Fluoride in dental care: protection or health risk? What the dentist says

Fluoride in dental care: protection or health risk? What the dentist says
Time and again, my patients ask me whether fluoride in toothpaste is really as dangerous as many people claim nowadays. Perhaps you too have already asked yourself this question. I can reassure you: No, in such small amounts fluoride is not dangerous at all, but rather helps to protect your teeth. Due to the fact that fluoride is literally on everyone's lips and is all too often demonized, we will now take a closer look at the topic.



How did fluoride actually get into toothpaste? Good question! It was by chance that people found out what a positive influence fluoride has on dental health. Due to a new water supply in the town of Bauxite in Arkansas, white fluoride spots suddenly appeared on children's teeth. This allowed the first scientific conclusions to be drawn about the influence of fluoride on teeth. The first attempts to specifically add fluoride to toothpastes were then made from around 1900, in Europe from around 1950. When Washington W. Sheffield brought the first toothpaste onto the market in 1850, it already contained fluorides, but they were not added separately. In this sense, fluoride has always been in toothpaste.

Organic toothpaste with fluoride


Many people are often not even aware of the difference. But the two substances are extremely different, which is also "not entirely unimportant" for our health.


In the earth's crust, fluoride is a frequently occurring mineral that occurs in various forms: sodium fluoride and fluorspar are the most important examples here. But fluoride also occurs very often as a trace element in nature in a wide variety of concentrations, including in our drinking water. Despite minimal concentrations, many trace elements are essential for our body, i.e. indispensable for our organism. Fluoride is not one of these essential trace elements, but it has the positive effect that it protects against caries.

How do we consume fluoride, if not through dental care? The main source of fluoride intake is our drinking and mineral water. The concentration in drinking water depends on the location and therefore varies depending on the area. Mineral water often has significantly higher levels of fluoride than drinking water. However, foods such as green and black tea, fish and many types of cereals also contain fluoride.


The chemical element fluorine is a highly reactive gas that hardly ever occurs in pure and elemental form in the wild, except, for example, during volcanic eruptions. Thus, elemental fluorine is a highly toxic and corrosive substance that we recognise even in small doses by its intense odour.


The surface of our teeth is not smooth, even if it sometimes feels that way. The outermost layers of tooth enamel are under constant attack from acid-forming lactobacteria, also called lactic acid bacteria, and acids from food. Especially at night, the bacteria can multiply unchecked and exert their damaging effect on the enamel unhindered. The acid strongly attacks the enamel surface and the enamel crystals are dissolved out. When we brush our teeth with fluoride toothpastes or use fluoride-containing dental care products (gels, mouthwashes, etc.), we counteract this process. By using fluoride, we practically build a protective shield around our tooth and thus increase the resistance of the enamel and thus dental health.


The route via the bloodstream enables fluoride to be incorporated into the tooth substance already in childhood. In addition, intake through food and drink ensures that our teeth are supplied with fluoride as they grow and that it is absorbed into the tooth substance. The result: a resistant tooth enamel that greatly reduces tooth-damaging influences in the form of acids and bacteria. However, a toothpaste containing fluoride is indispensable, otherwise the protection is not sufficient. Now let's go into a little more detail:


  1. The enamel formation
    In the enamel formation phase, fluoride can be incorporated directly into the tooth substance. The enamel formation phase begins after birth.
  2. Enamel maturation before tooth eruption
    After enamel formation, the so-called enamel maturation follows before the tooth erupts. This lasts three to four years. During this time, enamel substance continues to be formed and compacted.
  3. Enamel maturation after tooth eruption
    After tooth eruption, fluoride can only be absorbed externally. Local and systemic fluoride from saliva protects the enamel and is the only substance that can also repair superficial injuries caused by acids and caries-forming bacteria.


Fluoride is essential for tooth development

Is hydroxyapatite an alternative to fluoride?

Let us first clarify: What is hydroxyapatite or hydroxyapatite anyway?

Hydroxyapatite or hydroxyapatite is a natural compound between calcium and phosphate, which our body forms and thus produces very hard substances in our body. These substances are found, for example, in the dentin or enamel. Hydroxyapatite is therefore a component of the natural tooth structure. The problem is that hydroxyapatite crystals dissolve from the enamel when the tooth is exposed to acid in the mouth. This makes the tooth vulnerable - e.g. to caries bacteria. It also becomes more sensitive to pain and changes its color. Hydroxyapatite crystals, however, cannot be reinserted by external application. Fluoride is the only way to create a barrier against bacteria on the tooth and protect it.

More and more toothpastes advertise hydroxyapatite or hydroxyapatite as ingredients or active ingredients, but they are not an adequate substitute for a fluoride-containing toothpaste.

If you have any further questions, I recommend a medical consultation with a dental professional.


Is fluoride dangerous for our health?

We can reassure you about health concerns: Fluoride is found in the human body and in nature - including in groundwater and foods such as fluoridated table salt. So as an ingredient in toothpaste, it is not harmful. Of course, the same applies here: The quantity makes the poison. So if excessive amounts of toothpaste are swallowed - and we are talking about a total of 109 tubes - this can have negative effects. By the way, the same applies to excessive consumption of green or black tea or even mineral water.



A very clear YES! From the point of view of a dentist or dentistry in general, fluoridation of the teeth is essential and strongly recommended due to changes in eating habits. Especially when consuming industrially prepared foods as well as very sugary and acidic foods and drinks, you should pay attention to a sufficient supply.

Your Dr Roberto Lhotka


1 comment

  • Sabine Gmeiner -

    Thanks for the clarification - there are always so many discussions about fluoride in toothpaste that confuse!

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