Some patients ask for fluoride-free toothpaste recommendations as a result of misconceptions about fluoride and the belief that it is harmful. This situation can be a delicate conversation to handle. As dental professionals we are aware of the benefits of fluoride, but our patients might have questions and challenge its safety. This article will help dental professionals tackle this conversation and reassure our patients of the health benefits of fluoride address specific concerns.
According to the Alliance for Cavity Free Future (ACFF), fluoride has been safely used for over 50 years to prevent tooth decay. Letting patients know this can be reassuring. We can also let our patients know that fluoride works by:
- Preventing cavities by inhibiting demineralization
- Strengthening enamel by promoting remineralization
- At higher concentrations, inhibiting bacteria that cause dental caries by interfering with the ability of bacteria to produce acid that causes loss of minerals from the teeth
We can also let patients and parents know that the use of fluoride in water called water fluoridation reduces caries rates in children and adults by 25%, and that fluoride can be delivered in many other ways, for example in fluoride varnishes, toothpastes, or mouthwashes.
Sometimes patients, or parents of children, might want to opt for natural ingredients in the products they use and have the preconception that fluoride is an artificial chemical, rather than a natural mineral. Patients may have questions on fluorosis of the teeth. Other health concerns about fluoride and its safety may arise based on information from unreliable sources, including on social media.
When addressing patient or parent concerns, we need to do so delicately and honestly. Most patients will respond to evidence and literature supporting the use of fluoride. We can share the benefits described above with patients or parents and let them know that fluoride is present naturally. If patients or parents have questions on dental fluorosis, we can explain that this occurs when there is overexposure to fluoride while the dentition is developing. Parents may have heard that this causes brown areas on teeth or heavy white mottling. It helps to let patients/parents know that the level of fluoride required for this is very high and occurs in parts of the world with very high levels of fluoride in well water. For other health concerns, we can let them know that multiple reviews have confirmed that fluoride is safe and effective for caries prevention.
The ACFF has also published resources which can be downloaded and used for or given to patients to help them understand the benefits of fluoride and answer any questions they have. These resources include useful pictures, frequently asked questions and leaflets to be used in the dental office or signposted to from the practice's website or social media.
Explain to your patients that fluoride for caries prevention is supported by leading health authorities and countries globally which should reassure them. Ultimately, to address any patient or parent's concerns about fluoride, dental professionals need to listen and answer any specific concerns, and reassure them that fluoride is a safe ingredient, a natural mineral found in rocks and that it has been proven to prevent caries over a 50 year history of use.