Fluoride - why do I want it? Published Aug. 17, 2012 By Maj (Dr.) Aaron Krance 22nd Aerospace Medicine Squadron general dentist MCCONNELL AIR FORCE BASE, Kan. -- If you've ever been to the dentist, seen an advertisement for toothpaste or tuned in lately to the heated discussion about Wichita's water supply, you've heard about fluoride. There's been a lot of talk about the pros and cons of fluoridating the city's water, so let's talk about fluoride: what it is, how it works, why the American Dental Association recommends it and where to get it. Fluoride is a compound of elemental fluorine with another element, usually sodium, used to treat water or applied directly to teeth to prevent tooth decay. Fluoride is incorporated in developing mineralizing tissues like teeth and bone. This process is why early supplemental introduction is important - to gain the benefit of having fluoride incorporated into the developing teeth. This conveys greater resistance to cavity development. How? Fluoride replaces "softer" minerals in the teeth to create "harder" acid resistant enamel that resists cavity formation. Also, ingested fluoride concentrates in the saliva, inhibiting the production of acid by cavity producing bacteria. Fluoride is also incorporated into the surface layer of teeth through topical application via your toothpaste, mouth rinses and in-office treatments. These daily applications are important because they facilitate the remineralization of tooth enamel that has been demineralized by the acid attack of the cavity producing bacteria in the mouth. In summary, there's a three-fold benefit to the controlled application and ingestion of the small amounts of fluoride recommended by the ADA. McConnell's water supply is fluoridated and monitored daily to maintain an optimal level of fluoride, but the surrounding areas of Sedgwick County and Derby, Kan., are not. If this is a surprise to you, don't panic! There are a number of overseas bases that also deal with a non-fluoridated public water supply off-base. As an adult, the twice daily topical application of fluoride toothpaste along with a daily fluoride mouth rinse is sufficient to maintain the protective benefits of fluoride. For children, Air Force Pediatric Dentists recommend using only fluoride toothpastes. Children who cannot yet spit should only use a smear amount. The tiny amount ingested if swallowed is negligible to the protective benefit of fluoride on their erupting teeth. For children who can spit, a pea-sized amount of toothpaste should be used twice daily in addition to a daily fluoride mouth rinse. It is also recommended to supplement children's daily intake with bottled fluoridated water available at local grocery stores. Eight ounces a day is sufficient. If your baby's formula contains fluoride, just use tap water. The dental clinic no longer advocates prescription fluoride drops as the potential for over fluoridation is too high. Lastly, when you come in for your annual exam and cleaning you will be offered a fluoride varnish before you leave. The Air Force Dental Corp solely advocates the use of the varnish over the previously used gel, because the varnish delivers more than twice the concentration of fluoride and remains on the teeth longer to provide maximum benefit. Hopefully, this information helps educate you on the benefits of and proper use of fluoride. See you around the clinic.