By Deborah Jeanne Sergeant
Only about 36% of Americans use a fluoride mouth rinse daily, according to Statista.com, even though most people could benefit from using it.
“Fluoride rinses are recommended for everyone except maybe children who could swallow the material as opposed to spitting it out,” said dentist Matthew Hall, director of the St. Joseph’s Health Dental Residency Program. “They are especially important for anyone who has active tooth decay or a history of being cavity prone.”
The people who are most at risk for cavities include older adults and young children.
For older adults, taking medication that causes dry mouth can limit the positive effect of saliva in balancing the mouth’s pH. Diabetes can contribute to cavities. Arthritis can hamper movement, making brushing harder. People experiencing dementia can be less fastidious with oral care. Older adults who no longer drive may find it challenging to receive regular dental cleanings and examinations.
“We also strongly recommend fluoride rinses to patients who have a dry mouth, caused by either systemic diseases or medications,” Hall said. “These are meant to be used every day. Fluoride gels and varnish are available to treat teeth that are sensitive to cold, especially those that have receding gums and exposed root surfaces.”
Many middle-aged and older adults experience gum recession.
Young children are typically at risk because of poor home care and practices such as allowing babies to take a bottle of juice or milk to bed, which exposes the teeth to enamel-eroding acid for hours.
“Fluoride treatments are used as a preventive measure in children at every cleaning and checkup appointment,” Hall said. “The amount of fluoride in these treatments is much more concentrated than that in a fluoride rinse which is why we do not use it as often.”
It may not seem important to save baby teeth from cavities but experiencing fillings or extractions while very young can create in children anxiety about dental care. Baby teeth serve as placeholders for permanent teeth, so losing baby teeth can contribute to a higher risk of needing orthodontic care.
At-risk people can ask their dentist to apply fluoride varnish and schedule dental exams to occur more frequently, as well as using good home care. Dentists can prescribe higher fluoride rinses and toothpastes to help at-risk patients.
Unless directed otherwise by their dentist, home care for most people includes brushing twice daily, flossing and using a fluoride rinse to help reduce risk of cavities.
Some people believe that using any fluoride is harmful to health; however, used properly at the appropriate levels in toothpaste and rinses, it’s perfectly safe.
“We will also prescribe at-home fluoride treatment for adults using trays that are made to custom fit to a patient’s teeth for those patients who have aggressive amounts of decay or who may be susceptible to rampant dental decay as a side effect of radiation and chemotherapy treatment of cancer,” Hall said.
Most municipalities add a small amount of fluoride to their water supply to benefit residents’ oral health.
“Studies have shown that it strengthens enamel by remineralization or rebuild weaken enamel cause by our acidic foods in our diet, thinning enamel from wear and tear over time, and reduced saliva flow,” said Meng Lin, a dentist with Rochester Regional Health in Clifton Springs. “Fluoride can stop or in some cases, even reverse early signs of tooth decay before it becomes a cavity and needs a filling.”
If swallowed, small amounts of fluoride rinse can cause upset stomach or in large amounts, nausea and vomiting. Small children should only use fluoride rinses under their dentist’s guidance and with careful supervision once it’s established that the youngsters can safely swish and spit without swallowing.
Lin said that patients should ask about fluoride rinses if they have traditional braces, as brackets and wires trap bacteria. Also, people who have had cavities in the past are more likely to have them again. Adults with gum disease, those with thin enamel, and those who consume high acid diets (including coffee, orange juice, soda, wine and beer).
“Fluoride is especially important for people who drink well water or untreated water that does not contain fluoride,” Lin said. “Regulated fluoridated water is safe to drink and rarely causes issues. Usually, issues arise when there are multiple sources of fluoride intake or for people with fluoride sensitivity. However, if there are any issues, consult your provider.”