How often to Fluoride rinse?

Hi Dr Ellie, 

I’ve read your blog with intense interest. I have plenty of cavities and fillings to show over the last 30 years. I’m interested in starting your complete system, but I’ve read the back of the ACT bottle (Sodium Fluoride 0.05%) and it states to only use once a day. Should I not worry about this? I’m worried about fluoridosis over the long run. The ACT Restoring (which I know you say to stay away from) has only half the fluoride, so seems safer for 2x a day use.

Should I just ignore the directions on the bottle and swish away?

Also, I know you recommend we stick with the name brand ACT, but what about the Listerine? Can we use one of the many store-brands as long as it has the same active ingredients?

Thanks in advance!
E. G.

Hi E. G.,

Good questions!
Fluoride is a big subject and I have a whole chapter devoted to fluoride in the book I hope to publish later this year.

Basically you need to worry about two things:
– The amount of fluoride ingested regularly
– The kind of fluoride in the water and products we use (such as toothpaste and mouth rinse)

1. Rinsing with a small amount of a stable sodium fluoride and spitting it out is my recommendation. ACT is very dilute and the amount of rinse you use is not important so you could actually have the same benefits using only half the “recommended” amount of rinse each time.

My concern is any hazard associated with absorption of fluoride into the body.
The only fluoride that would be ingested from using a rinse would be from the tiny amount present in the thin (and very dilute) residue that remains on your teeth after spitting out, or possibly absorbed through the skin of the mouth during rinsing (this has never been shown to happen, but I guess it is theoretically possible). Because the rinse is so dilute, the amount of fluoride present in this film or possibly absorbed would be extremely small. Also remember that 98 percent of any fluoride absorbed is excreted by the body – bringing this minute amount down by 98 percent. I think our quantity here is minuscule. I concede that there is exposure, but you need to balance this extremely small risk against the benefits of preventing dental disease.

On the other hand, there are very real risks associated with plastic or mercury-containing metal restorations and the whole process of restoring damaged teeth. I believe it is worth using fluoride and xylitol in a complete mouth care program to build up the strength of damaged teeth, repair early cavities and stop the need for future fillings, root canal treatments and cleanings.

I have used the system two to three times a day for decades and recommend it to all my family, patients and friends: this is a system of prevention that really works.

I filter fluoride out of my drinking water, because I am not comfortable with the kind of fluoride used to fluoridate water, or the fact that aluminum is added to drinking water. Fluoride and aluminum together in an acidic environment is a kind of “chemical soup” that I believe we should worry about.

I would never recommend fluoride supplements for children nor dentist applied fluoride gels or treatments. These contain high concentrations of fluoride that do not give the same benefits as a dilute fluoride rinse used regularly. Drinking or eating fluoride is how you get too much fluoride into your body and develop fluorosis. Tea can be a source of very strong fluoride, so be especially careful of things like tea especially if it is dehydrated (as in iced tea powder) which is then reconstituted with fluoridated water. I believe that these are the things to worry about not rinsing with an ounce of dilute fluoride that you spit out.

2. The best, most tested, most stable fluoride that does not stain teeth is sodium fluoride as in ACT rinse.

The original ACT rinse seems to coat the teeth and perform particularly well the store brands do not seem to do this so well . I would not suggest the Restore for this and other reasons. If you wish you can use half or a third of the “measuring” cup volume each time you rinse ( so that you divide the amount but use it more often twice or three times a day). The quantity of rinse you use each time does not matter….because the benefits come from the LENGTH of time that fluoride is in contact with your tooth surface. The longer the contact, the more help it gives your teeth. There is no time that is too short but the longer fluoride is in contact, the stronger, shinier and whiter your teeth will become! This is why twice a day is good especially if you leave the residue to work on your teeth for half an hour or so after spitting out. I use the rinse last thing before bed every night this way my teeth are protected all night long.

I am not sure if store brands of Listerine work as well as the original. This is one rinse that is relatively inexpensive so I would suggest sticking to the real thing perhaps look for sales on larger quantities in the discount drug stores.

Hope this helps you feel free to arrange a telephone consult with me if you would like no charge!

I am happy to chat with people to help them on their pathway to dental health.
Thanks again for your interest and questions,

Best Wishes,

Ellie Phillips DDS
Dental Health for Everyone!
26, Corporate Woods,
Rochester NY 14623

The amount of fluoride recommended (by me) is not one ounce it is 5 – 8 ml******
The ACT manufacturer recommended dose is 10 ml per rinse…..I think a little less is adequate ….. A bottle of ACT should give you about 50 (10 ml rinses)
By reducing the recommended dose just a little one bottle should give you a good amount for one month! Remember it is the amount of time the rinse is in contact with the teeth that matters!

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  • Anonymous says:

    Last year I had to replace five old crowns.I presently have about sixteen. The water in Vancouver is quite soft and doesn’t contain added flouride. The problem was that bacteria was working it’s way underneath these layers and causing decay. No amount of brushing or flossing could control this effect. My dentist recommended the use of a daily flouride rinse,which I willingly complied. Yesterday I nervously went for my six month check. Today I’m walking on air after finding out I have no more cavities. Don C.

  • heatherdumas says:

    Please respond to this one and not the other (so I will receive an email). I use ACT alcohol-free mouthwash because, like you, another dentist recommended it on their website. I'm just wondering if it's better to use the alcohol-free or not? The other dentist recommended it, because he said the alcohol dries out the mouth. I actually feel like my breath is worse because of the switch to alcohol-free. And I hate having to wait 30 minutes to drink anything (all I drink is water anyway). I used to use Listerine but nixed it because of the alcohol and switched to ACT (because the dentist recommended it). Would Listerine alc-free be just as good as ACT alc-free?The flouride amounts in our water here are slightly above what is recommended (by .3). I'm assuming that's not too bad, but I figured I'd ask…

  • Dr. Ellie says:

    I recommend a complete mouth care system – which incorporates three mouth rinses – used in a specific sequence with a specific toothpaste.The results of using my system are amazing – but it is like a recipe – it has to be used in the exact order and using the correct products.If you want to know more about WHY these products work – then I have a 200 page book called Kiss Your Dentist Goodbye which would explain!

  • Jones says:

    I am attempting to form habits of brushing my teeth every day twice a day as an adult. When I was a child my mother told me that toothpaste was for rich people, mouthwash was unnecessary, and toothbrushes would scrape my teeth away. I realize now, as an adult, that she said those things because she couldn’t afford dental products over food for our family. As a result I never formed the habits. I’m trying to now but often, my husband has to remind me, and if he doesn’t I just completely forget to do it. Would you have any tips for me?

    Thanks in advance!

    • When my next book (Mouth Care Comes Clean) is published later this year – I discuss why not brushing teeth CAN work – but only for people who eat well, have excellent habits and who have a community of healthy bacteria in their mouths. Today this is a rare person!
      So, my advice is to use my Complete Mouth Care System. The feeling from using this system is that teeth FEEL shiny and smooth, fresh, and wonderful!
      This makes me look forward to doing the system! It’s more like an exciting massage/spa treatment for your mouth, which is completely different from brushing with a bad toothpaste (and there are lots of bad pastes) and using a bad brush (most brushes are bad). These bad tools will leave your mouth feeling dry and “boring”. No wonder tooth brushing is a chore for most people!
      I encourage you to join those of us who use the “system” and L-O-V-E the feeling it creates in our mouths twice a day!!!

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