Frequently Asked Questions

Fluoride is a mineral found in soil, water (both fresh and salt) and various foods.

Fluoride has a positive effect on oral health by making teeth more resistant to decay. Fluoride can also prevent or even reverse tooth decay that has started.

For many Canadians, fluoride is in public drinking water, which provides protection to the entire community. Fluoride toothpaste and rinses are available for purchase, and your dentist can provide professional fluoride products such as gels and varnish.

Dental fluorosis is a change in the appearance of teeth. It is caused when higher than optimal amounts of fluoride are ingested in early childhood. In its mildest and most common form, it affects the look of the tooth with small white specks appearing on a child’s teeth.

The Canadian Health Measures Survey 2007-2009 found that dental fluorosis is not an issue of concern for the vast majority of children (84%). Some children (16%) have mild forms of fluorosis that often go unnoticed by both the children and their parents.

Water fluoridation is the process of adjusting the level of fluoride in a public drinking water supply to optimize the dental benefits of preventing tooth decay.

Fluoride is added to public drinking water to protect all members of the community from tooth decay. Community water fluoridation is a safe and effective way of preventing tooth decay at a low cost.

The Federal-Provincial-Territorial Committee on Drinking Water makes recommendations about the optimal level of fluoride in public drinking water to prevent tooth decay. The recommended level takes into account that Canadians receive fluoride from other sources such as food and beverages.

An optimal level of water fluoridation is achieved by adjusting the level of fluoride in the water to achieve the right balance between the benefit of preventing tooth decay and the risk of developing dental fluorosis.

With the exception of dental fluorosis, scientific studies have not found any credible link between water fluoridation and adverse health effects.

For children from birth to 3 years of age, the use of fluoridated toothpaste is determined by the level of risk of tooth decay. Parents should consult a health professional to determine whether their child up to 3 years of age is at risk of developing tooth decay. If such a risk exists, the child’s teeth should be brushed by an adult using a minimal amount (a portion the size of a grain of rice) of fluoridated toothpaste. Use of fluoridated toothpaste in a small amount has been determined to achieve a balance between the benefits of fluoride and the risk of developing fluorosis. If the child is not considered to be at risk, the teeth should be brushed by an adult using a toothbrush moistened only with water.

For children from 3 to 6 years of age, only a small amount (a portion the size of a green pea) of fluoridated toothpaste should be used. Children in this age group should be assisted by an adult in brushing their teeth.

Young children tend to swallow toothpaste when they are brushing, which may increase their exposure to fluoride and contribute to dental fluorosis. For this reason, children need to be assisted or supervised with tooth brushing. An adult needs to ensure that an appropriate amount of toothpaste is used, that the child spits out the toothpaste rather than swallows it, and that the teeth are cleaned effectively.

Your dentist is able to assess your child’s risk of developing tooth decay and advise you of an appropriate level of fluoride protection.

How often you go for dental exams depends on your oral health needs. The goal is to catch small problems early. For many people, this means a dental exam every six months. Your dentist may suggest that you visit more or less often depending on how well you care for your teeth and gums, problems you have that need to be checked or treated, how fast tartar builds up on your teeth, and so on.

Ask yourself the following questions:

• Do I floss every day?
• Do I brush twice a day with a fluoride toothpaste and follow my dentist's instructions on how to brush properly?
• Do I eat a well-balanced diet, including food from all food groups, and limit sweets and sticky foods?
• Do I smoke?
• Do I have a history of cavities or gum disease?
• Is my overall health good?
• The answers to these questions are all factors that affect your oral health. They will help you and your dentist decide how often you need to visit for dental exams. It's worth noting that you should not determine your need for dental care on what your dental plan covers.

How often you need to have x-rays also depends on your oral health. A healthy adult who has not had cavities or other problems for a couple of years probably won't need x-rays at every appointment. If your dental situation is less stable and your dentist is monitoring your progress, you may require more frequent x-rays.

If you are not sure why a particular x-ray is being taken, ask your dentist. Remember that dental x-rays deliver very little radiation; they are a vital tool for your dentist to ensure that small problems don't develop into bigger ones.

It's important to get an early start on dental care, so that your child will learn that visiting the dentist is a regular part of health care. The first step is to choose a dentist for your child.

It may be your own dentist or one who specializes in treating children (called a pediatric dentist). Once you have selected a dentist, call the office to find out at what age he or she prefers to see child patients for the first time. CDA encourages the assessment of infants, by a dentist, within 6 months of the eruption of the first tooth or by one year of age.

It's important to make the first visit a positive experience for your child - one reason why it's best to visit before a problem develops. If you think there is a problem, however, take your child to the dentist right away, no matter what age.

If you are a nervous dental patient, ask your spouse or another family member to take the child for the appointment. If your child senses that you are nervous, he or she may feel nervous too. When you talk to your child about going to the dentist, explain what will happen without adding things like "it won't hurt" or "don't be scared."

Be sure to get an early start on regular dental care at home. Start cleaning your child's mouth with a soft damp cloth before teeth come in and continue with a soft toothbrush once he or she has a first tooth. Limit the number of sugary treats you give your child, and focus on healthy food choices from the very beginning.

Dentists have been doing what's called "non-vital" bleaching for many years. Non-vital bleaching is done on a damaged, darkened tooth that has had root canal treatment. "Vital" bleaching is done on healthy teeth and has become more popular in recent years.

Vital bleaching, also called whitening, may be carried out in the dental office or the dentist may instruct the patient on how to do the bleaching at home. There is also a wide variety of products for sale in stores. Not all products are the same and not all give you the same results.

Different products, including those used by dentists, may also have different risks and side effects.

Here is an overview:

Whitening toothpastes with abrasive ingredients are really not bleaching products at all, but work on surface stain only. These products are sold in many stores.

Some whitening toothpastes do contain a chemical ingredient (or "bleach") that causes a chemical reaction to lighten teeth. Generally, they have the lowest amount of "bleach." They may not whiten as well as stronger products, but they have less chance of side effects. These pastes are brushed onto teeth and rinsed off, like regular toothpaste.

Bleaching kits sold in stores stay on your teeth longer than toothpaste and contain stronger "bleach". These store-bought products do not come with the added safety of having your dentist monitor any side effects. They also come with a one-size-fits-all tray that holds the "bleach" and is more likely to leak the chemical into your mouth.

Dentists may use products with stronger "bleach", but they give patients careful instructions to follow. They are also trained to spot and treat the side effects that patients sometimes report during bleaching. In addition, if a tray is needed to apply the "bleach", dentists supply custom-made trays. Because products used by dentists are strong, they tend to produce the best results.

Patients should be aware that the long-term use of whitening or bleaching products may cause tooth sensitivity or tooth abrasion. Please consult with your dentist before using a whitening or bleaching product.