Fluoride is a mineral that is found in water in different amounts, depending on where you live.

Fluoride can help prevent tooth decay. It’s included in toothpaste and sometimes added to drinking water.

Fluoride toothpaste

Brushing with fluoride toothpaste twice a day is a highly effective way to prevent tooth decay. You can also reduce your risk of decay by limiting the amount of sugary foods and drinks you consume.

The amount of fluoride that is in toothpaste is measured in parts per million (ppm) and can be found on the tube.

Children can use a toothpaste containing 1,000 – 1,450 ppm fluoride.

• Children under 3 years old use a smear of toothpaste
• Children over 3 use a pea-sized amount

Children and adults at a higher risk of dental caries may be advised to use a higher strength toothpaste.

Dentists may prescribe a high fluoride toothpaste that can contain either 2,800ppm or 5,000ppm fluoride. This should only be used by the person it is prescribed for, and not used for the whole family.

Further information on toothbrushing can be found on the Designed to Smile website

Other fluoride treatments

Fluoride mouth rinses

Fluoride mouth rinses can be prescribed for adults and children over 8 at risk of tooth decay. They should be used daily in addition to brushing twice daily.

Mouth rinses should be used at a different time to brushing to avoid washing the toothpaste off your teeth.

Fluoride varnish

Fluoride varnish can be applied to both baby teeth and adult teeth by a dental professional.

This involves painting a varnish containing a high level of fluoride onto the surface of the tooth to prevent decay. It works by strengthening tooth enamel, making it more resistant to decay.

For more information see the Designed to Smile website.

Community water fluoridation

All water supplies contain varying small amounts of naturally occurring fluoride. Community water fluoridation is the process of adjusting the level of fluoride in drinking water to optimal levels to prevent tooth decay. There have been effective water fluoridation schemes worldwide for over 70 years.

Community water fluoridation has consistently been found to be safe and effective in reducing tooth decay. There is no evidence of any significant health risks associated with water fluoridation.

Over 400 million people worldwide receive fluoridated drinking water. There are currently no community fluoridation schemes in Wales.

Is fluoride safe?

There has been concern that fluoride may be linked to a variety of health conditions. There is no convincing evidence to support these concerns.

A cosmetic condition called dental fluorosis can occur if a child’s teeth are exposed to too much fluoride during development (between birth and 6 years of age). Mild dental fluorosis can be seen as very fine pearly white lines or flecking on the surface of the teeth. Severe fluorosis can cause enamel of the tooth to become pitted or discoloured.

It's uncommon in the UK for fluorosis to be severe enough to seriously affect the appearance of teeth. This is because fluoride levels in water are carefully monitored by the Drinking Water Inspectorate (DWI) and adjusted if necessary.