Fluoride Treatment At The Dentist – Guide

Ever wondered what getting fluoride at the dentist entails? Well look no further because this guide will explain everything that you need and want to know about this dental procedure.

We’ll talk about all the different types of treatment that are available and what to expect for them. The benefits of getting it and also the potential side effects from excessive intake of it. Last but not least we’ll cover the costs and also alternatives for it.

Different types of fluoride treatment

There are actually different types of fluoride treatments that you can receive for the dental check up and cleaning visit. The various treatments apply fluoride to your teeth in different ways because the procedures are not the same.

• Varnish
• Gel
• Paste

The post-operative instructions for what you can do afterwards will also differ. Therefore it is important to know exactly which one you got so you know what you can and can’t do after.

Fluoride Varnish

Fluoride varnish is a treatment that applies a sticky gel which is full of tooth minerals over the surfaces of your dentition. The gel will harden once it comes into contact with saliva but it’ll continuously strengthen your teeth until you finally brush it off.

The varnish usually comes in a 5% sodium fluoride concentration. Some of them will contain other minerals such as calcium and phosphate. It is also sweetened by xylitol and tend to be gluten free.

How to recognize you’re getting varnish:

• It is individually wrapped.
• The packaging consists of a small amount of sticky fluoride along with a brush.
• Your dentist will paint it on your teeth and it will feel very sticky.

This is a topical treatment which means that it works based on being in contact with your enamel. The gel will keep supplying your enamel with fluoride, calcium, and phosphates as long as it is on your teeth. Due to this reason alone, the longer you leave it on your teeth the more benefits you will get out of it. Consequently the more value you’d get out of it if you had to pay for it.

It also implies that if you eat or drink too soon, you won’t reap the full benefits of fluoride varnish treatment. This is why there is a waiting period before you can do so.

What to expect

1. Your dentist will dry the teeth.
2. Paint the varnish on all of the teeth with the brush.
3. aNo eating or drinking for 2-6 hours depending on manufacturer instructions.
4. The residue should come off while you’re eating or you can simply brush it off.

The biggest disadvantage from using the varnish version of fluoride is the long no eating or drinking time afterwards. Some brands say you just have to wait two hours while others say to wait up to 6 hours. However they all agree that if you can hold off for eating or drinking as long as possible, that would help your teeth the most.

Our recommendation is to make sure you eat and have your coffee before your appointment if you know that you’ll be getting fluoride varnish.

Fluoride APF gel

Fluoride APF gel treatment uses a gel-like foam that is applied to your teeth via disposable trays. The trays are left in your mouth for a specified duration of time. Afterwards you spit out and try not to eat, drink, or rinse for about 30 minutes.

As the name implies, the gel usually comes in a 1.23% concentration of acidulated phosphate fluoride. Some of the concentrations may vary but it depends on the brand.

How to recognize you’re getting the APF gel:

• You will have disposable trays in your mouth that is filled with fluoride.
• The fluoride comes out of the bottle in a gel state but quickly starts foaming once you place it in your mouth.

This is also a topical treatment in that the longer you leave it in your mouth, the more effective it becomes. This is why the instructions tell you to not eat, drink, or rinse afterwards so that you don’t wash away the fluoride. You want it to stay in your mouth and work undisturbed.

The advantage of the APF gel over the varnish is that it provides a more pleasant experience. You don’t have this sticky substance in your mouth for the next few hours unlike the varnish. Also the no eating or drinking time is significantly less restrictive because it only requires 30 minutes.

What to expect

1. Your dentist will also dry your teeth.
2. Squirt the APF gel into the fluoride trays.
3. Place trays into mouth.
4. Have the patient bite down into the trays.
5. Wait for stated duration of time.100Wait for stated duration of time.
6. Remove trays and spit but don’t rinse for 30 minutes.

As with all fluoride treatments, you really should not eat or drink immediately afterwards. In fact, you shouldn’t rinse either. Please wait a minimum of 30 minutes prior to doing any of that. The longer you wait, the more benefits you’ll get out of it since it is topical treatment.

Prophy paste

Were you aware that the polishing past at the end of your dental cleaning is actually a type of fluoride treatment? Everyone calls it polishing paste but it does in fact contain 1.23% sodium fluoride in it. That is technically 5x more concentrated than your plain old fluoridated toothpaste that you have at home.

How to recognize you’re getting the fluoridated prophy paste:

• This is the polishing that is done after your cleaning.
• It comes in a variety of colors and flavors.
• It may feel a little gritty but overall it is very similar to toothpaste.

This type of fluoride treatment is included for all check up visits as long as you’re getting your teeth cleaned. Pretty much standard protocol and there is no additional charge for it.

What to expect

1. Immediately after the cleaning, you will rinse out.
2. Your dentist will brush on the prophy paste all over your teeth.
3. Rinse out and spit.
4. Wait to eat if you can but not necessary.

You can basically think of this as just toothpaste but with extra fluoride. It is not necessary to wait as long as the varnish or APF gels before you can eat because your teeth will feel normal just like after brushing. If you can wait, it would be good for you since the fluoride can work longer!

Misc products with it

Aside from the varnish, gel, and paste there are various other dental products which contain fluoride in it. These aren’t considered to be fluoride treatment but they do help strengthen your teeth.

Materials where you may find fluoride:

• Dental cement
• Glass ionomer restorations
• Core build up material
• Whitening gels

Is fluoride treatment necessary?

Fluoride treatment is not necessary because your teeth will still function even without it. You can speak, chew, and eat just fine even if you never come into contact with it ever again.

However getting it can provide multiple benefits for your teeth which would put you in a better position than someone who is fluoride free.

Benefits of fluoride:

• Strengthens teeth
• Repairs teeth
• Protects your enamel
• Antibacterial
• Decreases sensitivity

Who should get this treatment:

• Those at high risk or prone to tooth decay.
• History of a lot of dental work.
• You don’t live in a fluoridated community.
• You eat a lot of sweets.

We will give you a succinct overview of all the beneficial effects that it can bestow upon your dentition. However for a more comprehensive understanding of what it does, please check out our article on fluoride.

Makes your teeth stronger

Fluoride can transform your tooth mineral hydroxyapatite into fluorapatite which makes it stronger. Fluoride is the only mineral in the world which can do this.

Reasons why fluorapatite is superior:

• Increased resistance to acid dissolution.
• Decreases mineral solubility.
• Increased stability of mineral structure.
• Promotes remineralization to reverse cavities.

The end result is that your teeth become more resistant to cavities. That essentially makes it less likely for the carious lesions to progress through the stages of tooth decay. That can save you from getting dental fillings and various other procedures. These effects can be quantified by the fact that the pH at which your tooth demineralizes improves.

• Hydroxyapatite starts to demineralize at 5.5 pH
• Fluorapatite starts to demineralize at 4.5 pH

Helps repair small enamel defects and cavities

Fluoride can reverse small cavities by remineralizing the enamel. Cavities begin by demineralizing the enamel, which is when the tooth loses the minerals calcium and phosphate.

Fluoride can reverse this process by remineralizing all of these lesions. Essentially it goes into the enamel and then pulls the calcium and phosphates from the saliva back into the tooth to repair it.

Protects your teeth from acid attacks and decay

If you brush your teeth consistently with fluoridated toothpaste or get fluoride treatment, it can protect your teeth. It does so by forming a calcium fluoride-like layer over the surface of the enamel.

This extra layer of protection serves as a sacrificial layer in that it gets attacked by acids and decay first. That leaves the actual tooth underneath unscathed. Also once this layer dissolves, it will serve as a reservoir for additional phosphates which can help buffer the acids in the mouth.

Antibacterial

The antibacterial effects of fluoride have been well established but there is a lack of consensus on how much it contributes in preventing cavities. Essentially how it works is that it prevents the bacteria from metabolizing sugar. They eventually starve to death.

Can treat dentin hypersensitivity

There are two ways that fluoride can be used to treat sensitive teeth.

• Fluoride varnish. A high concentration application of varnish can significantly reduce teeth sensitivity. Studies have shown that there are no differences in various brands and they were all effective.
• Stannous fluoride. This particular form of fluoride is found in certain toothpastes. It decreases sensitivity by occluding dentinal tubules.

If your teeth are normally relatively sensitive, you may want to consider using a stannous fluoride based toothpaste instead.

Side effects

It is relatively safe to use when done so properly and all directions are followed closely. However there can be adverse effects if too much of it is being used or ingested. This is typically not a problem if you live in community with a controlled fluoridated water supply.

It can be a problem if the water supply is not managed because some communities naturally have a high level of fluoride. That was actually how dentist discovered the anti-cavity effects of fluoride to begin with!

Potential side effects:

• Fluorosis. A cosmetic condition where the teeth acquire an unsightly brown stain due to excessive intake of fluoride. Despite the appearance these teeth are actually more resistant to tooth decay!
• Neurotoxicity. Studies have shown that there is a possibility but it isn’t conclusive.
• Skeletal fluorosis. Fluoride can potentially strengthen the bones too much and that can be a problem. A very rigid bone may be more prone to fracture. Studies have found that due to this potential conflict, fluoride is no longer being recommended for patients with osteoporosis.
• Thyroid problems. Those with hypothyroidism may want to limit the intake of excessive fluoride because it can potentially reduce thyroid hormones.

Alleged side effects but no evidence

According to the CDC there has not been no convincing scientific evidence that links fluoridated water with any adverse health effects.

There are no risks associated with:

• Cancer
• Down syndrome
• Heart disease
• Osteoporosis
• Bone fracture
• Immune disorders
• Low intelligence
• Renal disorders
• Alzheimer disease
• Allergic reactions

How much fluoride do you need?

There is currently no daily recommended amount of fluoride to take. Although there is a proposed level of water fluoridation by the FDA and the ADA which is 0.7 ppm and considered safe. Studies have shown that when levels increase above 1.5 ppm, the risk of fluorosis concurrently increase.

That amount of drinking water along with brushing your teeth for two minutes twice a day with a fluoridated toothpaste shouldn’t pose an issue.

However if you live in a community with a non-fluoridated water supply, you can consider taking fluoride supplements. The recommendations are mostly meant for children. Below is a chart showing the suggested dosages for each age group and the amount of water fluoridation that is present.

Dietary sources

The most common source is through drinking water but unbeknownst to most, there are plenty of foods with fluoride in it.

• Brewed black tea and coffee
• Fluoridated water
• Canned shellfish like shrimp and blue crab
• Oatmeal
• Raisins
• Potatoes

Treatment cost at the dentist

The average cost for fluoride treatment is about $45. According to the American Dental Association 2022 survey of fees, it can be as low as $30 and as high as $65.

Those numbers are based on a survey for dentist offices which responded. That means there can be offices where the cost is higher and also lower than stated. Most of the pricing has to do with the cost of living in your community so you can use that as a gauge.

Insurance coverage

Fluoride treatments at the dentist are covered by most insurances but ONLY for children. There is usually a clause which states that eligibility is only up to age 13 or 14. That means adults are typically out of luck if they were hoping to have it covered.

However there are exceptions because at our practice, 1311 Jackson Ave Dental we have seen a couple of instances where it was covered. If you want coverage for it, you should read the fine print and choose an insurance plan that does have benefits for it!

Can I do it at home instead?

You may not be able to provide the same exact treatments as your dentist at home but you can still treat your teeth with fluoride. Aside from food, the two most common ways to get extra fluoride at home is through your drinking water and also toothpaste/mouthwash.

These methods will just supply a lower concentration of it as compared to having it done professionally. That is not to discredit the power of drinking enough water and brushing your teeth. We would actually argue that is even more important than getting a treatment done at your dentist 1-2x a year.

Fluoridated water supply

According to the latest data from CDC, as of 2018 about 73% of the US population is served by a fluoridated water supply. Simply drinking the recommended amount of water per day should supply your teeth with enough of this mineral.

Oral care products

Most of the oral care products that we use on a daily basis do indeed contain fluoride. That means your toothpaste and even your mouthwash will have it. As long as you’re keeping up on your oral hygiene you should be getting a sufficient amount of the mineral.

Alternative to fluoride

There is currently no replacement that can do exactly what fluoride does for your teeth. However there is one promising alternative, hydroxyapatite toothpastes which share a lot of the same anti-cavity benefits. The exact ingredient in these toothpastes are actually nano-sized thus they’re called nano-hydroxyapatite.

Benefits of nanohydroxyapatite toothpastes:

• Remineralizes teeth. It can repair small cavities and enamel defects by inserting itself into the lesions. It is a legitimate replacement because it is literally made of the same mineral as your enamel.
• Protects teeth. Forms a layer of hydroxyapatite over the enamel which serves as a sacrificial layer and as a reservoir for minerals.
• Plaque control. Hydroxyapatite can bind to the tooth surface and prevent bacteria from adsorbing to it, thereby decreasing plaque formation. It can also attach to bacteria and prevent them from sticking to your teeth.
• Reduces teeth sensitivity. It can occlude dentinal tubules, thus preventing sensitivity.
• Whitens teeth. Hydroxyapatite doesn’t oxidize stains but it is naturally white in color. Whenever it fills in enamel defects, it just makes the teeth look whiter.
• Non-allergenic. It is literally what our teeth are made of so it is impossible to be allergic to it. Otherwise we’d be allergic to our own teeth.

The only thing that hydroxyapatite can’t do which fluoride can is the formation of fluorapatite.

Takeaway

Fluoride treatment at the dentist is quick and painless. There are many benefits to getting it such as strengthening and protecting your teeth. The only downside is that you’re restricted from eating and drinking for a certain amount of time.

This article was written by Dr David Chen. If you’re looking for fluoride treatment and you’re in the NYC area, please check out our dental practice.