What is Fluoride and How Does it Work?
Fluoride is formed when the natural element, fluorine, is dissolved in water. Fluoride is found naturally in most food, water, rocks and soil. In a fluoridated area, about one third of the adult fluoride intake comes from foods such as fish, meat, fruit, vegetables and eggs. The other two-thirds comes from drinking-water and toothpaste.  Its specific function is to help teeth resist dental decay or cavities, and it may reverse the caries process once it's begun. When a baby's teeth are developing (before they erupt or appear in the mouth), the fluoride the baby swallows becomes part of the tooth's outer layer, the enamel. Teeth that incorporate fluoride during this crucial period are strengthened against cavities, because the fluoride makes the enamel more difficult for decay- producing acids to dissolve. After the teeth have erupted, fluoride in saliva not only inhibits tooth decay but also causes early cavities to remineralize.

Many studies have shown that people who drink water containing the correct amount of fluoride have less decay. Fluoridation is a great way for everyone to have good teeth. Before fluoride was adjusted in our water supplies, a 12-year-old child would have about 8 permanent teeth affected by decay. By 1990, this had reduced to fewer than 2 permanent teeth. 

Is Fluoridation Expensive? 
The average national cost of fluoridation is about 20 cents per person per year. According to the Centers for Disease Control, every $1 spent on fluoridation saves up to $75 on dental bills. No other method produces comparable caries protection more economically. Eight of the 50 states have passed laws making fluoridation mandatory, and in another 10 states more than 90 percent of the population drinks fluoridated water.

Fluoride Toothpaste
Fluoride toothpaste should be used at least twice a day by all children, as it contributes to reduced tooth decay. Normal toothpaste contains about 1mg fluoride per gram of toothpaste. Low fluoride toothpaste contains about half this amount.

Young children (under 6 years of age) should be discouraged from swallowing toothpaste. If small children swallow fluoride toothpaste, they may get too much fluoride which can affect the formation of permanent teeth, but the younger the child, the more difficult it is to prevent swallowing. 

Some tips for children:
-use a low fluoride toothpaste. My First Colgate Junior®, Macleans Milk Teeth®, and Oral B Children's Toothpaste® are low fluoride toothpastes available in W.A.; 
-use only a pea-sized amount of low fluoride toothpaste or a smear of regular fluoride toothpaste on the toothbrush for children under six; 
-encourage your child to spit out the toothpaste and rinse after brushing; 
-avoid toothpastes that are brightly coloured or contain attractive flavouring agents, so that toddlers do not think toothpaste is for eating. 

A combination of better oral hygiene, better diet and regular access to small amounts of fluoride have undoubtedly contributed to the improvement in children's dental health that most parents have noticed. 

Research and Controversy Related to Fluoride:
Numerous responsible studies over the past 40 years have proven beyond a doubt the immense value of adding fluoride to public drinking water. The American Medical Association, the American Academy of Pediatrics, the American Dental Association, the World Health Organization, the American Cancer Society, the U.S. Public Health Service, the National Research Council, and every surgeon general since the mid-1950s all have agreed that water fluoridation is a cheap, effective and safe way to reduce cavities, especially in children. Over half of all 12 year old children who live in an area where the water is fluoridated are cavity-free!

Nearly 61% of all Americans drink fluoridated water. So why has it taken so long to add fluoride to our water? One reason is that the debate over fluoride has been taken out of the scientific and thrown into the political arena. A second reason is that many opponents of fluoridation condemn the practice by misrepresenting legitimate scientific research. Scare tactics that fluoride causes birth defects, cancer, heart disease and arthritis are frequently voiced. The discussion becomes intense and emotional rather than calm and objective. The well respected magazine, Consumer Reports, stated in 1978, "The simple truth is that there is no scientific controversy over the safety of fluoridation. The practice is safe, economical, and beneficial. The survival of any controversy is one of the major triumphs of quackery over science in our generation."
 

Impact of fluoride on dental health -- Position of ADAJ Am Diet Assoc. 1994;94:1428-1431.
(This position was reaffirmed by the House Executive Committee on September 28, 1998)
The appropriate use of fluorides through water fluoridation, fluoride supplements, or topical application, has been shown to be an important factor in the prevention of dental caries and remineralization of teeth. This is true for persons of all ages. The use of fluorides and fluoridation is endorsed by almost all professional health organizations as the most effective dental public health measure in existence.

Fluoride is a natural element found at varying concentrations in all drinking water and in soil. It is considered a beneficial nutrient (1) and is present in trace amounts in the body. When consumed in optimal amounts in water and food and used topically in toothpastes, rinses, and office treatments, fluoride reduces the risk and prevalence of dental caries (decay) and helps promote enamel remineralization throughout life.

Position
The American Dietetic Association reaffirms that appropriate fluoride supplementation, through its beneficial effects on dental health, has an important, positive impact on health and nutritional status.

Mechanisms of Fluoride Action
Scientists have proposed that fluoride has several functions (2):
-Promotes remineralization of incipient lesions;
-Increases resistance to acid demineralization;
-Interferes in the formation and functioning of dental plaque microorganisms;
-Increases the rate of posteruptive maturation; and
-Improves tooth morphology.

1. Food and Nutrition Board. Recommended Dietary Allowances. 10th ed. Washington, DC: National Academy Press; 1989. 
2. Ripa L. A half-century of community water fluoridation in the United States: review and commentary. J Public Health Dent. 1993; 53(1):17-44