Over the past several decades, dentistry has seen some controversies. Oil pulling, amalgam fillings, and the supposed dangers of orthodontics have been hot topics of discussion. At Matthew Nawrocki DMD, MS, our blog is a great venue for discussion regarding oral health topics and current dental news. We will dig into the controversial issues above in future discussions but today we will talk about fluoride. We hope you enjoy!
The CDC has placed public water fluoridation in the illustrious group of the “ten greatest public health achievements in the 20th century”. Others claim that this is forced medication and state that fluoride is poison, carcinogenic, and should be banned. What is the truth? We will attempt to demystify this topic if we can.
What is Fluoride?
Fluoride is an anion of fluorine. This is found in many places including the Earth’s crust, the air, the soil, many of the foods we eat and drinks we drink. Tea, raisins, table wine, baked potatoes, and lamb all contain fluoride. In the 1940’s, the addition to fluoride in the municipal water supply began and the debate has raged since.
What is Good About Fluoride?
Our teeth gain and lose minerals all day every day. The acid content in the mouth essentially pulls minerals out of the tooth structure. Our salivary contents attempt to remineralize the teeth but often the demineralization wins. When this happens to a significant degree, we get cavities. A cavity is the breakdown of the tooth structure from this demineralization. To simplify things greatly, fluoride strengthens the tooth’s defenses against demineralization. The outer tooth structure is slightly different in composition when fluoride is present and cavities are prevented.
Fluoride is in many of our toothpastes, mouth rinses, and given in a varnish form by dentists across the country.
When assessing fluoridated vs. non fluoridated water communities, we see up to a forty percent decrease in the amount of dental decay in those communities adding fluoride to the water. We have to recognize that there are many other factors at play here but studies have shown a correlation between fluoride use and cavity prevention too large to ignore.
Why is Fluoride Said to Be Dangerous?
Fluoride is said to be dangerous because it can be dangerous. In excessive quantities, fluoride can be dangerous to bones and teeth. The evidence of this can be easily seen in fluorosis. The teeth can be pitted and have a mottled appearance. The danger is generally seen in development. This is when our teeth and bones are generally in their developing stages and can be in danger if excessive fluoride ingestion occurs.
How much is excessive? This really should be the question we ask. In 206BC, there is an ancient account of death of Chryssipus. He was a philosopher that died from too much laughter. He saw his donkey eat a fig then saw someone give it some wine and died laughing. In 1771 the king of Sweden died from eating too much food. The point is that too much of anything could be bad. The US Department of Agriculture states that an adult can drink up to 10L of fluoridated drinking water with NO adverse risk. The truth is that we do not know exactly what that dangerous level is. We are told that the levels in the water supply are not bad but we don’t have clear data of just how much over that can be problematic. We do know that if a developing child eats an entire tube of toothpaste, evidence of fluorosis may occur in the permanent teeth.
Finally, studies have been completed showing that fluoride has the potential to cause neurotoxicity, lower IQ scores, and a host of other health problems. While we should always pay attention to studies showing potentially damaging effects of products we use daily, we cannot ignore some of the problems with these studies. First, Harvard University warns us from paying too much attention to the IQ score debate because most of the research was completed in other countries where some of the levels of fluoridation were more than 10 times our recommended levels. In addition, between the 1940’s and 90’s, IQ scores of American children grew by an average of 15 points. During this time we saw progressive increases in public water fluoridation. There are so many factors in these studies which make it difficult to see them as proper cause and effect.
This has been a raging controversy for many years. As a result, much research has been completed regarding fluoride. As a dental community, we simply cannot avoid or ignore the findings regarding the health benefits of fluoride. We cannot ignore the risk either. Normal drinking water levels have not been shown to contribute to malformation of bones and teeth but excessive ingestion should be avoided especially in children. The current levels of drinking water suggested at this time is .7-1.2ppm (parts per million). Most fluoridated toothpastes are more than 1000ppm. Due to this, we strongly recommend that parents keep toothpaste and mouth rinses out of the reach of children. Fluoridated toothpaste is still recommended by nearly all dental professionals but the amount should only be a smear for toddlers and children. This can protect them from harm if swallowed.
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