A Guide To Fluoride

Fluoride is mentioned an awful lot in dental care. In this article we will explore the ins and outs of fluoride and why it is such an important topic with regards to your lovely teeth.


Many people have the misconception that fluoride is an artificial chemical dreamed up in a lab and put into our dental products. Fluoride is in fact a naturally occurring mineral that can be found in the Earth’s crust, soil, the oceans, food and lots of other natural sources. Our teeth are actually made with fluoride!



Fluoride Toothpaste

The enamel of our teeth contains mineral that can be naturally lost (demineralisation) or gained (remineralisation) over time for a number of reasons,

Demineralisation is most problematic for adults and it is often triggered by the bacteria in your mouth that cause pesky plaque to form. You see the bacteria in your mouth thrive on sugars and other carbohydrates that enter your mouth from your diet. The bacteria (perhaps unsurprisingly) eat what you eat and their consumption process causes your saliva to become more acidic which eats away at your tooth enamel.

Fluoride helps to remineralise your enamel using your natural saliva acting as a carrier for fluoride into your enamel. Fluoride in your tooth enamel combines with phosphate and calcium that naturally exist in your enamel creating fluorapatite, a strong material that is resistant to acid attack. So fluoride can strengthen your teeth which can help to prevent cavities (holes in your teeth) in order to keep them healthy.

When your saliva is less acidic fluoride can also help. Fluoride helps to replenish other minerals your teeth need to be healthy like phosphate and calcium that help to harden your teeth making them more resistant to being worn away.


Fluoride can help keep your teeth healthy in two main ways:

  1. When we were children, small doses of fluoride that are consumed through food and drink are used to form the foundations of our developing teeth from the inside out.
  2. Small doses of fluoride also fuse with our saliva which carries it directly into our teeth helping to strengthen our teeth from the outside in.


Numerous studies, across multiple countries over a number of decades have shown that adding fluoride to toothpaste leads to significant reductions in cavities caused by tooth decay. In fact many dental associations around the world including The British Dental Association actively recommend that toothpastes contain fluoride for proper oral health.

Brushing you teeth with a fluoride toothpaste as directed by your dentist is considered very important for the health of your teeth. One of the most widely recommended regimes is to brush your teeth at least twice a day with a fluoride toothpaste in order to help protect your teeth against cavities.



Fluoride Toothpaste

The NHS guidelines for the dosage of fluoride in toothpaste are quite clear and differ from person to person, for adults:

  • Toothpastes containing 1,350ppm to 1,500ppm of fluoride are the most effective although depending on your oral health needs your dentist may advise you to use even higher strength if you are at particular risk of tooth decay.

At Waken we believe the sweet spot for fluoride in toothpaste is 1,450ppm of fluoride which is what all Waken toothpastes are formulated with.

Also, to get the most out of fluoride toothpaste it’s best not to rinse with mouthwash (or water for that matter!) at the same time or immediately after using it. This is because the mouthwash or water will wash away the more concentrated fluoride in the toothpaste making it less effective at protecting your teeth from cavities.

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Fluoride is the iodised version of the chemical element fluorine. Fluorine is a highly reactive element meaning it forms chemical compounds with other elements very easily. One of its best know compounds is of course fluoride. Examples of different types of fluoride are:

  • Sodium fluoride
  • Sodium monofluorophosphate
  • Stannous fluoride
  • Calcium fluoride

Sodium fluoride and sodium monofluorophosphate are two types of fluoride commonly used in toothpaste to help protect teeth against tooth decay. Waken toothpaste gels and Waken mouthwashes contain sodium fluoride (1,450ppm) whilst Waken waterless toothpaste tablets contain sodium monofluorophosphate (1,450ppm).


Children can use fluoride toothpaste under very specific circumstances. We do not recommend the use of fluoride toothpaste for children under 7 years old. Once a child is 7 years old they can use fluorinated toothpaste as directed by their dentist.

The typical recommendation is often for children who are 7 years old or over to use a fluoride toothpaste whilst be supervised by a responsible adult where necessary and for them to spit out the toothpaste when brushing.


According to the NHS, a medical condition called dental fluorosis can affect the developing teeth of children if they are exposed to too much fluoride.

Mild fluorosis (the most common kind) is observed as fine pearly white lines or flecking on the surface of the teeth. It is often quite subtle to the point that only a dentist may be able to notice it. Sever fluorosis, can cause brown, black or grey discolouration and pitting on the surface of tooth enamel.

The good news is that fluorosis is quite a rare condition in the UK (as fluoride levels in tap water are regulated so carefully, for example by the Drinking Water Inspectorate for England and Wales). If fluorosis does occur it causes no discomfort to the child, will not affect the long-term health of their teeth and any discolouration is treatable and reversible.

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That’s right, it is entirely possible to have a fluoride deficiency which could harm your teeth, overall oral health and even bones:

  • The most obvious sign of fluoride deficiency is the presence of tooth decay. If your teeth are not exposed to enough fluoride, bacteria that causes plaque (or biofilm) can grow out of control generating acids that eat away at your teeth. If your tooth enamel is worn away too significantly his can cause cavities to form on your teeth which can be painful and expensive to fix.
  • More prominent in older adults when fluoride deficiency exists is the presence of brittle or weak bones.


If used properly and appropriately it is widely researched an accepted that fluoride is a safe and recommended addition to toothpastes, mouthwashes and even tap water in many countries to help people improve and maintain good oral health.

To date there is no conclusive scientific evidence linking fluoride to adverse health problems when it is used and consumed in the recommended way. The National Health Service (NHS) recommends fluoride containing dental products such as mouthwashes and toothpastes be used to care for teeth and prevent dental caries, cavities, subsequent infections and ultimately the untimely removal of teeth.

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Fluoride Mouthwash

Fluoride toothpaste is not the only source of fluoride that can help care for your teeth. Other sources of fluoride include:

  • Fluoride mouthwash: fluoride mouthwash is mouthwash that contains fluoride. We recommend using one that contains 250ppm of fluoride to help protect your teeth against cavities. Fluoride in mouthwash works much the same way as fluoride in toothpaste. Fluoride mouthwash can be used as an additional layer of protection when brushing may not be possible or for those who are particularly at risk of tooth decay. Fluoride Mouthwash should not replace brushing at least twice a day but instead be used to supplement this behaviour.
  • Fluoride in tap water: in many countries including the UK fluoride is added to municipal water sources that don’t already contain enough fluoride. This is a public health measure in order to protect that nation’s teeth against cavities. Multiple reports, including those by Public Health England explain that ensuring water fluoridation at 0.7mg/l would reduce hospital admission for tooth extractions in some groups by up to 68%. The Drinking Water Inspectorate carefully monitor the level of fluoride in water for England and Wales and adjust if necessary to ensure it is always at safe and effective levels.
  • Fluoride dentist treatments: if you are not getting enough fluoride from your toothpaste, mouthwash, tap water, etc your dentist may recommend a professional fluoride treatment performed by your dentist or dental hygienist. There are many types of fluoride treatments dentists can offer, including:
    • Fluoride varnish: that your dentist will apply directly to your teeth.
    • Fluoride foam: that your dentist applies to a soft dental tray that they insert into your mouth and ask you to bite down on for a number of minutes.
    • Fluoride rinse: a liquid that your dentist will ask you to swish around your mouth for several minutes before spitting out.
  • At-home fluoride treatments: if your dentist identifies that you are at particularly high risk of developing tooth decay they may decide you could benefit from an at-home fluoride treatment. Your dentist will prescribe a fluoride gel for you to apply to your teeth as directed.
  • Fluoride supplements: are similar to vitamins or other supplements and can come in tablet, lozenge or liquid form. If your dentist believes you could benefit from fluoride supplements they will prescribe them for you. Please discuss any over-the-counter fluoride supplements with your dentist or dental professional before buying them to ensure you or your family could benefit from them.
  • Bottled water: with the introduction and establishment of bottled water as a source of drinking water it has become more challenging for people to get the right amount of fluoride. The majority of bottled water brands do not contain fluoride and may affect whether you are getting enough fluoride in the following ways:
    • The amount of bottled water you drink in a day
    • The dosage of fluoride in the bottled water you drink (check the ingredients label of any bottled water)
    • Whether or not bottled water is used in your cooking
    • Whether or not you supplement bottled water with fluorinated water at work, school or elsewhere in your life

If bottled water is your primary source of drinking water, please check with your dentist to ensure you are getting the optimum level of fluoride.