Diet - fluoride
Fluoride occurs naturally in the body as calcium fluoride. Calcium fluoride is mostly found in the bones and teeth.
Small amounts of fluoride help reduce tooth decay. Adding fluoride to tap water (called fluoridation) helps reduce cavities in children by more than half.
Fluoridated water is found in most community water systems. (Well water often does not contain enough fluoride.)
Food prepared in fluoridated water contains fluoride. Natural sodium fluoride is in the ocean, so most seafood contains fluoride. Tea and gelatin also contain fluoride.
Infants can only get fluoride through drinking infant formulas. Breast milk has a negligible amount of fluoride in it.
A lack (deficiency) of fluoride may lead to increased cavities, and weak bones and teeth.
Too much fluoride in the diet is very rare. Rarely, infants who get too much fluoride before their teeth have broken through the gums have changes in the enamel that covers the teeth. Faint white lines or streaks may appear, but they are usually not easy to see.
The Food and Nutrition Board at the Institute of Medicine recommends the following dietary intake for fluoride:
These values are adequate intakes (AI), not recommended daily allowances (RDAs).
- 0 to 6 months: 0.01 milligrams per day (mg/day)
- 7 to 12 months: 0.5 mg/day
- 1 to 3 years: 0.7 mg/day
- 4 to 8 years: 1.0 mg/day
- 9 to 13 years: 2.0 mg/day
Adolescents and Adults
- Males ages 14 to 18 years: 3.0 mg/day
- Males over 18 years: 4.0 mg/day
- Females over 14 years: 3.0 mg/day
The best way to get the daily requirement of essential vitamins is to eat a balanced diet that contains a variety of foods from the United States Department of Agriculture (USDA) MyPlate food guide plate.
Specific recommendations depend on age and gender. Ask your health care provider which amount is best for you.
To help make sure infants and children do not get too much fluoride:
- Ask your provider about the type of water to use in concentrated or powdered formulas.
- DO NOT use any fluoride supplement without talking to your provider.
- Avoid using fluoride toothpaste in infants younger than 2 years.
- Use only a pea-sized amount of fluoride toothpaste in children older than 2 years.
- Avoid fluoride mouth rinses in children younger than 6 years.
Berg J, Gerweck C, Hujoel PP, et al; American Dental Association Council on Scientific Affairs Expert Panel on Fluoride Intake From Infant Formula and Fluorosis. Evidence-based clinical recommendations regarding fluoride intake from reconstituted infant formula and enamel fluorosis: a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2011;142(1):79-87. PMID: 21243832 www.ncbi.nlm.nih.gov/pubmed/21243832.
Chin JR, Kowolik JE, Stookey GK. Dental caries in the child and adolescent. In: Dean JA, ed. McDonald and Avery's Dentistry for the Child and Adolescent. 10th ed. St Louis, MO: Elsevier; 2016:chap 9.
Palmer CA, Gilbert JA; Academy of Nutrition and Dietetics. Position of the Academy of Nutrition and Dietetics: the impact of fluoride on health. J Acad Nutr Diet. 2012;112(9):1443-1453. PMID: 22939444 www.ncbi.nlm.nih.gov/pubmed/22939444.
Ramu A, Neild P. Diet and nutrition. In: Naish J, Syndercombe Court D, eds. Medical Sciences. 3rd ed. Philadelphia, PA: Elsevier; 2019:chap 16.