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Woman at Dentist
27 July, 2022

Tooth Decay and Fluoride

Have you ever noticed a fuzzy, gritty or sticky coating on your teeth in the morning? That fuzzy film is commonly referred to as dental plaque. Dental plaque contains bacteria, which produce acids that can soften and erode the teeth's protective enamel. Over time, a build-up of plaque can lead to numerous dental health concerns such as tooth decay, gum disease and tartar build-up.

What is tooth decay?

Tooth decay, also commonly known as cavities, is usually a result from the acid, produced by bacteria in dental plaque, attacking the tooth surface. The acid causes minerals from the surface to be lost, a process also known as demineralisation5. In its early stages, tooth decay can appear as a white or dark spots on teeth where minerals have been lost. At this point, the decay may be stopped or reversed and your enamel can still repair itself with better oral care10. However, if the tooth decay process continues and as more minerals are lost a cavity or hole may appear8. This is permanent damage that a dentist would need to repair with a filling.

Preventing tooth decay

It’s important to not let plaque make a permanent home on your teeth. Following some of the following practices can help prevent tooth decay.

Practicing good oral hygiene

It is recommended to brush your teeth twice a day; in the morning and before bed. Dentists recommend using an electric toothbrush or a toothbrush with a small head and soft bristles and a pea-sized amount of fluoride toothpaste8. Flossing at least once a day is also an essential step to help clean between teeth where a toothbrush can’t reach.

Eating a healthy well-balanced diet

Certain foods can increase the risk of tooth decay and promote the build up of plaque. Making smart food choices greatly impacts your oral health by changing the pH level in your mouth9. The more acidic the environment of your mouth, the more harmful bacteria thrive. It is best to limit foods and drinks that are high in sugars and starches and avoid snacking on high GI foods. Some sources recommend to have a small amount of dairy, such as a piece of cheese, after eating anything sweet or acidic to assist in repairing damage by decay-causing bacteria8.

Keeping hydrated with water

Many beverages, other than water, contain high levels of sugar or can be acidic, promoting an environment that harmful bacteria love to thrive on. Limit your consumption of soft drinks, sports drinks, cordials, fruit juice, tea, coffee and alcohol.

Staying hydrated and drinking 6-8 glasses of water per day is not only good for your health and well-being but can also help to improve your saliva production. The saliva in your mouth helps protect against tooth decay and can repair decay in its early stages8.

Drinking fluoridated water and using toothpaste that contains fluoride

It is well known that fluoride has been added to many toothpastes and water supplies in Australia in an effort to prevent tooth decay and dental health problems.  There is consistent and reliable evidence to suggest that fluoride found in drinking water, toothpastes, mouth rinses and other oral-care products prevents tooth decay by hardening tooth enamel and reducing the chance bacteria have to stick to teeth3,6.

Regular dental visits

Tooth decay can be stopped or managed if it is caught early. Visiting your dentist every 6-12 months will increase the likelihood of spotting any problems early, and receiving the best care and treatment to avoid future problems.  Having no pain does not always mean that your teeth and mouth are healthy11. If you have not seen your dentist in the last 12-24 months or longer, it might be a good idea to book an appointment.

What is Fluoride?

Fluoride is a mineral which can be found naturally in seawater, freshwater, soil and many foods such as apples, grapes, tea and almonds. It also occurs naturally in the human body as calcium fluoride, which is found mostly in bones and teeth.

The amount of fluoride naturally occurring in water depends on the type of soil and rock through which the water drains3. In Australia, most drinking water has low levels of fluoride naturally present and is not always at what the National Health and Medicine Research Council (NHMRC) and public health experts consider to be the optimal level for tooth decay prevention4.

Water fluoridation, the processes of adjusting the amount of fluoride in drinking water, was first introduced in Beaconsfield, Tasmania, in 19533. As of February 2017, 89 percent of Australians have access to fluoridated drinking water3.

Should I still use toothpaste containing fluoride if I am drinking fluoridated water?

Yes, it is recommended that drinking fluoridated drinking water and using toothpaste with fluoride provide important and complementary benefits3. It is advised that both offer more protection than using either one alone3.

The current Australian guidelines advise that fluoride supplements in the form of tablets or drops should not be used unless under the advice of an oral health professional and are generally not readily available in Australia. If your drinking water is not fluoridated or you use tank water, ask your dental health professional for advice on other options for gaining the benefits of fluoride7.

Does bottled water and filtered water contain fluoride?

Bottled water is often not fluoridated, however depending on the source it may contain some naturally occurring fluoride. If any additional fluoride has been added, the bottle must be clearly labelled and state the product contents as per all packaged food regulations in Australia3.

Although it is not desirable, filtering systems that contain ion exchange resins, activated aluminium or reverse-osmosis membranes will often remove most of the fluoride from water3.

Facts to remember

  • Practicing good oral hygiene, eating a healthy well-balanced diet low in sugar, drinking plenty of tap water instead of sugary drinks, and staying hydrated to improve saliva is very important for protecting your teeth from decay.
  • Drinking fluoridated water and using fluoride toothpaste can help to strengthen teeth against plaque and acid attacks7.
  • Early stages of tooth decay can be stopped or managed. Ensure you have a regular 6-12 monthly check up with your dentist to spot any early damage and prevent it from getting worse.


- By Irene Vergos, Healthcare Pharmacist at Direct Chemist Outlet




DISCLAIMER: This material contains general information about medical conditions and treatments and is intended for educational purposes only. It does not constitute medical or professional advice, nor should it be used for the purposes of diagnosing or treating any illness. If you have or suspect you may have a health problem, you should consult your local pharmacist or health provider to obtain professional advice relevant to your specific circumstances.

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