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If you use a fluoride toothpaste, drink water with the recommended level of fluoride, and get regular dental check-ups with professional fluoride applications, your teeth have a much better chance of fighting tooth decay and staying where they belong … in your mouth.

Fluoride is a mineral found naturally in water and many foods. In drinking water, the recommended level is one part of fluoride to one million parts water. Communities that don’t have a natural fluoride level to meet this standard will add just the right amount of fluoride to the water supply. Why? The reason is simple: fluoride helps prevent tooth decay.

Sugars in the mouth set up a favorable environment for the growth and development of germs. These germs produce acids that cause decay and leave behind deposits that injure the teeth. Fluoride is one of the big defenses against this process, because it builds up the resistance of teeth by strengthening the tooth’s enamel. It works its way into tooth enamel crystals and makes teeth harder and more resistant to these acids.

Fluoride works two ways: It works systemically by being ingested through drinking water and foods, and by topical application, such as toothpastes, mouth rinses and professional dentist-applied applications. It is the combination of these methods that helps fluoride have its maximum benefit.

It is the fluoridated water that has proven to be the most effective and simplest application. It should be emphasized that fluoride toothpastes are not a substitution for the combination of fluoridation of community drinking water and professional fluoride treatments, which have been shown to significantly reduce the incidence of tooth decay. As a result, some 7,000 communities have chosen to treat their water with fluoride over the past 30 years.

Chicago was the first big city to fluoridate its water supply, and has reported that tooth decay was cut in half among its school children as a result. (An added plus: Chicago parents saved millions of dollars on dental bills.) The city credits the fluoride for this improvement.

New York State’s health department conducted one of the first and most rigorously controlled research projects in medical history. Teams of dentists examined the teeth of thousands of school children in two upstate cities, both of which had fluoride-free water. In both cities, the incidence of tooth decay was the same.

Then, fluoride at 1.2 parts per million was filtered into the water supply of one of the cities. Over the next 10 years, physicians and dentists repeatedly checked the children, medically and dentally. When the decade ended, they found only one difference: The children ages 6 through 10 in the city with the fluoridated water had 60 percent fewer decayed, missing or filled teeth than the other city with no fluoride. And, there were no harmful medical effects noted during the examination of these children.

In the five boroughs of New York City, we have the optimum amount of fluoride supplied to us in our drinking water. But, what if your child does not drink tap water? What if your child drinks bottled or natural spring water? Well, it is advised to switch to tap water or buy bottled drinking water that has fluoride in it, which is readily available at the supermarket.

Don’t forget — even the tap water with which we cook allows us to get some fluoride into our system, and most people do cook with tap water.

What if you live in a town that does not contain any fluoride in its drinking water, like many towns in New Jersey? Then, a prescription for a vitamin that contains fluoride can be given from the pediatrician or pediatric dentist, based on the age and weight of the child. This type of treatment is only advisable to those children that have no fluoride in the tap water at all. In areas where the water is not fluoridated, children’s teeth can be substantially protected against cavities by this prescription, which is available in drop or tablet form.

Today, fluoridation is accepted and endorsed as a major public health measure in preventing tooth decay by virtually every scientific and health organization in the country. Fluoride in drinking water is the single most effective element we have for preventing tooth decay, particularly for infants and young children whose tooth enamel is in the formative stage. Starting fluoridation at a young age will help your child have a lifetime of good dental health.

Dr. Phyllis G. Merlino is a board-certified pediatric dentist with a private practice in Staten Island and is the proud mother of two young boys. She is active on the teaching staff of Staten Island University Hospital’s Dental Residency Program and is involved in many local dental organizations. She spends much of the month of February visiting schools and giving oral health presentations. For more information, visit www.DrMerlino.com.

Updated 4:29 pm, July 9, 2018
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