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Preventing Cavities: Questions About Fluoride Use


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By Dr. Melissa McCool

Fluoride is a hot topic for dentists; one that we felt was high time for exploration with our partners over at The Smile Shop.

Do a lot of children need prescription fluoride?

There used to be a much higher amount of children who used prescription fluoride, but these days, it’s being prescribed a little bit less. The reason for that is that it’s more of a case-by-case basis. Each individual child has their own unique health plan – one that takes into account dental history, parent’s dental history, dental hygiene, health concerns, and diet. The other reason is that there is a halo effect – and even though Reno isn’t a fluoridated city, children often receive fluoride from other sources of food that might have been prepared in a different location or community where fluoride is more common. We will usually only recommend prescribed fluoride if the children are in high risk situations, have a history of napping or sleeping with bottles, or high rates of decay in both parents.

What do you recommend for children in terms of fluoride use?

We recommend use for fluoride for all children, starting with a fluoridated toothpaste by the age of two. Some kids we will recommend that they start a little bit earlier, based on their specific situation. Once the children are older, usually around the age of five, we recommend using the fluoride rinse, like Act, as well as the fluoride toothpaste. Under the age of five, it’s more likely that these children would swallow the rinse, so we generally wait until they are a little more mature.

Why should you use fluoride?

Fluoride helps keep the enamel on our teeth hard and mineralized. Over time, as our teeth are exposed to acids, the enamel can lose calcium and phosphate. This is called demineralization. Fluoride can help protect teeth from demineralization and also reverse the process in some cases.

Are there any risks to using fluoride?

The primary risk to fluoride is the risk of overuse (or underuse). With too much fluoride, the teeth can get fluorosis, which causes a yellow or white staining or pitting on the teeth. With underuse, you run the risk of leaving your teeth more susceptible to cavities and decay. Fluoride is a naturally occurring element on the periodic table. Just like our bodies need iron, we need fluoride. The important part is moderating the amounts we get so that we don’t receive too much, or too little.

How do you find the balance with fluoride for dental health?

First things first, we always take into account the unique individual. If that child has soft spots on their teeth, a history of dental difficulties, or sleeping with a bottle, we might be a little more aggressive in our plans for cavity prevention. But for most children with low risk, we recommend brushing twice a day with fluoridated toothpaste, keeping a healthy diet, and using a fluoride rinse.

Dr. Melissa McCool is a native Nevadan, born and raised in Boulder City, Nevada. She attended both UNR and UNLV for her undergraduate education, majoring in biological sciences. She received her DDS from the University of the Pacific in San Francisco and after graduation, practiced as a general dentist in Boulder City and Las Vegas. She also held a part-time faculty position at the UNLV School of Dental Medicine. After practicing for two years as a general dentist, she decided to pursue her passion for treating children and attended a two-year pediatric residency at Children’s Hospital in Wisconsin to become a certified pediatric dentist. Dr. McCool has taken additional examinations to become a board certified pediatric dentist. She loves spending time with her husband and son.


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