Dentists Explain Why We Can Stop Demonizing Toothpaste With Fluoride

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Brushing our teeth will always be a priority in our routines, but what happens when a common ingredient in your toothpaste that you've grown up with suddenly sparks controversy? Chances are you've heard of or seen the word "fluoride" on your toothpaste, mouth wash, or floss packaging and didn't think much about it. According to Dr. Jennifer Jablow, a celebrity dentist and founder of intelliWHiTE, fluoride is a naturally occurring mineral found throughout the Earth's crust and used in toothpaste.

Lately, the discussion surrounding fluorides' existence in toothpaste formulas is stirring major debate about whether it's toxic for consumption or deteriorating our teeth. Some swear it's necessary to maintain good dental health while others think you should proceed with caution. To better understand how safe, or unsafe, fluoride is, we tapped two experts to explain everything there is to know about this controversial ingredient.

Is fluoride bad for your teeth?

Let's put this debate to rest—fluoride isn't bad for your teeth. When used in safe doses, fluoride helps support the mineralization of your teeth by strengthening the enamel aka the protective barrier on your teeth, explains Dr. Jablow.

"Fluoride helps protect your teeth from losing minerals when your mouth is in an acidic state or fighting bacteria," she says. "Fluoride also aids in remineralization and replenishing the calcium and phosphate ions that make your teeth harder and more protected." The fluoride in your toothpaste bonds with the calcium and phosphate that naturally exists in your teeth to create a strong material that resists decay and prevents cavities, she explains.

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Why do some people believe fluoride is bad for your teeth?

The biggest concern surrounding fluoride is dental fluorosis, which can cause permanent streaks or spots on the teeth. According to the American Dental Association, however, fluorosis mainly occurs in small children (ages three to six) when they consume too much fluoride.

We know that too much of anything is bad, and the same goes for fluoride. "If you ingest large amounts, it can cause the malformation of the enamel of teeth or can have some toxicity," adds cosmetic dentist and founder of Silicon Beach Dental, Dr. Lawrence Fung.

It's important to take the recommended amount to avoid any potential toxicity or fluorosis. The American Dental Association recommends only using a pea-sized amount (0.25 grams) of toothpaste. To get an idea of how much that is exactly, a study posted in the International Dental Journal shows how much 0.25 grams looks like on a toothbrush in this diagram.

International Dental Journal

"Fluoride is considered a drug, so the amount one should use is monitored by the FDA," says Dr. Jablow. The average amount of fluoride in over-the counter toothpaste is 1,000 to 1,500 parts per million (ppm), explains Dr. Fung. "Anything that is sold over-the-counter will have a ppm that is within a safe range, so the risk for toxicity and fluorosis is very low." That means, you can safely brush your teeth twice a day with fluoride toothpaste for two minutes using the recommended amount without having to worry.

So, when should you use fluoride-free toothpaste?

It's totally up to you. "There's not much evidence to suggest not to use fluoride," says Dr. Fung. For those who are super-cautious, you can always alternate using fluoride and fluoride-free toothpaste. Similarly, you might find it beneficial to have your children use fluoride-free toothpaste to ensure they don't sallow too much fluoride when they're young. The CDC says it's safe for children from three to six years old to use a "smear the size of a rice grain and a pea-sized amount of toothpaste."

If you do opt for a fluoride-free toothpaste, Dr. Jablow says to look for a formula that has nano-hydroxyapatite (Nano HAP), xylitol, and an alkaline pH which has similar effects as fluoride. "The Nano HAP mimics the calcium molecule found in our tooth structure and deposits on our enamel surface, but it only works well if the paste also has xylitol and an alkaline pH."

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However, both dentists agree that fluoride is safe for your teeth. "I wholeheartedly recommend using fluoride to prevent cavities," says Dr. Fung.