For years, the debate has raged over the value of fluoride. Although one would assume that the passage of time would bring more clarity to the issue, it still seems that there are more questions than answers.
For patients who are trying their best to care for their teeth, the confusion about fluoride can seem overwhelming. However, by taking some time to understand more about fluoride and how it affects your teeth, you can make a more informed decision that will positively influence your overall health.
Fluoride: An Oral Health Breakthrough
Fluoride is a natural element that’s found in the ground, water, and air. Natural water supplies have varying amounts of fluoride. It is absorbed by the teeth and bones when we drink it.
According to the Department of Health and Human Services, research on the connection between tooth decay and drinking water started around the turn of the 20th century. Highlights from the DHHS article include the following:
- In 1945, Grand Rapids, Michigan became the first municipality to add fluoride to their drinking water.
- Children who were born in Grand Rapids after their water supply was fluoridated experienced an astounding 60% drop in cavities over the previous generation of kids.
- Armed with these results, cities, and towns across the country began adding fluoride to their drinking water in earnest.
According to the Center for Disease Control, almost 75% of public water supplies are fluoridated today.
The Advent of Fluoride Toothpaste
Most people today don’t realize that until the 1950s, toothpaste was fairly ineffective. At best, they were abrasive pastes that attempted to remove plaque from the teeth using sheer grit.
However, in 1956, Crest introduced the first fluoride toothpaste, which revolutionized the industry. In fact, the now-ubiquitous “Seal of Acceptance” from the American Dental Association was first awarded to Crest for its revolutionary formula.
Over a short period of time, tooth decay was reduced to historic levels in the United States. Overall oral health was at an all-time high. Much of the credit for these results were given to the addition of fluoride to drinking water and toothpaste.
The Pros of Fluoride for Oral Health
There’s no doubt that, when you look at the historical evidence, there’s a correlation to Americans’ use of fluoride and their overall improvement of oral health. Those who advocate for the use of fluoride point to these advantages:
- Fluoridated public drinking water significantly improves overall oral health. According to the American Dental Association, towns and cities with fluoridated drinking water have a 25% drop in tooth decay in both children and adults over municipalities with untreated drinking water. Additionally, the cost of this treatment is extremely low. The same study states that, for every $1 spent on fluoridated water, a city will save an average of $38 on dental costs per person.
- Fluoride toothpaste can help protect teeth and even heal tooth decay. Fluoride applied topically to the teeth via toothpaste can have wonderful preventative results. Fluoride can help remineralize the enamel, reversing the effects of tooth decay.
- The addition of naturally occurring fluoride to water and toothpaste is commonplace. Although some may be hesitant when considering an “additive” to their water or toothpaste, it shouldn’t be unusual to our current way of thinking. Many common products we use today are fortified with vitamins or minerals and our health is better for it. Whether it’s iodine in salt, vitamin D in milk, or riboflavin in our cereals, public health has improved thanks to this practice.
The Cons of Fluoride for Oral Health
Although there’s no denying the statistics that show a vast improvement in oral health as fluoride was introduced into the American water supply and dental products. However, some experts draw different conclusions from the same data.
For instance, the Fluoride Action Network, an anti-fluoride advocacy group, points to statistics showing that the rate of tooth decay has fallen across the Western world over the years, regardless of whether countries added fluoride to their water or not.
Those who advocate for a fluoride-free water supply and who buy toothpaste free from fluoride point to several arguments that support their position:
- The fluoride additive differs from naturally-occurring fluoride. Critics of fluoride are often not critical of calcium fluoride, as it’s a naturally occurring element. Rather, they point to the effects of industrial fluoride, which is what is typically added to the water supply. This type of fluoride reacts differently in the body compared to calcium fluoride and the effects can be pronounced. For instance, since industrial fluoride is completely soluble by the body, there can be side effects to ingesting too much of it, including fluorosis.
- There’s no method of tracking fluoride ingestion. Ingesting too much fluoride can cause health issues in some cases. You may wonder if there’s a way to monitor how much fluoride you take in on a daily basis. Unfortunately, tracking fluoride use isn’t as simple as counting calories or keeping tabs on your caffeine intake each day. The reason? There is no accurate methodology for testing fluoride levels in the body, leaving people unsure about their actual fluoride absorption level.
- Safer methods of encouraging enamel growth are now available. Although fluoride may have been the best method to strengthen enamel in the 1950’s, some argue that there are safer alternatives available today. Many anti-fluoride advocates point to toothpastes containing hydroxyapatite particles as far superior to their fluoride-containing counterparts. Also, they argue good oral health practices, like brushing twice a day, scraping your tongue, and flossing once daily are the best preventatives you can implement to keep cavities at bay – much more so than fluoride.
So, What Does Fluoride Actually Do To My Teeth?
It’s easy to see compelling arguments on each side of the fluoride debate. Each patient has to do their own research and arrive at their own conclusions. However, everyone should agree that no matter your position of fluoride, good oral health is a must. Always make sure you:
- Have a daily routine of brushing, flossing (consider a water flosser), and tongue scraping to keep bacteria from festering in your mouth.
- Change your toothbrush every three months, or discard it for a new one even sooner if the bristles show significant signs of wear.
- Monitor or modify your diet if necessary to ensure that your food and drink choices aren’t damaging your teeth.
- Visit your dentist every six months for teeth cleaning and an oral health exam.
If you have questions about fluoride, make sure you talk to your dentist at your next appointment. They will be glad to walk you through fluoride’s pros and cons and help you make a more informed choice.
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Ben Salar, DMD
Dr. Salar grew up in Los Angeles, California and after earning a bachelor degree in Biological Sciences from the University of California Berkeley, he attended Temple University School of Dentistry and earned his dental degree. Upon graduating, he attended the prestigious NYU/Bellevue hospital program where he received a specialty certificate in pediatric dentistry.
Dr. Salar now serves infants, children, and adolescents in the Great Sierra Nevada area at Toothfairy Dental of Reno and Children’s Dentistry of Las Vegas. Dr. Salar emphasizes preventative dental care at home and through conservative dentistry practices. His experience in sedation, dental surgery, and full-mouth oral rehabilitation have made him an authority in the field. He is most trusted for treating children who require complex care, suffer from anxiety, or who have special needs and symptomatic health conditions.
He believes that all kids deserve high-quality care with a smile. He treats all of his young patients and their families with cheerful kindness.