral, enters the bloodstream through food and water and becomes part of the tooth enamel even before the teeth erupt making them stronger and more resistant to decay. (Later on, fluoride applied topically through toothpaste or at my office also makes the teeth more resistant to decay and strengthens the enamel as it repairs itself from normal wear.)
Whether or not you need to add fluoride to your baby’s diet depends on how he or she is being fed and on the level of fluoridation in your local water supply. Breastfed babies do not need additional supplies of fluoride, and for infants under age 12 months, formula that requires water should be mixed with fluoride-free bottled water rather than fluoridated water.
While fluoride occurs naturally in water in some parts of the country, in close to 73% of communities it is added to the community water supply, which some people find alarming. The American Dental Association, however, compares fluoridation of community water supplies to other safe supplements such as fortifying milk with Vitamin D, table salt with iodine, and bread and cereals with folic acid. In other words, it’s a way to optimize levels of a naturally existing mineral to encourage the prevention of tooth decay.
That said, it’s important that your child receives just the right amount of fluoride. Not enough could leave your child’s teeth without the long-term dental health benefits that fluoride offers. Too much can cause harmless but unsightly discoloration of the teeth called fluorosis. Usually fluorosis causes only a few white spots or patches on the teeth, but more severe cases can cause a brownish mottling and weakened enamel. This occurs only when baby and permanent teeth are forming under the gums. Once teeth break through the gums, they cannot develop enamel fluorosis.
Sometimes I’m asked about fluoride tablets, drops, or lozenges. They are available only by prescription and for good reason. Even children living in non-fluoridated areas who are considered to be at high risk of developing tooth decay may be consuming fluoride at daycare or school or through bottled water and processed foods. I never recommend them for children in a fluoridated community when they are possibly ingesting fluoride from many other sources.
The Centers for Disease Control and Prevention considers community water fluoridation as one of 10 great public health achievements of the 20th century, and studies prove that water fluoridation continues to be effective in reducing tooth decay by 20-40%. In fact, this is so important that the American Academy of Pediatrics, the U.S. Public Health Department, and the American Dental Association have all recommended fluoride supplements for children in either their diet or the water they drink starting at age six months and up to age sixteen. Please feel free to call me or your physician if you are not sure if your family is getting the recommended dosage.