Is it necessary to get polishing & fluoride treatment at the dentist?

May 3, 2021 4:09 PM

You're not my dentist, but after my most recent visit dental cleaning (today) I couldn't help but wonder if it's actually necessary/beneficial to actually get the polishing & fluoride treatments during dental appointments? My dental insurance doesn't cover either and I'm wondering if they're something I can skip.

When it comes to my teeth, they're fine. I don't have very many cavities and I don't get cavities very often. I have saliva that's high in calcium (iirc), so I get a lot of tartar build up on my teeth. Despite how much I floss, it still happens.

I don't think my dental coverage has ever paid for polishing and certainly has never paid for fluoride (which is about $40), yet I get them every time I go to the dentist for a cleaning. I've never thought about it before until today, not sure why. I just thought it was something that I was supposed to do, so I never questioned it. Is it actually worthwhile to keep paying for these treatments? Can I skip them without causing much harm to my teeth? What's the consensus?

(Also, I think what's causing me to ask this question is that my dentist recently sold his office to a chain of dental clinics. Good for him, he's a nice guy, but I'm a little more wary of what they are pushing on me there now. But I've always had polishing/fluoride done.)

posted by VirginiaPlain to Health & Fitness (14 answers total)

I never get polishing. It doesn't do anything for tooth health, it's just cosmetic: most people like it, they like the shine and the smooth sensation. I hate the way the treatment feels so I haven't had it done for years.

The fluoride, I don't know, but I do tend to feel less sensitivity after I have it done, so I do it.
posted by fingersandtoes at 4:30 PM on May 3, 2021

MiPaste is a dental product a lot of people with thin enamel purchase for in between dental visits.

It's maybe $20 for long usage, if you have an electric toothbrush, you're probably good to go.

Fluoride can help, but is sometimes controversial and arguably unnecessary. It's always occurred as a nice perk, but its not a root canal. I think some commercial offices hustle it hard because it's inexpensive and can mystify some of their customers. I think you can diy something or skip it.
posted by firstdaffodils at 5:11 PM on May 3, 2021 [3 favorites]

If your teeth get plaque easily, look into a toothpaste with Xylitol in in - Xylitol inhibits bacterial growth on teeth (aka plaque). I use the Squigle brand, because it was cost effective and easy to get on Amazon.
posted by dbmcd at 5:21 PM on May 3, 2021 [1 favorite]

If you've got fluoridated water, you might not need the fluoride treatment. But if your water is untreated, it might be helpful.

(Anecdotally, I never had cavities until I moved to an area that doesn't fluoridate the water. Now I've got 3. Personally, I'm a believer.)
posted by hydra77 at 5:58 PM on May 3, 2021 [5 favorites]

I grew up in a city that didn't put flouride in the water, and now I live in the Portland area where there is no fluoride.

I've had a *ton* of cavities, and now I'm old enough that those old fillings are breaking and/or falling out, causing broken teeth, crowns, and recently a tooth extraction (that perforated into my sinus cavity, resulting in oral surgery).

If your municipality doesn't put flouride in the water, it is worth it to pay the dentist for the treatment. Trust me.
posted by tacodave at 6:06 PM on May 3, 2021 [6 favorites]

My dentist told me insurance won't pay for fluoride for adults since there's little research it helps after your teeth are "grown up." He said the evidence was pretty compelling but not conclusive.
posted by blnkfrnk at 6:49 PM on May 3, 2021

Have you had dental work done like a crown, fluoride treatments can help prevent cavities forming at the margins? Have you had a cavity filled in the preceding year? Do you suffer from dry mouth? Receding gums exposing softer enamel? Do you have sensitive teeth? If so you'll want a fluoride treatment. If you rarely get cavities, ie years go past between fillings, eat a lot of fish with bones and use fluoridated water for your daily drinking and cooking and use a fluoride toothpaste you'll most likely be Ok without.
posted by wwax at 6:50 PM on May 3, 2021

Response by poster: Thanks for the answers so far. I forgot about fluoridated water, which every city I have lived in has had, so far! So I'm sure that has helped a lot with my lack of cavities in addition to my weird saliva. To be honest, I've always enjoyed sitting in the dentist chair with the fluoride foam trays in my mouth while holding the suction thing. I think I might keep doing it.

The polishing, I'm not really convinced about yet.
posted by VirginiaPlain at 7:23 PM on May 3, 2021

I've never heard of fluoride treatments for adults?? These were only covered every other time for my kids but I paid a bit for them out of pocket.

But, seriously, every effective penny you spend now for your teeth hopefully will pay off later.

I'm getting a second root canal this year later this week following two crowns. I'm already through my $1500 dental insurance coverage for the year so everything even cleanings are out of pocket now.

Signed - teeth full of fillings after a childhood lacking dentistry and fluoride. Every one of my molars are more fillings than teeth. My husband with strong teeth, consistent dental treatment, lots of plaque, has 1 (one!) filling. My kids - zero fillings - close dental attention plus fluoride, plus sealants.
posted by RoadScholar at 8:16 PM on May 3, 2021

I got a lot of cavities in a few years after moving to a place without fluoridated water and not getting optional fluoride treatments (after never having any when I lived with F water). Then I started to get fluoride treatments, no more cavities. I like the gross varnish way better than the gaggy foam trays.
posted by janell at 8:43 PM on May 3, 2021

As a former dental assistant, a polish is strictly cosmetic when it is part of a cleaning. You can decline it if you don't prefer to have it. It's odd that a dentist will charge for it as its part of the cleaning. I could be wrong (since I didn't deal with insurance/front desk) but I don't think there is even a separate insurance code for just a polish.

Fluoride coverage will vary according to the type of dental insurance you carry. Some will cover under 18 years of age, some will cover 0 to 99 years of age, some cover only once a calendar year, etc, etc. You can decline it whether you have to pay out of pocket or if insurance covers it and you just don't like fluoride for personal reasons.

If its *silver diamine fluoride* its a different type of fluoride and is used for specific reasons. Most insurance does not cover this and patients need to be fully informed and be ready to pay out of pocket for this.
posted by tipsyBumblebee at 9:27 PM on May 3, 2021 [2 favorites]

On contact, fluoride bonds with teeth and makes them stronger. I try to leave the toothpaste in my mouth while I wash my face, sometimes I have to spit, but I delay rinsing. Can't hurt, might help. My teeth are soft, my dentist recommends high-fluoride toothpaste. Happy to hear about toothpaste with xylitol, will try it, as long as it has fluoride(it does).
posted by theora55 at 6:24 AM on May 4, 2021

Fluoride believer here.

I went full hippie and used “natural” toothpaste in my 20s, got a mouthful of cavities which (gasp) went away after switching back. Never again.

I can get the polish clean mouthfeel by: electric toothbrush + attentive floss along side of tooth to scrape off the biofilm + mouthwash

And after brushing alone: don’t rinse your mouth. Leave that small coating of toothpaste on and go to bed.
posted by St. Peepsburg at 8:55 AM on May 4, 2021 [2 favorites]

My dentist told me insurance won't pay for fluoride for adults since there's little research it helps after your teeth are "grown up." He said the evidence was pretty compelling but not conclusive.

I second this. First time I encountered a ~$30 out of pocket charge for the leave on fluoride (especially since it was a completely disgusting fake caramel flavor), I was curious to see what the research said about adults use, and could not find any at all. No clinical trials.

Not to say that it isn't truly useful, but assuming something is useful in one stage or life doesn't mean it is in the other.
posted by lizjohn at 12:45 PM on May 4, 2021