Tablets, Drops & Mouthwash

Mouth rinses, containing either 0.05% sodium fluoride (230 ppm F) for daily use or 0.2% sodium fluoride (900 ppm F) for weekly use, have been shown to reduce dental decay in adult teeth by 26%.

Fluoride rinses should not be used by children under seven years of age. Ideally, rinses should be used at a different time of day to brushing and should be used for two minutes and spat out after rinsing.

They may also be used by adults to reduce the risk of tooth decay. Fluoride mouthwash can be prescribed by your dentist.

Over-consumption of fluoride can lead to tooth fluorosis. Therefore, it is vital you keep to the prescribed dose. Also, if a child accidentally swallows a large number of tablets, this could cause serious illness.
Keep fluoride supplements out of the reach of young children.

Ideally tablets should be sucked and allowed to dissolve slowly in the mouth.

Fluoride drops and tablets should not be used in areas where household water is fluoridated or where the concentration of fluoride naturally present is greater than 0.7ppm. This would put the child at risk of developing dental fluorosis.

Fluoride drops and tablets are no longer recommended for every child who lives in a fluoride-deficient area. They are used only for children thought to be at a greater than average risk of developing tooth decay or who are at risk of serious disease because of tooth decay. The NHS Health Development Agency (the scientific basis of dental health education) says:

[Supplements] should be prescribed by a dentist or doctor for individual children who are at increased risk of decay. Supplements should be considered for those whom the consequences of decay pose a hazard to general health or for whom dental treatment would be difficult because of their medical or physical condition. The need for their use should be determined with professional advice and reviewed at intervals. Parents should be advised of the benefits, and risks, of the long-term commitment to the use of this measure and of the importance of safe storage away from the reach of children.

There is no reason why older people with a tooth decay problem should not benefit from sucking a fluoride tablet each day. Older adults, particularly if they have decay of the roots of their teeth due to gum shrinkage (recession), should also benefit. However, they should also continue to brush twice a day with a fluoride toothpaste.

There are several possible reasons for enamel wearing away, which include: enamel erosion, dental decay, excessive grinding of teeth and excessive brushing of teeth with abrasive paste or, often, a combination of these. There are also some genetic disorders that make teeth more likely to wear away. It is recommended you seek advice from your children's dentist on the likely reason(s) for the rapid wear of enamel.

If the loss is caused by dental decay, then fluoride will help to prevent this decay. Fluorides may help enamel erosion but the evidence is much less certain. These would include toothpaste or mouth rinses or even a varnish or gel applied to the teeth. Your dentist can advise you about this, as well as on remedies for grinding or brushing excessively, and provide information on genetic disorders.

If this happens then you are advised to seek medical help immediately and the child should be quickly admitted to hospital. If a very large number of tablets are swallowed there may be muscle contractions and convulsions. Heart and lung problems may lead to disorientation and collapse.

If your child will not take tablets, then the fluoride can be given in the form of drops added to food or drink. Your dentist will tell you the correct dosage, which will vary depending on the type used. As with other home-based measures, it is vital you maintain a daily routine in order to obtain the benefits.

Fluoride supplements are licensed products and dosages appear in the British National Formulary as follows:

The daily schedule for areas with less than 0.3ppmF in the water supply are:

• 6 months to 3 years - 0.25mgF (0.5mg NaF)
• 3 years to 6 years - 0.5mgF (1.1mg NaF)
• 6 years and over - 1.0mgF (2.2mg NaF).'

Fluoride supplements should be given daily, but the dose must not be increased if days are missed. No supplements should be given in areas where the water supply contains more than 0.7ppmF.

Fluoride supplements cannot be purchased and can only be prescribed by your dentist.

Twice daily brushing with a fluoride toothpaste, together with occasional sugary food and drinks, will reduce the risk of tooth decay. However, if your dentist thinks your child is showing signs of being at increased risk of developing tooth decay, they may advise the use of fluoride supplements as additional protection.

If your dentist recommends fluoride tablets, then the benefits are increased if they are;

• sucked, rather than swallowed immediately;
• taken at a different time from when the teeth are brushed.