Fluoride

What is fluoride?

Fluoride is a material that is found all around us in small amounts. It is very effective in protecting teeth against decay.

Public health experts have known for many years that fluoride protects teeth. Some parts of America have natural fluoride in their water and more than 50 years ago, dentists noticed that people living there had stronger healthy teeth.

How does fluoride work?

We all have bacteria in our mouths all the time. They live on food that is left in their mouth and produce acids as a waste product. The acids attack the teeth by dissolving the minerals in the tooth surface.

Luckily, there are minerals in saliva which can mend the teeth when decay first starts, but the mending process needs fluoride to work properly.

• In a few places, water supplies contain enough fluoride to keep teeth healthy. This can happen naturally or the amount of fluoride can be changed to make it right for teeth. In Britain, only one person in 10 gets enough fluoride from the water supply.
• Most people get fluoride from toothpaste. Packs tell you how many parts per million (ppm) of fluoride the toothpaste contains. It might have a low fluoride level (around 500 ppm) or a higher dose (1000 or 1500 ppm). You should use mow-dose toothpastes for children under seven.
• For a few patients, dentists recommend they take extra fluoride, either as tablets or drops, or as a varnish painted onto the teeth. Extra fluoride is only recommended for patients with very bad decay or who have illnesses which make it especially important to avoid dental problems.

The amount of fluoride you get in water or toothpaste is completely safe. If there is fluoride in local water supply, you can still use fluoride toothpaste as well.

There is just one thing to be careful about when children use fluoride toothpaste. Up to the age of seven, while the permanent teeth are forming, too much fluoride can produce marks on the teeth. To be sure this will not happen, you should help children up to the age of seven clean their teeth to make sure they do not eat the toothpaste and only use a small amount of toothpaste (the size of a pea is recommended).

What are the benefits of fluoride?

• Fluoride helps teeth stay healthy and strong.
• Fluoride can help heal early decay.
• You will need less dental treatment.
• Healthy teeth look better than repaired teeth.

Healthy Eating

Why does healthy eating matter?

The most common dental problems are caused by foods and drinks.

• Bits of food left on teeth from plaque which causes gum disease if it is not cleaned off regularly.
• Bacteria in plaque produce acids which cause decay.
• Acids in food and drink can dissolve away tooth surface – this is called “erosion”.

Good oral hygiene will prevent most dental problems. But you can also reduce the risks for your mouth by having sticky or acid food and drink less often.

How can I tell what’s healthy?

You won’t always be able to tell whether a product will harm your teeth.

• Labels sometimes hide what is in the product. A label might say “carbohydrate” instead of “sugar”, for example.
• Some products say “no added sugars” even though they contain a lot of natural fruit sugar.
• Products containing small amounts of sugar could be harmless if they also contain ingredients such as calcium.
• There is not a simple test of how erosive foods and drinks are so labels cannot answer this question for you.

Milk and water are safe drinks. So are tea and coffee if you do not add sugar to them. Fruit, vegetables, dairy products (such as cheese) and starchy products (such as bread, rice and pasta) are all safe foods.

Because it is not easy to be sure exactly what is harmful, the best advice is to cut down on how often you have sugary or acidic food and drinks. Just use food and drink sensibly and don’t bathe your teeth in a stream of acid or sugar or other stickiness.

Remember the rules

• Clean your teeth twice a day.
• Don’t eat sugary, sticky or erosive foods more than five times a day.
• Eat at least five servings of fresh fruit and vegetables a day.

During the day, when you cannot clean your teeth, think about chewing sugar-free gum. Chewing gum increases the flow of saliva around the mouth, helping to remove bits of food. Also, minerals in saliva (and fluoride in toothpaste) will help the tooth mend after it has been attacked by plaque acids.

What are the benefits?

• A healthy diet and good oral hygiene should prevent most dental problems.
• Nutritionists give the same advice as dentists about healthy eating. If you change how you eat so as to look after your teeth, the rest of your body will be healthier too.

Tooth Erosion

What is it?

As well as being damaged by decay, your teeth can be “eaten away” (eroded) by acids in the mouth. The acids may come from food and drink or, sometimes, from your stomach. Acids dissolve minerals out of the hard enamel surface, making the teeth thin. The teeth can then become extra sensitive to hot and cold food and drink.

Erosion can also be linked to drinking a lot of acidic drinks for example, fizzy drinks (“diet” drinks are just as bad), acidic fruit drinks and “sports” drinks. Dentists look for erosion in teenagers especially and may ask how much of these types they drink.

Some people suffer from erosion more than others. People with eating disorders may suffer from erosion because stomach acids attack the teeth. Dentists may ask about eating disorders if they see teeth that are very badly eroded.

Can I prevent erosion?

You can protect teeth from erosion by being careful how you use acidic drinks.

• Drink them less often.
• Drink them quickly.
• Drink them cold.
• Use a straw so that the drink misses your teeth.

Some foods are acidic too – for example, pickles.

Because acids temporarily soften the tooth, don’t brush your teeth immediately after eating or drinking something acidic. If you can, rinse your mouth with water instead and brush your teeth later (if possible 20 or 30 minutes after having an acidic food or drink in your mouth).

Dentists tell you to brush your teeth twice a day (twice a day is enough if you do it thoroughly), and always use fluoride toothpaste. Like teeth which are attacked by decay, eroded teeth can use the minerals in saliva to mend themselves. Fluoride helps this process.

Can my dentist treat erosion?

Because erosion attacks all of a tooth’s surfaces, you may not notice it at first. Sometimes, the teeth can be weakened so much that they have to be protected with crowns or veneers which replace the lost tooth surface.

Fissure Sealants

What are fissure sealants?

Fissures are grooves in the chewing surface of back teeth. They are difficult to keep clean so there is more risk of decay. Fissures can be sealed with tough plastic to protect them. The plastic is runny at first but sets hard, like paint. Sealants may be see–through or tooth coloured. They are normally only used for children and only on permanent teeth, not on milk teeth.

Your dentist will discuss whether you need sealants. If you do, you will also have to agree to which teeth need to be sealed. The need for sealants will depend on:

• The shape of each tooth;
• How much a child’s teeth have already decayed;
• How much decay a brother or sister has had (because there can be family patterns in tooth decay); and
• A child’s general health (because general health problems can make it especially important to avoid dental problems).

What will my dentist do?

The dentist will:

• Clean the tooth thoroughly with a rotating brush or rubber polisher;
• Dry the tooth and keep it dry by putting cotton wool round it and using suction;
• Dab a mild acid on the tooth and leave it for a short time to make the tooth surface rough (this will not hurt at all);
• Wash and dry the tooth by blowing water then air onto it;
• Change the cotton wool rolls around the tooth to keep it dry;
• Paint plastic onto the fissures;
• Harden the plastic by pointing a bright light at it (you will see the dentist and dental nurse protecting their eyes);
• Check that the tooth is comfortable to bite on; and
• Trim and polish the sealant.

What are the benefits?

• Fissure sealants protect teeth from decay.
• They can last for years. Or, if they fall out or wear out, they can usually be replaced if there is no decay underneath.

Click here for opening times