Fluoride is a mineral that helps prevent tooth decay and makes your child’s teeth stronger. It can be put on your child’s teeth by their dentist and is also found in drinking water, some foods and beverages, toothpastes and mouth washes, or taken in a supplement.
Here are some common questions you may have about how fluoride helps keep your child’s teeth healthy.
Why do we need fluoride?
Fluoride is a natural mineral that helps prevent tooth decay by slowing or stopping the development of cavities. Bacteria in the mouth interact with sugars from food and drinks to produce acid, which can damage the outer layer of the teeth, known as enamel. Fluoride helps protect the teeth by making enamel more resistant to acid and by aiding in the remineralization (repair) of weakened enamel.
For this reason, many communities add fluoride to their public water supply. Children should drink plenty of fluoridated water and brush their teeth twice daily with fluoride toothpaste to help keep their teeth strong and healthy.
Is fluoride in drinking water safe?
Yes. America has been preventing tooth decay with fluoridated water for over 80 years.
Health organizations including the American Academy of Pediatrics (AAP), the American Dental Association (ADA) and the Centers for Disease Control and Prevention (CDC) agree that water fluoridation is effective, safe and works to prevent tooth decay. Learn more from Scott Hadland, MD, FAAP, in this video:
Fluoridation benefits people of all ages. Community water fluoridation has been shown to reduce tooth decay by 25%.
Can fluoride affect my child’s IQ level?
Fluoride in drinking water at the recommended level has not been shown to lower IQ in children.
Some studies have reported a possible association between very high levels of fluoride—more than twice the amount typically found in U.S. public water systems—and lower IQ scores. These studies were conducted in non-U.S. countries where pregnant women and children were exposed to fluoride levels exceeding 1.5 milligrams per liter of water.
The American Academy of Pediatrics (AAP) continues to recommend using age-appropriate amounts of fluoride toothpaste and drinking fluoridated water to help prevent tooth decay. If your community does not have fluoridated water, or if you use a private well, talk to your pediatrician about whether your child may benefit from fluoride supplements.
When should my child start using fluoride toothpaste?
The American Academy of Pediatrics (AAP) recommends using fluoride toothpaste as soon as your child’s first tooth appears. From the time the first tooth comes in until age 3, use a smear (about the size of a grain of rice) of fluoride toothpaste twice a day. Once your child turns 3 years old, you can begin using a pea-sized amount of fluoride toothpaste.
Encourage your child to spit out the toothpaste when they are able, but there is no need to rinse with water after brushing.
What if my community doesn’t have fluorinated water? What can I do?
To find out if your tap water contains fluoride, check with your local water utility or visit the Centers for Disease Control and Prevention (CDC) website.
If your water is not fluoridated—or if you use well water that does not contain fluoride—talk to your pediatrician or dentist. They can assess whether your child is at high risk for cavities and may recommend fluoride supplements, such as drops or tablets, or suggest using fluoridated bottled water.
Should my child get fluoride varnish at the dentist?
Yes, fluoride varnish helps prevent or slow down tooth decay in young children. Your pediatrician or dentist can begin applying fluoride varnish once your baby’s first tooth appears. (It’s also a good time to schedule your baby’s first dental visit.)
The varnish is painted onto the tops and sides of each tooth, where it quickly hardens. Parents can brush it off at home after 4 to 12 hours. It’s recommended that children receive fluoride varnish 2 to 4 times per year until age 5.
What should I know about fluoride if I am breastfeeding or using formula?
Babies younger than 6 months old do not need fluoride supplements. Both breastfed infants and those fed with infant formula typically get all the fluoride they need without extra supplementation at this age. It is safe to mix formula with fluoridated water, even for babies under 6 months, but there is a small risk of developing mild dental fluorosis—a cosmetic change in the appearance of tooth enamel.
If you prefer to avoid fluoridated water before your baby’s first tooth appears, you can:
- Use bottled or purified water labeled as containing no fluoride to mix with formula.
- Choose ready-to-feed formula that doesn’t require added water.
Talk with your pediatrician or dentist if you have questions or need personalized guidance.
What is dental fluorosis, and will fluoridated water mixed with my child’s formula increase the risk?
Dental fluorosis is usually mild and does not affect the health of the teeth. It typically appears as very faint white streaks or spots on the enamel and is often only visible to a dental professional during an exam. Mild fluorosis is not painful and does not interfere with how teeth function.
Using fluoridated water to prepare infant formula may slightly increase the risk of mild fluorosis, but most cases are cosmetic and not a cause for concern.
Once your child’s permanent (adult) teeth have fully developed—usually by around age 8—the risk of developing fluorosis no longer exists.
Should pregnant women switch to bottled water?
During pregnancy, tap water is generally preferred over bottled water—unless there are concerns about water quality or contamination. Unlike most tap water, bottled water may not contain fluoride, and manufacturers are not required to list the fluoride content on the label unless they specifically make a claim about it. Drinking fluoridated tap water can help support the development of healthy teeth in your baby.