Should I use fluoride-free toothpaste?

By Dr Anthony Hua

October 14th was World Cavity-Free Future Day (WCFFD), an annual event now in its fifth year, which is dedicated to raising awareness of the fact that anyone of any age can fall prey to dental decay. Throughout the world, tooth decay and oral disease affect 3.9 billion people, with untreated tooth decay impacting almost half of the world’s population. As Australians, we are lucky to live in a country which provides fluoride in our drinking water to help prevent tooth decay. Much of Australia’s drinking water has had safe levels of fluoride in it since the 1960s, and as of March 2012, fluoride has been in over 70 per cent of Australia’s drinking water sources. But with all this fluoride in our water do we need fluoride in our toothpaste as well? We investigate the pros and cons so you can make the call.

What is fluoride?

Fluoride is a natural mineral that has been essential for oral health treatment for decades. It was first discovered in the 1900s when researchers observed that many children in Colorado Springs had brown stains on their teeth but had teeth resistant to tooth decay. They found large amounts of natural fluoride in the water in Colorado Springs, which made most of the community resistant to tooth decay. However, by the 1960s, scientists worked out what was the optimum amount of fluoride to be added to water to both prevent decay but not be harmful where fluorosis can occur. Fluoride supports healthy tooth enamel which is the outer protective layer of the tooth, and it also fights the bacteria that harm teeth and gums. Fluoride is especially helpful if you’re at high risk of developing tooth decay. Plaque produces an acid that erodes teeth and inflames gum tissue. If the plaque breaks down the enamel layer, bacteria can infect and harm the nerve tissue and blood supply at the core of the tooth. Read on to learn about fluoride treatment benefits, side effects, and what to expect.

What is in fluoride-free toothpaste?

In some brands, fluoride might be replaced by ingredients such as charcoal, clay or baking soda. There’s no scientific evidence that these ingredients prevent cavities or eliminate gum disease. Brushing with a fluoride-free toothpaste won’t actually remove the dental plaque from your teeth. It’s the actual brushing that disrupts the plaque. The mechanical action of brushing the teeth with the bristles and flossing is the important step in removing the dental plaque, not the actual fluoride-free toothpaste.

Pros of using fluoride-free toothpaste

Safe for young children

It’s fantastic to teach your children early on how to brush their teeth and set them up with good dental hygiene habits. However, it’s also difficult to get very young children not to swallow the toothpaste. Young children shouldn’t consume too much fluoride, or they may be at risk of fluorosis. Fluorosis occurs when children ingest large amounts of fluoride and streaks, spots or staining consequently may develop on their teeth. It usually only occurs if they are taking fluoride supplements, there are large amounts of naturally occurring fluoride in the water, or they are swallowing lots of adult strength fluoride toothpaste, so the condition is rare. But It’s still a good idea to limit fluoride in young children. A pea-size drop of age-specific toothpaste is enough for young children.

Reduce the risk of bone weakness and skin irritations

Over time, it’s possible if you swallow too much toothpaste or mouthwash with fluoride in it your bones and ligaments could become weakened. Like any medication, if it’s overused, it can be harmful. It’s also possible that skin conditions such as rosacea and perioral dermatitis have become linked with fluoride sensitivity. However, if you only use it in your mouth to brush and spit it out without ingesting large amounts, it is unlikely to be absorbed systemically to cause these side effects.

Cons of fluoride-free toothpaste

Higher risk of tooth decay

When you consume food or drinks that contain sugar, bacteria acid from the food and drink break down the outer layer of the tooth, and that’s how decay will begin to form. Without fluoride, your teeth will be left unprotected. The fluoride acts as a protective agent which helps prevent tooth cavities and shields your tooth enamel. Brushing your teeth will help prevent plaque, but it’s not enough to stop cavities. You need fluoride toothpaste to maintain your oral health.

Bacteria build-up

If you use toothpaste without fluoride, your teeth will be left unprotected from bacteria and their by-products. Fluoride can interfere with bacterial acid production, which leads to reducing demineralisation. It also acts as an antibacterial agent.

From a professional dentist’s perspective, toothpaste with fluoride in it does help you maintain your oral health. It has been proven to help prevent bacteria build-up and reduce the risk of dental decay. However, recommendations indicate that children under the age of 6 should use a lower concentration of fluoride or fluoride-free toothpaste to brush their teeth. This should be done until parents are confident that their children are not swallowing large amounts. So, after weighing up the pros and cons if you’re still not sure which way to go, contact us to make an appointment to discuss your dental concerns and treatment goals in further detail.

dr anthony huaArticle by Dr Anthony Hua – Principal Dentist

Dr Anthony Hua is the Founder & Principal Dentist at Burleigh Dental Studio. His passion, expertise and dedication to the field of dentistry have been recognised by his achievement of Fellowship status with the Australian Society of Implant Dentistry (ASID) and the International Congress of Oral Implantologists (ICOI).

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