In small amounts, fluoride is safe and recommended by most dental health professionals. That includes fluoride in toothpaste, mouthwash, dental treatments and the U.S. public water system. Fluoride, like many minerals, can be harmful in very high amounts. But the levels used in dental products and procedures and in community water systems don’t come near that threshold. Topical fluoride — such as in toothpaste, mouth rinses and professional varnishes — works on the surface of your teeth. Fluoride in water affects your teeth from the outside and the inside of your body. It sits in your saliva, acting as a coating similar to topical fluoride. Systemic fluoride also gets incorporated into the actual structure of your teeth as they’re developing. For kids, that means that fluoride can help them develop stronger teeth as adults. Fluoride supports a process called remineralization. That means it helps restore the minerals that acid eats away. This process can slow or even stop early tooth decay. Fluoride also makes your enamel more resistant to acid. In children, fluoride swallowed from water can make its way into their developing teeth. That adds extra protection as their adult teeth form. Possible risks: ▪️Dental fluorosis: Too much fluoride during childhood can cause cosmetic changes to your tooth enamel. It’s typically mild and appears as faint white streaks on your teeth. ▪️Bone health concerns: Very high levels of fluoride over long periods have been linked to bone problems like pain, stiffness and bone deformities. These concerns are rare in the U.S., but are more common in parts of Asia and Africa, where groundwater naturally has excessive amounts of fluoride. ▪️Brain development concerns: Some studies examining regions with naturally high fluoride levels have raised questions about possible effects on brain development. These levels are significantly higher than what’s used in U.S. community water systems. Current U.S. guidelines set fluoride levels at 0.7 milligrams per liter. That’s well below amounts that have been associated with harm in research studies