How delicate is fluoride to the teeth? A Conversation with a Dentist


A GNA feature by Ivy Yemoteley Anum,

The teeth of every person remain one of their natural valuables not only for eating but as a show-off of pride, elegance and beauty.

Those with the diastema would flaunt their smile as bright as the morning sun while those who lost a tooth, especially on the frontal row, tend to shy away even in adulthood.

Mr Douglas Coupland, a Canadian novelist and artist said, “Good looking people with strong, fluoridated teeth get things handed to them on platters.”

A fluoridated tooth? Could there be any important role fluoride played in ensuring a stronger and healthier tooth? What then is fluoride?

Fluoride is a mineral in human bones and teeth, which could also be found naturally in water, soil, plants, rocks and air.

It is commonly used in dentistry to strengthen the enamel, which is the outer layer of human teeth, it helps to prevent cavities, decay and brittleness of the teeth.

In Ghana, fluoride is incorporated in dentrifice, that is in toothpaste and mouth rinses, it is known as the sodium fluoride in toothpastes, however, in the USA, fluoride is incorporated in water which is referred to as fluoridated water.

Dr Richard Atuwo-Ampoh, Head of Department in Dental Surgery at the Ho Teaching Hospital, in an interview with Ghana News Agency (GNA), gave more insight on fluoride.

He said fluoride can be incorporated in certain things such as milk, salt, water and in dentrifice such as toothpaste and mouth rinses.

Dr Atuwo-Ampoh revealed that there are some places in the Northern region and cited Bongo, where their water is highly fluoridated and this caused residents to have discoloration of teeth.

He suggested that people in such places are to use toothpaste without fluoride or less fluoride in order to balance the daily required intake to the body.

There is an adage that, “too much of everything would destroy you,” and this can be related to fluoride as well, though it is beneficial, excess intake can cause defects such as weakening of the teeth and discoloration of the teeth.

Dental fluorosis happens, when one consumes too much fluoride, especially while one’s teeth are still forming under the gum.

Toothpastes are grouped into two, that is the fluoridated toothpaste and fluoride-free tooth paste.

Dr Atuwo-Ampoh further said children below the age of two should use fluoride-free toothpaste, since they have not attained the age of using fluoridated toothpaste.

Fluoride free toothpaste, which is flavoured with strawberry, apple and the likes should be used for children under two years, the aim is to power the habit of brushing in them.

Do you know that topically, there is a certain required amount of fluoride the body needs or can tolerate?

Adults dosage is capped at – 1,500 parts per million (ppm) and that of children ranges 450- 500ppm.

A toothpaste with 1,500ppm qualifies to be good and can deliver the right amount of fluoride needed by an adult on a daily basis.

Dr Atuwo-Ampoh added that toothpaste for children is not common so if you would use an adult toothpaste for a child, use a minimal amount like a peanut-size on their toothbrush and make sure that they do not ingest it.

Studies have shown that ingesting about a whole tube of adult toothpaste by a child is lethal, therefore parents must supervise their children when brushing.

The bottom line is that fluoride is safe for use by both adults and children but the important thing is that it has to be used correctly.

However, if you are worried, there are a lot of other fluoride free toothpaste agents that can be used, but that means that you have to follow a proper regime for frequent visits to the dentist and regular brushing of the teeth, since there is no natural protection for the teeth.

It is required of producers of fluoridated toothpaste by the Ghana Dental Association, Food and Drugs Authority and the American Dental Association to inscribe the content with figures on the packaging for toothpaste.

The American Dental Association (ADA) says fluoride in water benefits communities against tooth decay by 20 to 40 per cent, which protects cavity formation and saves money.

The World Health Organisation (WHO) notes that long-term exposure to drinking water that contains more than 1.5 part per million (ppm) could lead to health problems such as abdominal pain, excessive saliva, nausea and vomiting, seizures and muscle spasms.

Dr Atuwo-Ampoh cautioned buyers not to purchase fluoridated toothpaste which had sodium fluoride less or more than 1,500ppm for adults and less or more than 450-500ppm for children in order that everyone would have strong teeth, reverse early signs of teeth decay and prevent the growth of harmful oral bacteria.

Mr Gorden Akurugu, Volta Regional Director, Food and Drug Authority (FDA), said the Authority licenses fluoridated-toothpaste with standards of 1,450 ppm as wholesome and that of water at 1.5mg/l.

He said the Authority usually clamps-down on sub-standard products that fail to conform in post-market surveillance activities to protect the population.

“We shall not compromise on standards. It’s non-negotiable.”

Checks by the Ghana News Agency in Supermarkets/ Malls and shops in Ho revealed brands in Close-Up, Colgate and Pepsodent maintaining standards corresponding to that of the FDA except the T-Guard brand that was 1,000ppm.

Mr Emmanuel Bavor, a trader disclosed to the GNA that he checked the expiry date of toothpastes anytime he made a purchase but had no knowledge on fluoride but however noted that he had never visited the dentist.

Madam Felicia Amegavi, a student, on her part said some of the things she considered before purchasing a toothpaste include the price, brand, popularity and expiry date.

She said “I do not have any knowledge on fluoride and have never visited a dentist”.

More education must be carried out on products especially the ones that find their way into our systems while as consumers we look at details when purchasing every product, we want to use.


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