Does Fluoride Toothpaste Prevent Cavities?


When it comes to protecting children’s teeth, brushing and flossing simply aren’t enough. The ADA recently reaffirmed something we’ve been telling parents for a long time — toothpaste needs fluoride to prevent cavities.

As a pediatric dentist, prevention is very important to me. I want our kids to have the best shot possible at living happy and healthy lives. I also support more conservative approaches to healing and medicine, making the best use of what Mother Nature gave us before we intervene with more invasive techniques. I’m concerned, however, that people may be putting themselves or their children at risk by switching to “natural,” fluoride-free products.

Although many well-intentioned (but misguided) individuals battle fluoridation in water and oral health products, the science is clear on this one: fluoride has demonstrable benefits in cavity prevention. A large body of research, underscored by a study published in Gerodontology last May, emphasizes that using fluoride toothpaste is the only proven way to prevent cavities.

What Is Fluoride?

Fluoride is a natural mineral that helps build your bones and teeth. In our environment, it’s commonly found in the soil, water, and flora.

When the bacteria in your mouth break down sugars, they produce acids that eat away at tooth enamel. This demineralization leaves teeth more susceptible to cavity-causing bacteria. Fluoride is beneficial for teeth because it helps rebuild weakened tooth enamel.

The History of Fluoride

Fluoride research began over 100 years ago in Colorado Springs. When Dr. Frederick McKay opened his first dental practice there, he was astounded to find many locals with splotchy, brown teeth. It wasn’t decay; in fact, their brown-stained teeth seemed impervious to tooth decay.

Years of research demonstrated that the water supply in Colorado Springs had very high levels of naturally-occurring fluoride, and it was responsible for the discolored teeth, called enamel fluorosis.

That left researchers with an intriguing question: Is there a level of fluoride that is safe and won’t discolor teeth, but still has the decay-fighting properties seen at higher dosages? It turns out that the answer to that question is “yes,” and it only takes a tiny amount.

In 1945, Grand Rapids, Michigan, became the first city in the world to intentionally fortify its drinking water with fluoride. Scientists spent the next 15 years keeping a very close eye on the development and oral health of tens of thousands of school-aged children.

The results were astounding. Dental caries among Grand Rapids children dropped by more than 60 percent. The discovery of fluoride benefits is often touted as one of the greatest achievements in health science, as it meant that we now had a way to prevent one of the most common ailments that we face.

Seventy years of research has proven that fluoride prevents cavities. There is simply no other ingredient with this kind of track record. Dentists have been recommending fluoridated toothpaste for decades because it’s the most effective way of delivering fluoride and protecting teeth.

What to Look for in Toothpaste

Many of us are guilty of using the wrong parameters for toothpaste selection. Some might opt for the toothpaste with the most popular children’s character, while some assume toothpaste is toothpaste and just go for the least expensive. Then there are those who intentionally shop for “natural,” fluoride-free toothpaste.

As your experts in children’s dentistry, we’re here to tell you that your choice of toothpaste matters. Fortunately, there’s a simple way to tell if you’ve got a toothpaste that will protect your children’s teeth or one that will just have them going through the motions.

Look for the ADA Seal.

Tom's Fluoride Toothpaste ADA Seal kids fluoride toothpaste

Even brushing and flossing every day won’t be enough to prevent cavities if the toothpaste is fluoride-free. If the product has a seal from the ADA (American Dental Association), that means the product has been tested and deemed safe and effective. It’s important to note that toothpaste products won’t be granted an ADA Seal of Acceptance if they don’t contain fluoride.

Toothpastes to Avoid

fluoride free toothpastefluoride-free Colgate fluoride free burt's

On these toothpastes, there’s no ADA seal. Fluoride isn’t listed as an active ingredient. Note that toothpastes for training infants and toddlers — kids who are too young to rinse and spit after brushing — sometimes don’t contain fluoride and are safe to swallow, but talk to our office before going that route for any length of time.

What’s All the Fuss About?

toothpaste tip

Many nutrients, even those essential for good health, can cause problems if consumed in great quantities. Natural fluoride is no different.

The amount of fluoride present in toothpaste is not great enough to pose significant health risks, but it still shouldn’t be swallowed. High intake levels could lead to fluorosis (enamel discoloration), though that’s primarily a cosmetic concern. It ranges from mild white flecks to brown spots on the teeth.

Most people, especially children, use far more toothpaste than is necessary. Very young children should be supervised so they learn to brush properly. Ensure that they spit rather than swallow the toothpaste.

From the time their first tooth arrives until they are three years old, children should use a dab of toothpaste the size of a grain of rice. From three to six years of age, they can move up to a pea-sized dab of toothpaste.

These amounts keep fluoride at acceptable levels (even if the kids accidentally swallow the toothpaste) while still providing ample benefit to oral health. There has been no evidence showing an association between the recommended amount of fluoride for preventing tooth decay and any harmful effects.

Choose Fluoride Toothpaste

Parents want the best for their children. It’s not always easy to know the right thing to do as a parent, but in the case of toothpaste, the choice is clear. Choose a fluoride toothpaste with the ADA Seal of Acceptance for the best chance at preventing tooth decay.


Dr. Duffy

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