The lovely Mary Poppins sang the praises of sugar; the bitter truth, unfortunately, is that sugar is enemy number one for the teeth of young and old alike! Luckily there is fluoride, a very useful substance that our own body also produces, which helps teeth grow healthy and protects them from tooth decay.
Fluoride, a substance naturally present in saliva together with calcium and phosphate, does two good things for the teeth: it makes tooth tissue stronger and more resistant, and it counters the action of bacteria, in particular Streptococcus mutans, which is responsible for the development of tooth decay. A lack or shortage of fluoride is therefore a risk factor.
Fluoride prophylaxis is thus essential in preventing tooth decay. Over the years, various ways of giving fluoride have been developed, with different concentrations and doses (fluoridated water, milk, salt, tablets, drops, toothpastes, gels and so on).
Despite its effectiveness in preventing tooth decay and helping teeth grow healthily, giving fluoride systemically (drops, fluoridated water, tablets and so on) to babies and children before their baby teeth come through has for some time been the subject of conflicting studies. Taking fluoride supplements during pregnancy to reduce the unborn child’s risk of tooth decay is not recommended either, given the lack of clear scientific evidence.
Today, the most effective prophylaxis is considered to be topical fluoride (through toothpastes, gels or mouthwashes) once the baby teeth have appeared.
However, very young children (up to about 2½–3 years of age) cannot yet control their swallowing reflex effectively and tend to swallow some of the toothpaste without meaning to. This risks taking in too much fluoride and developing dental fluorosis, a condition that shows up as light or dark spots on the teeth and can also affect the skeleton.
It is therefore advisable to keep a careful eye on the fluoride concentration and on the amount of fluoride toothpaste given to a child in the first years of life (pea-sized), to keep the risk of fluorosis to a minimum.
Of course, fluoride alone is not enough to prevent tooth decay: it is also important to teach children to look after their own oral hygiene every day and to follow a balanced diet rich in fruit and vegetables, limiting sugary foods and drinks (especially fizzy drinks) between meals.
Photo: S&B Vonlanthen on Unsplash
