Believe it or not, even drinking water and brushing your teeth can get a little bit complicated. The reason is Fluoride. Fluoride is an inorganic anion found in the earth, and it is added to tap water in order to strengthen our teeth. The city of Cartersville has 0.9 ppm (parts per million) but your municipality may have more or less. Recently, the federal government recommended that all drinking water have 0.7 ppm.
As with any chemical or drug, fluoride has side effects. One is tooth staining. A study quoted by the CDC showed that between 23% to 39% of teenagers had this fluoride staining http://www.cdc.gov/nchs/data/databriefs/db53.htm. Fluoride may also affect a person’s thyroid function, brain development, and other organs http://fluoridealert.org/issues/health/.
One problem with fluoride in the drinking water is that a person’s dose depends on how much water they drink. An infant who drinks one liter per day of formula made with tap water could get up to 1.0 mg per day of fluoride and this exceeds the recommended daily allowance. For this reason I recommend that infants less than 6 months old who drink formula, should mix it with water that has no more than 0.5 ppm of fluoride.
You can buy fluoride free bottled water, or filter fluoride from your own tap water, but research this carefully. Some “natural” water for babies has fluoride added back into it, and most filters we use on the refrigerator or tap don’t remove fluoride. Activated alumina and reverse osmosis filters do remove fluoride. Also, distilled water has no fluoride, but be aware that distilled water sold as drinking water may also have fluoride added back.
Since topical application of fluoride is better than ingestion anyway, I recommend removing fluoride from your water and brushing with fluoride toothpaste. This gives you better control of the dose and applies the fluoride directly to the teeth instead of having it go into your bloodstream. A child’s toothbrush filled with toothpaste has about 1 mg of fluoride. For children less than two years old, use a tiny amount (they say the size of a grain of uncooked rice) twice per day. Even if they swallow the whole thing every time it’s only going to be 0.2 to 0.4 mg per day which is OK. Two to five year olds can use a little more toothpaste (small pea sized), and older children can use a little bit more than that.
Finally, it is important to remember that cavities don’t come from a lack of fluoride, but from bacteria in the mouth that create plaque which leads to decay. This process is accelerated by having sugars in the mouth. Not sleeping with a bottle (or co sleeping and nursing all night long), and minimizing sugar drinks, sugar snacks, and carb foods like crackers will be very helpful in controlling plaque formation.