Fluoride & Dental Health

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Overview

Fluoride (said like floor-eyed) is a mineral that occurs naturally in soil, water, and rocks^1,2 that has been shown to prevent cavities, or tooth decay.^3,4,5

Read About Community Water Fluoridation.

For the past several decades, fluoride levels have been adjusted in community water supplies to improve oral health. Fluoride is also used in oral care products such as toothpaste and mouth rinse.^6,7,8 Fluoride works by strengthening the tooth’s hard outer surface, called enamel and helps reverse early decay by replenishing lost minerals.^9,10,11,12

You can get fluoride by drinking tap water in communities where the public water system adjusts fluoride⁶ and by using fluoride toothpaste and mouth rinse^4,5,7 , as well as from certain foods and beverages.¹³ In the dental office, a dentist can apply fluoride varnish or gel, and in some public health programs, children can have fluoride varnish applied to their teeth.^14,15

Fluoride can prevent tooth decay across the lifespan. Both children and adults benefit from it.

Ask the Expert

NIDCR Deputy Director Jennifer Webster-Cyriaque, D.D.S., Ph.D., answers common questions about fluoride and how it works to prevent tooth decay. Read the interview.

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Helpful Tips

• The amount of fluoride in your water depends on your water source. Although some bottled waters have the recommended amount of fluoride, many do not.¹⁶ Fluoride levels vary depending on if you receive water from the public water system or well water.^1,6 If you are interested in finding out the amount of fluoride in your community’s water, check with your local water utility company.¹⁷
• Brush with a fluoride toothpaste twice a day, floss regularly, and see a dentist for routine check-ups.
• Ask your child’s dentist or doctor about fluoride toothpaste use. You should not use fluoride toothpaste for children younger than age 2 unless you have been advised to do so by a dentist or doctor.^18,19

Fluoride Fast Facts

An infographic about fluoride.

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Download the graphic – [JPG - 685 KB]

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Additional Resources

• The Tooth Decay Process: How to Reverse It and Avoid a Cavity
  Information from NIDCR about the factors contributing to dental decay and maintaining oral health.
• The NIH Office of Dietary Supplements has fact sheets on fluoride: one for health professionals and one for consumers (available in English and Spanish).
• Centers for Disease Control and Prevention (CDC) Water Fluoridation page 
  An overview of community water fluoridation that provides information about benefits, safety, statistics, other fluoride products, guidelines and recommendations.
• My Water's Fluoride (CDC) 
  My Water's Fluoride allows consumers to learn about the fluoride level in their drinking water.
• The Story of Fluoridation 
  The story of how dental science discovered, and ultimately proved to the world, that fluoride, a mineral found in rocks and soil, prevents tooth decay.
• MedlinePlus: Fluoride 
  The NIH National Library of Medicine's collection of links to government, professional and non-profit/voluntary organizations with information on water fluoridation.
• Fluoridated Water
  Facts about fluoridated water from the National Cancer Institute (NCI).

Related Publications

A Healthy Mouth for Your Baby

Brochure for parents on dental care for infants and toddlers.

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References

1. McMahon PB, Brown CJ, Johnson TD, Belitz K, Lindsey BD. Fluoride occurrence in United States groundwater. Sci Total Environ. 2020 Aug 25;732:139217. doi: 10.1016/j.scitotenv.2020.139217. Epub 2020 May 11.
2. National Research Council. 2006. Fluoride in drinking water: A scientific review of EPA's standards. Washington, DC: The National Academies Press. doi: 10.17226/11571.
3. Iheozor-Ejiofor Z, Worthington HV, Walsh T, O'Malley L, Clarkson JE, Macey R, Alam R, Tugwell P, Welch V, Glenny AM. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev. 2015 Jun 18;2015(6):CD010856. doi: 10.1002/14651858.CD010856.pub2. Update in: Cochrane Database Syst Rev. 2024 Oct 4;10:CD010856. doi: 10.1002/14651858.CD010856.pub3.
4. Marinho VC, Higgins JP, Sheiham A, Logan S. Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2003;2003(1):CD002278. doi: 10.1002/14651858.CD002278.
5. Marinho VC, Chong LY, Worthington HV, Walsh T. Fluoride mouthrinses for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2016 Jul 29;7(7):CD002284. doi: 10.1002/14651858.CD002284.pub2.
6. U.S. Department of Health and Human Services Federal Panel on Community Water Fluoridation. U.S. Public Health Service recommendation for fluoride concentration in drinking water for the prevention of dental caries. Public Health Rep. 2015 Jul-Aug;130(4):318-31. doi: 10.1177/003335491513000408.
7. Recommendations for using fluoride to prevent and control dental caries in the United States. Centers for Disease Control and Prevention. MMWR Recomm Rep. 2001 Aug 17;50(RR-14):1-42. PMID: 11521913.
8. National Center for Chronic Disease Prevention and Health Promotion (US), Division of Oral Health. Community water fluoridation. 2015 Apr 27. unnumbered pages. (70 years - Community Water Fluoridation).
9. ten Cate JM, Featherstone JD. Mechanistic aspects of the interactions between fluoride and dental enamel. Crit Rev Oral Biol Med. 1991;2(3):283-96. doi: 10.1177/10454411910020030101.
10. Featherstone JD. Prevention and reversal of dental caries: Role of low level fluoride. Community Dent Oral Epidemiol. 1999 Feb;27(1):31-40. doi: 10.1111/j.1600-0528.1999.tb01989.x.
11. Robinson C. Fluoride and the caries lesion: Interactions and mechanism of action. Eur Arch Paediatr Dent. 2009 Sep;10(3):136-40. doi: 10.1007/BF03262674.
12. Buzalaf MAR, Pessan JP, Honório HM, Ten Cate JM. Mechanisms of action of fluoride for caries control. Monogr Oral Sci. 2011;22:97-114. doi: 10.1159/000325151. Epub 2011 Jun 23.
13. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington (DC): National Academies Press (US); 1997.
14. US Preventive Services Task Force; Davidson KW, Barry MJ, Mangione CM, Cabana M, Caughey AB, et al. Screening and interventions to prevent dental caries in children younger than 5 years: US Preventive Services Task Force recommendation statement. JAMA. 2021 Dec 7;326(21):2172-2178. doi: 10.1001/jama.2021.20007.
15. Weyant RJ, Tracy SL, Anselmo TT, Beltrán-Aguilar ED, Donly KJ, Frese WA, et al. Topical fluoride for caries prevention: Executive summary of the updated clinical recommendations and supporting systematic review. J Am Dent Assoc. 2013 Nov;144(11):1279-91. doi: 10.14219/jada.archive.2013.0057. Erratum in: J Am Dent Assoc. 2013 Dec;144(12):1335. Dosage error in article text.
16. U.S. Food and Drug Administration. Beverages: Bottled Water. Fed Regist. 2022 Apr 20.
17. Division of Oral Health: My Water's Fluoride. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, 2016.
18. American Dental Association Council on Scientific Affairs. Fluoride toothpaste use for young children. J Am Dent Assoc. 2014 Feb;145(2):190-1. doi: 10.14219/jada.2013.47. Erratum in: J Am Dent Assoc. 2014 Mar;145(3):236.
19. American Academy of Pediatric Dentistry. Guideline on infant oral health care. Pediatr Dent. 2011;33(6):124-8.