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2. Fluoride - How Much Do We Use ?

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How Fluoride Works, And Why Is It Necessary?

For many years now, millions of people have benefited from the decay-preventing properties of fluoride in their drinking water and toothpaste. Today, most dental authorities around the world agree that fluoride is an excellent and a very safe way to improve people's dental health. In fact, the level of tooth decay among 12 years old in Malaysia has fallen by 30-40 % over the last decade, largely as a result of the use of fluoride.

Some researchers have argued that the widespread use of fluoride in the water supply, in tooth pastes, and in special treatments has been the single most important advance in dental health!

How Does Fluoride Help Prevent Cavities?

When plaque develops on your teeth, it produces an acid which begins to attack the minerals in your tooth enamel. This acid attack, which occurs soon after you eat (particularly carbohydrates and sticky foods), continues with diminishing intensity for about 30 minutes. When this happens repeatedly to an unprotected tooth, the acid eventually will break through its hard enamel, and dental cavities will result.

This is where fluoride is so vital for protecting your teeth. Fluoride actually gets into the hard enamel shell, strengthening it against the acid attack. Brushing your teeth regularly will clear away the food that encourages plaque to form, but brushing with a fluoride toothpaste will ensure that the enamel that protects your teeth remains hard and strong.


Since caries is a dynamic process that consists of demineralization and demineralization phases, any preventive treatment must:

  1. Minimize the former
  2. Maximize the latter

When present in dental plaque and saliva, even in concentrations as low as 0.1 to 0.2 ppm, fluoride achieves both ends ; it catalyse the formation of non-carbonated fluorapatite, which in turn makes the incipient lesion more resistant to dissolution than normal enamel. This explains why people assuming all factors remain constant who move into fluoridated areas experience a reduction in caries while those who move from fluoridated to non-fluoridated areas experience an increase; and why caries level always rise when fluoridated is discontinued. It also explain why the management of incipient decay now often begins - and in many cases, ends - with an intensified, well monitored fluoride therapy.

But in as much as it reconfirms that fluoridated water is still the best and least expensive way of preventing caries in children, studies also reconfirms another notable phenomenon: even in the absence of fluoridated water, caries are on the decline throughout the industrilised world. The generalised decline in caries in the industrilised world is fairly easily explained. In the recent 50 years since fluoridation began, a number of new delivery system have been developed and become popular - topical fluorides, varnishes, supplements, rinses and ( in a class by itself ) toothpaste; in addition, there is considerable inadvertent ingestion of fluorides in foods and beverages, processed with optimally fluoridated water.

In the new context, control of total fluoride intake becomes highly individualised and, consequently, much more practitioner-intensive.

Investigators are also re-examining the fluoride levels in toothpaste - which in 30 years has become a far greater source of fluoride in the world than even fluoridated water and which, by consensus, is the overwhelming reason why caries incidence has plummeted in so many non-fluoridated communities in the industrilised world. Parents should supervise the amount of toothpaste for children to a "pea-sized" portion for brushing.

Is Fluoride Needed As Much By Older People As It Is By Children?

Fluoride has benefits for everyone, from young babies to older people, and the sooner a person's teeth come into contact with fluoride, the better.

Adults need the protection of fluoride too, no matter how old they are. As we become older, our gums can recede. These exposes areas of the teeth which have no enamel enamel coating and are particularly susceptible to decay. Fluoride can also help to protect and strengthen these areas.

Some parents wonder whether, when the water supply contains fluoride, there really is a need to brush with fluoride toothpaste. The answer is yes. Clinical tests have shown that there are significant additional benefits in using a fluoride toothpaste, even if the water is already fluoridated.


Malaysian Dental Association shall ensure that the collection, use and disclosure of your personal data is consistent with the Malaysian Personal Data Protection Act 2010 ( 'PDPA' ). It is acknowledged that personal data collected and processed is obtained voluntarily and with your consent.

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