By Barbara Quinn
Knight Ridder Newspapers

My mom has never had a cavity, and now she’s got more than her share. What happened?

She has a medical condition that prevents her mouth from making adequate amounts of saliva. Saliva is the fluid in our mouths that bathes the teeth with nutrients such as fluoride to help teeth resist cavities.

According to a recent position paper of the American Dietetic Association, fluoride is an “essential trace mineral.” That means it is a substance found in the earth required in teeny-tiny “trace” amounts for the proper functioning of our bodies.

Fluoride works from the inside out in teeth and bones to stabilize other minerals, such as calcium and phosphorous. It is one of only a few known substances, for example, that stimulates the growth of bone cells. Although fluoride has not been shown to decrease the incidence of bone fractures, it has been found to increase the density of bone in the spine.

Before teeth erupt into the mouth, fluoride fortifies tooth enamel to resist cavities. After teeth are formed, continuous exposure to adequate amounts fluoride on the surface of teeth prevents bacteria from eroding them into cavities. That’s the whole reason for fluoridated toothpaste and those fluoride swishes your dentist may spring on you during dental exams.

Like many trace nutrients in the human body, however, there is a fine line between enough and too much. Fluoride levels of just one part per million in drinking water are enough to protect teeth from cavities. Excess amounts — more than 1 milligram a day for infants or 10 milligrams a day for older children and adults — can be toxic and cause irreversible staining or “mottling” of teeth.

Here then, are some guidelines for the use of fluoride from the two ADAs — the American Dietetic Association and the American Dental Association:

• Find out if your water supply contains fluoride. (About two-thirds of the public water in the United States does.) Well water varies in fluoride content.

• Besides the water you drink, find out how much fluoride you get in your diet. Tea and fish can be significant sources of fluoride, for example. Find a complete listing of the fluoride content of foods at www.nal.usda.gov/ fnic/foodcomp/Data/Fluoride/ fluoride.pdf.

• Follow your dentist or doctor’s advice if you need supplemental fluoride. (Are you listening, mom?) Because the risk for mottled teeth is highest in younger children, the American Dental Association does not recommend the use of fluoride toothpaste or fluoride mouth rinses for unsupervised children under the age of 6 years.

• Don’t swallow your toothpaste. Fluoride in toothpaste works best on the surface of the teeth.

• Teach kiddos to use no more than a “pea-sized” amount of toothpaste when they brush.

Not everyone is happy about adding fluoride to public water supplies. Based on decades of research and observation, however, arguments against the use of water fluoridation are unfounded, states the dental association.

Fluoride is a natural element found in soil and drinking water. When used and consumed properly, it is safe and extremely beneficial to the integrity of bones and teeth. Just remember that a little goes a long way.

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