What To Know about Fluoride Treatments

A fluoride treatment is a procedure that involves applying or ingesting fluoride to promote dental health. Fluoride, a mineral found in many foods, water systems, and toothpastes, prevents cavities (dental caries) from forming and strengthens teeth.

When you receive a fluoride treatment in-office, the dentist may use various methods to apply fluoride directly to your teeth or have you ingest or swish the treatment.

Even though fluoride treatment is noninvasive, it can cause side effects when performed in a dentist’s office. It’s important to understand how this treatment works, its benefits and risks, and how to prepare and recover.      

Purpose of Fluoride Treatment

The aim of fluoride treatment is to strengthen the enamel (outside shell) of teeth and prevent cavities. Found in most municipal water supplies, fluoride is an ingredient in many toothpaste and mouthwash products. However, people with excessive cavities may benefit from receiving a stronger fluoride solution at the dentist. 

Topical fluoride—the type applied directly to the teeth—makes existing teeth stronger, assisting in their “remineralization.” It also reduces acidity in the mouth. Acidity causes tooth decay, so this treatment prevents cavities from forming. These solutions are safe for people six years or older, and some treatments are appropriate for children as young as six months.

Oral fluoride supplements, taken by mouth, help with tooth formation. They also raise fluoride content in saliva, which can reduce mouth acidity. Dentists may recommend oral fluoride supplements for children six or older who live in areas with un-fluoridated water.

In adults, fluoride treatments may be part of the treatment for other dental issues, such as tooth sensitivity, periodontitis (gum disease), and exposed roots.

Types of Fluoride Treatments

There are several ways you can apply fluoride to promote dental health. These include both at-home and in-office methods:

• Fluoride mouth rinses: A common method involves swishing a mouthwash fortified with fluoride daily or weekly. Both over-the-counter (OTC) and prescription mouth rinses are available.   
• Oral supplements: Supplements in the form of tablets, lozenges, or liquids can also work. As with mouth rinses, you suck or swish on these for some time before swallowing.  
• Fluoride gel or foam: In an in-office treatment, dentists apply specialized gels or foams directly to the teeth. These have a higher concentration than OTC options, so treatments are only needed every three months to one year.
• Silver diamine fluoride: Often used to treat tooth sensitivity, silver diamine fluoride is a varnish that dentists paint onto teeth. This helps strengthen existing teeth and may prevent cavities from spreading to other teeth.  

How Does It Work?

When conducting an in-office fluoride treatment, the dentist applies either fluoride gels or creams or silver diamine fluoride to your teeth. In some cases, you may have to swish a fluoride mouthwash. These procedures are painless. You don’t typically need any anesthetic or have your gums numbed.

Before the Procedure

You don’t need to do anything special to prepare for an in-office fluoride treatment. However, your dentist will recommend you come into the office with clean teeth that have been brushed and flossed. They perform the treatment while you recline in a dentist’s chair in a dentist’s office or dental clinic.

Before the procedure, you may need to fill out forms or answer questions about medications you (or your child) are taking, allergies, and any health issues you may have. It only takes about one to four minutes to apply the foam, gel, or varnish, so these appointments are quick.

During the Procedure

In-office fluoride treatments are painless. An X-ray isn’t needed before the procedure, and—unless your teeth are very sensitive—you won’t need local anesthetic.

The dentist uses specialized brushes, swabs, or a tray to apply gel or foam solutions of fluoride. Gels and foams stay on for a few minutes before you spit it out and rinse. In some cases, the dentist will ask you to swish a high-fluoride mouth rinse in the office and then give you a prescription-strength solution for home use (either once a day or once a week).

Throughout the procedure, you’re awake. If you feel any discomfort, you’ll be able to let the dentist know.

After the Procedure

Once the dentist has completed the fluoride treatment, you’ll be able to go home. Since they don’t use strong medications, you can drive yourself home or return to work.

After the procedure, your dentist will give you instructions on how to care for your teeth. Specific directions vary, but you’ll need to refrain from eating or drinking for at least 30 minutes to allow the gel, foam, or varnish to absorb into your teeth. The dentist may give you prescription mouthwash, lozenges, or topical solution and explain how to use them.  

To maintain results, you’ll need more than one fluoride treatment. Depending on your oral health, you may need to receive a treatment every three, six, or 12 months.

Risks and Precautions

While both in-office and at-home fluoride treatments are safe, they do carry some risks. In children under the age of six, excess fluoride can cause fluorosis. This is when developing, unerupted (below the gum) teeth develop dots, lines, or streaks, though their overall health isn’t affected.

In adults, side effects of fluoride treatments may include:

• Swelling, soreness, or itchiness in the gums
• Temporary discoloration of the gums around treated teeth with silver diamine fluoride treatment
• Cavities or treated teeth getting darker with silver diamine fluoride

Fluoride in high doses can be toxic to swallow, something that’s important to consider for infants and young children. Though rare, fluoride toxicity is a type of poisoning. It can become fatal and cause a range of health effects, including:

• Nausea
• Vomiting
• Abdominal pain
• Bone pain
• Skeletal fluorosis, a rare condition that causes stiff, painful joints, muscle weakness, and nerve dysfunction

How To Prepare for a Fluoride Treatment

In-office fluoride treatments are common, and all dentists are able to perform them. While you don’t need to do a great deal of preparation for this therapy, it’s important to know how to get ready. Your dentist will give you specific instructions, but here’s what you can expect:

• Location: Fluoride treatments can take place at any dental office or clinic.
• Food and drink: Show up to the appointment with your teeth brushed and flossed. Your dentist may advise you not to eat or drink right before the appointment.
• Medications: Any medications you’re taking shouldn’t interfere with the procedure. However, it's best to always double-check with your dentist.
• Items to bring: Make sure to have your ID and insurance information with you as well as a form of payment.

Cost and Insurance

Whether a fluoride treatment is covered by your insurance depends on the plan you have. In many cases, treatments are covered for children, as they have more of a medical necessity. In adults, these treatments are primarily preventative, so plans may not cover them. Talk to your dentist’s office and your insurance provider about what is and isn’t covered.   

Results

After an in-office fluoride treatment, you may need to come back every three to six months. In these appointments, your dentist will assess your progress and address any lingering issues. Imaging may be part of the follow-up, and some dental practices are able to share results in online portals or mobile apps.  

Research has found fluoride treatments effective in preventing tooth decay and cavity formation. For instance, twice-a-year, in-office topical fluoride treatments reduced cavities in 37% of people treated with baby (primary) teeth and 43% of people with adult teeth. Successful therapies help prevent these issues and fortify existing teeth.

Maintaining Your Results

As helpful as fluoride treatments may be, you’ll need to make an effort to maintain results and ensure cavities don’t form. As your dentist will tell you, this involves incorporating good dental habits and taking steps to ensure children and infants use a safe amount of fluoride. This involves the following:

• Brush twice a day for at least two minutes at a time
• Floss or using a floss pick or water flosser at least once a day
• Use only a pea-sized portion of toothpaste for infants and young children
• Schedule regular (at least once a year) dental cleanings and checkups
• Reduce consumption of sugar drinks or sodas, candies, and sticky foods
• Ensure that you’re drinking enough water

A Quick Review

Fluoride treatments involve introducing high volumes of fluoride to teeth to prevent cavities and tooth decay. This can involve using fluoride mouth rinses or topical solutions at home or going to the dentist for an in-office treatment.

These treatments are indicated for children who live in areas that don’t have fluoride in the water or have chronic dental issues. In adults, fluoride therapy can also prevent cavities and promote dental health.

Performed in dental offices or clinics, fluoride treatments are painless and quick. Your dentist may also prescribe fluoride products to use at home to promote results. Typically, patients need treatments every three months to one year. Side effects are rare, though this therapy can cause tooth discoloration (fluorosis) in the developing permanent teeth of children under the age of six.