Fluoride and Infant Formula

Fluoride added to infant formula can strengthen adult teeth

At her age, adult teeth are already forming!

In our practice in Orange, CT, we see lots of kids as well as lots of moms with newborns. We often get questions regarding if and when fluoride should be incorporated into the diet of their newborn.

Most parents are unaware that at birth, certain adult teeth are already forming! Even though these adult teeth will not start appearing until age six, they are beginning to form deep inside the upper and lower jaws.

Fluoride and Teeth Development

Teeth development timeline showing calcification and root completion

Tooth development timeline (courtesy wikipedia.org)

The chart above shows the initial calcification times for all the adult teeth. Why do we care about initial calcification times? Because this is when fluoride can be incorporated into the developing tooth structure! As you can see, at birth, the six year molars are already beginning to calcify.

When fluoride becomes part of the developing tooth in a child, the tooth becomes stronger and more resistant to dental decay. For the adult teeth, this critical time begins at birth and continues approximately through age 8 (except for the wisdom teeth). Once the teeth are fully formed, the fluoride can only affect the most superficial layer of the teeth. This is why we do topical fluoride application on kids.

Please note that excessive consumption of fluoride can lead to a damaging condition called fluorosis.

Fluoride, Breast Feeding, and Infant Formula

For those mothers choosing to nurse, we agree with the adage “breast is best.” But for those opting to feed their infant formula, we always inform families of the option of buying formula with fluoride.

Current recommendations from both the American Academy of Pediatrics and the American Academy of Pediatric Dentistry are to avoid fluoride supplementation during the first six months of life of your child. We agree with and adhere to these recommendations.

Water for infant formula with fluoride for stronger teeth at the dentist for kids

Nursery Water with Fluoride

Once your child is 6 months old, it may be beneficial to incorporate fluoride into the diet. One way to achieve this is to use a powder formula mixed with water that contains fluoride. An example is Nursery Water (photo on the left) which has the appropriate amount of fluoride added to it as recommended by the American Dental Association as well as the Department of Health and Human Services.

Another option is to mix the powdered formula with tap water if you live in a town with a fluoridated water supply. Orange, Milford, West Haven, Derby, New Haven and other local towns all have fluoride added. Some towns such as Woodbridge have homes with mostly well water. See here for a complete list of Connecticut cities and towns with fluoride.

Should you supplement with fluoride?

There is widespread scientific evidence which confirms that fluoridation can and will reduce the rate of dental caries in both children and adults.

Each and every child is unique and has different risk profiles for developing cavities. Some kids have a consistent exposure to fluoride already while others do not. As a result, we always discuss various options, including no fluoride at all, with parents. Contact us with any questions or go to this page to request an appointment.

All Ceramic Crowns – a Life Changing Event!

We perform a considerable number of cosmetic dentistry procedures in our office in Orange, CT. We always get excited when our dental work makes a life changing impact on our patients. To us, there is nothing better than knowing that our patients can smile again with pride.

We recently completed this case of all ceramic crowns on one of our patients from Milford, CT. After a hockey accident as a teenager where he nearly lost his two front teeth, he lived with brown and poorly shaped teeth for nearly thirty years. He was the first to admit that he never smiled in public.

After we discussed all the options for this front teeth, we decided on an approach involving all ceramic crowns and bonding.

All Ceramic Crowns and Bonding Photos

Porcelian crown photos from our dental office in Orange on a patient from Milford, CT

Before and after photos on our patient from Milford, CT. Dentistry and photos by Dr. Nicholas Calcaterra. Clicking on the image will show a high resolution version.

He went from never smiling to smiling from ear to ear! This truly was a life changing event for him!

To learn more about our services, please visit this page to request an appointment or call (203) 799 – 2929.

Recent Teeth Whitening Case

In our office in Orange, CT, we routinely perform same-day whitening using two different professional systems: Zoom Whitening and EZ White. Below are before and after photos seen with Zoom Whitening that we recently completed:

Before and After Teeth Whitening Zoom Orange and Milford and Woodbridge, CT

Before and after teeth whitening photos. The patient lives in Woodbridge, CT. He had a bridge with a lighter shade and wanted his teeth to match. We succeeded! Photo by Nicholas Calcaterra DDS.

They say a picture is worth a thousand words and we agree! For more information on teeth whitening, visit this page, or ask Crystal or Toni at your next cleaning. Not a patient? Call us at (203) 799 – 2929 or visit this page to schedule an appointment.

Dry Mouth Medications: A Recipe for Tooth Decay

Many prescription pills will cause xerostomia or dry mouth - dentist in Orange, CT

Is this causing dry mouth?

Many older patients in our practice in Orange, CT take medications as part of their daily routine.  However, many of these prescription drugs have an unwanted side effect: dry mouth, more formally called xerostomia.

In fact, the most commonly prescribed medication in the United States in 2012 lists xerostomia a common side effect!

Chronic dry mouth can have a profound effect on the oral cavity, leading to dental decay (cavities) as well as inflammation of the gum tissue.

Without treatment, the results of the dry mouth can be devastating: loss of some or all of your teeth!

Photo of Tooth Decay from Dry Mouth

Photo of teeth with decay from dry mouth or xerostomia from radiation treatment

Teeth with decay (cavities) from chronic dry mouth on a patient from Woodbridge, CT. Photo and subsequent treatment by Dr. Nicholas Calcaterra.

The above photo shows quite dramatically the decay (also known as cavities) that can occur due to dry mouth. We see decay both at the gum line as well as near the edges or tips of the teeth. This is the classic pattern of decay due to xerostomia.

Common Drugs which Cause Xerostomia

Medications and Drugs which cause dry mouth xerostomia leading to dental decay and cavities

The most widely prescribed drug in the U.S. is associated with dry mouth!

Older adults take many medications which can lead to dry mouth. Some of them include:

  • Medications for high blood pressure: ACE inhibitors, Angiotensin II Receptor Blockers, Diuretics, and others.
  • Anti-cholinergic medications used to treat a variety of conditions.
  • Many anti-depressant medications (Zoloft, Celexa, etc.).
  • Narcotic based pain relievers such as Vicodin and Percocet.

As previously mentioned, the most commonly prescribed pain medication in 2012 was Vicodin and is associated with xerostomia.

Why Dry Mouth Leads to Tooth Decay

Saliva has numerous qualities which help to reduce decay and gum disease. A partial list includes:

  • Contains buffers which help to neutralize acids from foods (soda, candy, fruits, etc.)
  • Possess several anti-microbial proteins which kill harmful bacteria.
  • Serves to mechanically cleanse and remove food debris.
  • Helps to remineralize damaged tooth structure.
  • Any many other functions.

As you can imagine, if the amount of saliva is reduced, the normal benefits of saliva are not realized.

photograph and picture of cavities from dry mouth with ropey saliva

Another photo of dental decay from chronic dry mouth from medications. This patient was from West Haven, CT. Photo and subsequent treatment by Dr. Nicholas Calcaterra.

Treatment for Chronic Xerostomia

Our patients are on medications for important reasons, so we can’t have them discontinue the medications solely because of the effects of dry mouth. But there are several options for either increasing the amount of saliva and/or protecting the teeth. These include:

  • High fluoride content toothpastes and rinses to reduce the likelihood of further tooth decay. An example is Prevident.
  • Chewing xylitol based gum. The chewing action stimulates salivary flow and the xylitol is proven to reduce tooth decay.
  • Various toothpastes, mouthrinses, gels and other products designed solely to moisten the soft tissue and help your mouth feel wetter. The products from Biotene are the most common.
  • Sucking on sugar free candies throughout the day, stimulating saliva flow.

You should work with your dentist and physician to determine if your medications are causing dry mouth and if so, the degree to which the dryness is affecting your overall oral health. From there, the appropriate treatment (if any) can be recommended.