Of all the things I have learned over the years, nothing seems as important as remembering that Dentists work on the only parts of the body that do not repair themselves.
Teeth are the hardest parts of the body, but are so specialized that there is no mechanism to repair damage to them. The outside of teeth is made of enamel, harder than bone, made almost entirely of mineral. Enamel is harder enough to resist most wear, but like other minerals can be broken and dissolved. Acids can dissolve enamel, and acids are produced by bacteria as by-products of processing food material left on the teeth. The result is decay, which only a dentist can fix, but which you, the patient, can prevent.
Enamel can be made more resistant to acid attack with fluoride, a substance found in nature that the body does not produce. When combined with enamel, the result is a substance much more resistant to acid attack and decay. The best way to get fluoride is through diet and fluoridated water. This is most important during the enamel-forming years, birth to 15 years or so.
The vast majority of communities in the United States have fluoridated water, as 48 states have regulations mandating this important health measure. The State of New Jersey has no mandate, and it seems the present administration will not permit it to be enacted into law. Since this could potentially reduce the incidence of tooth decay from 40% to 60%, the cost savings could be enormous. You might ask your elected legislators why this has not been given greater priority.
Fluoride, in the proper concentration in water, produces no measurable effect other than reduction in decay. Water fluoridation has been cited by most world health organizations as one of the 10 greatest advances in disease prevention in the past century, making the list with polio vaccine and penicillin. It is the duty of our public health officials to see that we are not deprived of an important preventive measure.
Even without a statewide mandate, there are communities in New Jersey that provide fluoridated drinking water, and this is important to know. If your child does not get fluoride from drinking water, your doctor may prescribe fluoridated vitamin supplements, and you should know what is in your water first. Check here:
http://www.njapd.org/NJ_Fluoride.pdf
If your town is listed, ask your doctor to find out the fluoride levels in your water before administering fluoride supplements, as they may not be needed.
Present recommendations are 0.7 ppm fluoride for drinking water. Less than that may require supplements. For more information on water fluoridation, see this:
http://jada.ada.org/content/140/1/126.full.pdf+html?sid=85700b38-ef3b-4754-bf28-1b33d31f5aed
Fluoride is not just for children. Adults that experience dry mouth conditions due to medical treatment or side effects of medications are at risk for increased rates of tooth decay. The decrease in flow of saliva, plus self-treatment with sugar-containing candies or lozenges can be a recipe for dental disaster.
Please remember that it is not just the quantity of sugar that can promote decay, but the total length of time that sugar remains in the mouth. In the form of hard candies, cough drops and throat lozenges, the teeth may be exposed to high sugar concentrations for a long time. First, if you must use lozenges, use sugar-free products. It may also be advisable to use a home fluoride treatment, in the form of a prescription toothpaste. There are several OTC products made by Biotene that help, in the form of mouth rinse, an oral spray, and special lozenges.