By Deborah Jeanne Sergeant
Only about 36% of Americans use a fluoride mouth rinse daily, according to Statista.com, even though most people could benefit from using it.
Dentist Sangeeta Gajendra, professor, clinical chief and residency program director at Eastman Institute for Oral Health, said that fluoride strengthens the tooth enamel and makes it harder and more resistant to decay. According to him, “it has antibacterial properties. People who use it will be less likely to have cavities. Developing dental caries is multifactorial. It’s not just whether you brush or what you eat. This is a protective factor that helps impact the negative factors.”
The people who are most at risk for cavities include older adults and young children. For older adults, taking medication that causes dry mouth can limit the positive effect of saliva in balancing the mouth’s pH. Diabetes can contribute to cavities. Arthritis can hamper movement, making brushing harder. People experiencing dementia can be less fastidious with oral care. Older adults who no longer drive may find it challenging to receive regular dental cleanings and examinations.
In young children, Gajendra said that “baby bottle mouth” contributes to cavities.
“Cavities are quite severe as mothers give sugar-sweetened beverages that are kept continuously in the mouth,” he said. “Children should not have a bottle while sleeping if it has sugar or carbohydrates. It causes an acid attack on the tooth enamel.”
It may not seem important to save baby teeth from cavities but experiencing fillings or extractions while very young can create in children anxiety about dental care.
In addition, “if you have cavities in your baby teeth, you’re more likely to have them in permanent teeth,” Gajendra said.
Baby teeth serve as placeholders for permanent teeth, so losing baby teeth can contribute to a higher risk of needing orthodontic care.
At-risk people can ask their dentist to apply fluoride varnish and schedule dental exams to occur more frequently, as well as using good home care. Dentists can prescribe higher fluoride rinses and toothpastes to help at-risk patients.
Unless directed otherwise by their dentist, home care for most people includes brushing twice daily, flossing and using a fluoride rinse to help reduce risk of cavities.
“I always tell my patients that if you do a fluoride rinse, don’t eat or drink anything right after,” Gajendra said. “Do this before you go to bed: floss, brush, rinse. When you floss, debris come out, so then you need to brush and rinse last.”
Some people believe that using any fluoride is harmful to health. However, Gajendra said that used properly at the appropriate levels in toothpaste and rinses, it’s perfectly safe.
“If you see studies about neurodevelopmental problems, these were studies where the fluoride levels were very high,” he said. “We are not recommending anything that is toxic; the FDA would not approve it.”
Most municipalities add a small amount of fluoride to their water supply to benefit residents’ oral health.
“Studies have shown that it strengthens enamel by remineralization or rebuild weaken enamel cause by our acidic foods in our diet, thinning enamel from wear and tear over time and reduced saliva flow,” said Meng Lin, a dentist with Rochester Regional Health in Clifton Springs. “Fluoride can stop or in some cases, even reverse early signs of tooth decay before it becomes a cavity and needs a filling.”
If swallowed, small amounts of fluoride rinse can cause upset stomach or in large amounts, nausea and vomiting. Small children should only use fluoride rinses under their dentist’s guidance and with careful supervision once it’s established that the youngsters can safely swish and spit without swallowing.
Lin said that patients should ask about fluoride rinses if they have traditional braces, as brackets and wires trap bacteria. Also, people who have had cavities in the past are more likely to have them again. Adults with gum disease, those with thin enamel and those who consume high acid diets (including coffee, orange juice, soda, wine and beer).
“Fluoride is especially important for people who drink well water or untreated water that does not contain fluoride,” Lin said. “Regulated fluoridated water is safe to drink and rarely causes issues. Usually, issues arise when there are multiple sources of fluoride intake or for people with fluoride sensitivity. However, if there are any issues, consult your provider.”