First impressions are important, and one of the first things people notice is your smile. Because of this, many consumers are considering tooth whitening to achieve a whiter, brighter smile. However, there are a variety of tooth whitening products on the market today, both in-office and at-home, so how do you know which option is best for you?
Over-the-counter whitening strips – These typically yield a very subtle lightening of the teeth.
Over-the counter whitening toothpastes – While these will not change the natural color of teeth, some contain a special chemical or polishing agent to help more effectively remove stains from the tooth’s surface.
Prescription bleaching kits – Dispensed by a licensed dentist, these kits contain peroxide(s) that will bleach the tooth enamel. They contain higher levels of carbamide or hydrogen peroxide than their non-prescription counterparts. Peroxide whiteners typically come in a gel and are placed in a tray similar to a mouthguard. By obtaining the bleaching solution from your dentist, he or she can make a custom-fitted tray specifically designed to fit your teeth. Poorly fitting trays can cause gingival irritation and tissue burning.
Zoom whitening (power whitening) – This in-office procedure combines a high concentration of hydrogen peroxide gel with a high intensity light used to whiten the teeth. The cost is approximately $600 and results typically last about three years.
Fluoride and Infant Formula Frequently Asked Questions (FAQ)
The ADA’s interim guidance contains recommendations to simply and effectively reduce fluoride intake from infant formula:
- Breast milk is widely acknowledged as the most complete form of nutrition for infants. The American Academy of Pediatrics recommends human milk for all infants (except for the few for whom breastfeeding is determined to be harmful). Babies who are breastfed do not appear to exceed the optimal amount of fluoride.
- Ready-to-feed formula is preferred over formula mixed with water containing fluoride during the first year of life to help ensure that infants do not exceed the optimal amount of fluoride intake.
- Powdered or liquid concentrate infant formula can be mixed with water that is fluoride-free or contains low levels of fluoride to reduce the risk of fluorosis. Examples are water labeled purified, demineralized, deionized, distilled or reverse osmosis filtered water. Many stores sell these types of drinking water for less than $1 per gallon. Some, but not all, home water treatment systems also remove fluoride from tap water, so check with the manufacturer. Parents and caregivers should consult with their pediatrician, family physician or dentist on the most appropriate water to use in their area to reconstitute infant formula. Since some children may have special medical needs, ask your pediatrician or physician whether water used in infant formula should first be sterilized.
Recent developments led the Association to offer interim guidance on infant formula and fluoride while more research is conducted. These developments include the U.S. Food and Drug Administration’s health claim notification October 14 , 2006 allowing bottlers to claim that fluoridated water may reduce the risk of dental cavities or tooth decay, but not make the claim for bottled water products specifically marketed for use by infants, and the March 22 release of the National Research Council (NCR) Report: “Fluoride in Drinking Water: A Scientific Review of EPA’s Standards.”
Studies cited in the NCR Report have raised the possibility that infants could receive a greater than optimal amount of fluoride through liquid concentrate or powdered baby formula that has been mixed with water containing fluoride during a time when their developing teeth may be susceptible to enamel fluorosis.
Infants (ages birth to 12 months) need less fluoride than everyone else because of their size. While more research is needed before definitive recommendations can be made on fluoride intake and reconstituted formula, the American Dental Association issued interim guidance so parents, caregivers and health care professionals who are concerned have some simple and effective ways to reduce fluoride intake from reconstituted infant formula.
The U.S. Food and Drug Administration (FDA) announced in October 2006 that it will allow bottlers to claim that fluoridated water may reduce the risk of tooth decay. The ADA agrees with the FDA that this health claim is not intended for use on bottled water marketed to infants for whom lesser amounts of fluoride are appropriate. The right amount of fluoride is essential to help prevent tooth decay. But fluoride intake above optimal amounts creates a risk for enamel fluorosis as teeth develop before they erupt through the gums. The ADA’s interim guidance contains recommendations to simply and effectively reduce fluoride intake from infant formula reconstituted with water containing fluoride.
Water labeled as purified, distilled, deionized, demineralized, or produced through reverse osmosis is known to be low in fluoride. Most other types of bottled water contain low fluoride concentrations but variations exist and some brands may contain optimal or higher levels. If you have questions about the fluoride content in the bottled water you use, check the label or contact the bottler. Because some children may have special medical needs, ask your family physician or pediatrician whether water used for infant formula should be sterilized.
The ADA has long-standing recommendations concerning fluoride use. One of the most important things to remember is that if children are younger than six years old, an adult should supervise their use of fluoride-containing dental products.
When children’s teeth start to appear, brush them with a child’s size toothbrush. Do not use fluoride toothpaste until the child is two years old unless advised to do so by a dentist or other health professional.
For children age two and older, place only one pea-sized amount of fluoride toothpaste on the toothbrush at each brushing. Young children should always be supervised while brushing and taught to spit out, rather than swallow the toothpaste. Many children under age six have not yet fully developed their swallowing reflex so they may be more likely to accidentally swallow fluoride toothpaste.
Unless advised to do so by a dentist or other health professional, the ADA does not recommend the use of fluoride mouthrinses for children under six years of age. Many children under age six have not yet fully developed their swallowing reflex so they may be more likely to accidentally swallow fluoride mouthrinse.
You can find extensive information in “Fluoridation Facts,” the ADA’s comprehensive publication with facts from over 350 scientific references. Fluoridation Facts includes information from scientific research in an easy to use question and answer format on the topics of effectiveness, safety, practice and cost-effectiveness of fluoridation.
A-Z Topic: Fluoride & Fluoridation
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Please note: The ADA does not provide specific answers to individual questions about fees, dental problems, conditions, diagnoses, treatments or proposed treatments, or requests for research. Information about dental referrals, complaints and a variety of dental procedures may be found here. Please refer to our Frequently Asked Questions page before submitting an e-mail.