Is fluoride safe? Recently, many people have wondered how necessary and safe fluoride is. Additionally, a new and sometimes unheard option is hydroxyapatite.
Read this FAQ to learn all about fluoride and hydroxyapatite and which is the best and safest choice for you and your children.
What is fluoride?
Fluoride is a mineral widely used in dental care because it improves and strengthens tooth enamel and prevents cavities. However, it’s use has been debated in recent years over the safety and necessity of putting fluoride in the water. In this first section, we will answer your most frequently asked questions about fluoride.
Why would a kid need fluoride?
Fluoride integrates into the molecular structure of tooth enamel, making it more resistant to bacteria and sugars that cause cavities in children. It is used pediatrically for remineralization of teeth and cavity prevention.
Because of its low cost, it is a widely available mineral: it is generally found in toothpaste, dentists’ treatments, and even water, and it is present in almost every state in the United States.
Is our water mixed with fluoride?
In the United States, water is usually mixed with a supplemental amount of fluoride. The exception is in Utah, where new legislation will take effect on May 7, 2025, to ban the addition of fluoride to public drinking water. Although communities will be prohibited from adding fluoride to water, individuals will still be allowed to get prescriptions for fluoride supplementation.
Although water fluoridation is considered a public health measure to prevent cavities, North Dakota and Tennessee are joining the debate on mandatory fluoridation and considering banning fluoride in water. This debate stems from studies indicating that high amounts of fluoride can cause some problems, such as dental fluorosis.
What is dental fluorosis?
Excessive fluoridation has potential associated risks. One of these risks is dental fluorosis (also known as mottled enamel), which is especially worrisome in children, as they are forming the enamel, a protective layer of the tooth. Dental fluorosis usually presents with brown stains on the teeth in the most severe cases. Since most commercial toothpastes have fluoride added, to avoid dental fluorosis, you should:
- Recommend children to never swallow toothpaste.
- Start using fluoride toothpaste once your kid turns three.
- Use only a small amount of toothpaste (usually pea-sized).
- Consult with your dentist whether fluoridation as a supplement is necessary for each individual case.
If the damage from dental fluorosis is too great, cosmetic and whitening treatments can be used on teeth. Additionally, once your kid turns eight years old, the risk of developing dental fluorosis diminishes, as the enamel of permanent teeth is already formed.
How about breastfeeding and giving formula with fluoride water?
Another frequently asked question when fluoridating water is whether it is safe to mix formula with water when babies are still young. Although using fluoridated water to prepare formula may increase the risk of dental fluorosis, most cases are mild.
It is not necessary to supplement fluoride for infants who are breastfeeding or taking infant formula.
If you prefer not to use fluoride before your baby’s first tooth erupts, you can prepare the formula using fluoride-free water.
Could Fluoride be linked to my kid’s IQ?
Some studies (including U.S. government studies) have described the possibility that too high a level of fluoride may be linked to lower IQ scores in children. However, the levels in these studies are higher than the levels added in the US.
A recent analysis published in JAMA Pediatrics raised questions about whether it is safe to fluoridate water, especially for pregnant women and young babies, as children’s IQ may be affected. However, to reach meaningful conclusions, we need more studies on the topic.
What are some pros and cons of fluoride?
Some fluoride pros include:
- It prevents tooth decay
- It improves the enamel
- It saves costs
Some fluoride cons include the following points:
- The possibility of dental fluorosis
- The possibility of overexposure
- Supervision needed from the parents
What is hydroxyapatite?
Another mineral that is naturally occurring is hydroxyapatite. In recent years, it has emerged as a safe alternative to fluoride. Hydroxyapatite has the following applications useful for pediatric dental procedures:
- Remineralizes teeth
- Prevents cavities
- Non-toxic
- Reduces pain in children with hypomineralization
For pediatric patients, hydroxyapatite offers an effective solution as an alternative to fluoride.
What is hydroxyapatite toothpaste?
Hydroxyapatite toothpaste is a product specifically designed to be fluoride-free and to improve the mineral composition of the tooth, improving the enamel. Let’s analyze some key points of hydroxyapatite:
- Remineralization: Hydroxyapatite particles fill the spaces in the enamel and restore its protective layer.
- Reduction of sensitivity: This mineral also occludes the dental tubules, decreasing hypersensitivity and pain in the teeth.
- Reduction of bacterial adhesion: Studies show that cavities are less likely to develop when using hydroxyapatite toothpaste.
Some individuals may have allergies to other products added to hydroxyapatite toothpaste, such as additives like xylitol or glycerin.
Can we use hydroxyapatite in preventive dental care?
Yes, Hydroxyapatite (HAp) is recognized as a safe replacement for fluorine. It can help in some specific aspects, such as:
- Prevent tooth decay
- Remineralize teeth
- Prevent gingivitis or gum disease
- Protect against tooth erosion
Hydroxyapatite is a fluoride-free alternative for the prevention of dental problems. Although it is more expensive than fluoride, many odontologists prefer it.
Is hydroxyapatite safe for children?
One of the greatest advantages of hydroxyapatite is the low risk it poses to children, unlike fluoride.
Hydroxyapatite can be ingested, and clinical research so far labels it as safe for children of all ages.
What are some of the cons of hydroxyapatite?
Even though hydroxyapatite has numerous advantages, there are some limitations for pediatric use. Compared to fluorine-containing products, some hydroxyapatite cons include the following:
- Higher cost: The cost of hydroxyapatite compared to fluoride is significantly higher.
- Fewer studies: There are decades of studies on fluorine, while hydroxyapatite is relatively new.
- More difficult to obtain: Obtaining hydroxyapatite can be more difficult, so not many parents will opt for this option.
Which should I choose for my kid? Fluoride or Hydroxyapatite?
In the end, it is up to each parent to decide whether to use fluoride toothpaste or hydroxyapatite toothpaste. Now that you know the pros and cons, you can make an informed decision.
- US Department of Health and Human Services: Fluoride Exposure: Neurodevelopment and Cognition
- UT Health: Hydroxyapatite as Remineralization Agent for Children’s Dental Care
- The New York Times: Utah Becomes First State to Ban Fluoride in Public Water
- NBC News: Fluoride once again scrutinized for possible effect on children’s brains
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