Fluoride comes in natural and synthetic forms and has been dubbed “nature’s cavity fighter” due to its ability to ward them off. Recently fluoride has come under scrutiny and its benefits and risks need to be better understood.

Fluoride Defined

Fluoride is simply a combination of elements that together form an omnipresent mineral. This naturally occurring substance can be found in air, plants, rocks, soil, water and food. It is also found in our teeth and bones.

Benefits and Functions of Fluoride

Fluoride is shown to strengthen dental enamel, help prevent tooth decay and the need for a dental filling or dental crown. It does this by re-mineralizing and essentially, rebuilding fragile enamel. This inhibits further mineral loss, even reversing preliminary symptoms of decay. It also prevents bacterial growth known to increase acids when processing sugars and carbohydrates.

Fluoride Toothpastes, Rinses and Supplements

Fluoride has been synthetically manufactured and incorporated into dental treatments, toothpastes and mouth rinses, due to its proven benefits. For those who are prone to cavities, many dentists prescribe fluoride mouth rinses to keep their patient’s teeth healthy. But we can’t rely on these dental products alone, we still have to practice daily brushing and flossing teeth to avoid needing a tooth filling or dental crown procedure.

Water Fluoridation

Water fluoridation is a measure where public water providers add fluoride to reduce the incidence of cavities. In the 1930s dentists discovered that those who drank water with natural fluoride exhibited cavity protection. This prompted studies by the US National Institutes of Health to understand how fluoride works, its safety and potential usage. It was determined that natural water didn’t have enough fluoride to ward off cavities and that adding fluoride to water would help safeguard the population from dental decay.

In 1945 water fluoridation was instituted in Grand Rapids, Michigan, and within five years they had successfully achieved a reduction in childhood cavities. In short order this process quickly spread across most of the US, and from the late 1960s to the early 1990s this practice reached even more communities. The Centers for Disease Control and Prevention (CDC) cite this added prevalence to account for the 68% drop in lost or decayed teeth in 12-year-old children.

Dental and Skeletal Fluorosis

We can’t just drink fluoridated water and consume vast amounts of fluoride supplements and think we are in the clear. In fact, large doses can cause dental fluorosis. Not unlike white spots that occur with unprofessional teeth whitening treatments, excessive fluoride consumption can cause white spots to appear on teeth. Children under 8 years old who still have permanent teeth developing seem to be the most affected as they tend to swallow their toothpaste. Don’t be alarmed if you see these telltale specks or streaks, as while they may be a tad unsightly, they aren’t harmful. Just teach your little one not to swallow toothpaste when they brush and keep an eye on them, just in case.

Skeletal fluorosis is another thing altogether as it is where excessive fluoride intake affects the structure of bone and calcifies the ligaments. This condition is often due to high concentrations of fluoride found in water. Asia and Africa have vast fluoride sediments in the soil which can flood their water with unhealthy levels that contribute to skeletal fluorosis. In the U.S. only .7 parts per million (ppm) are allowed for use in fluoridated water. However rare explosions or fires may cause unintentional excess and trigger this condition. In truth, the few reported cases in the U.S. are attributed to toothpaste consumption.

The Water Fluoridation Controversy

There is a movement afoot in cities and countries worldwide due to the alleged fluoride risks.

Despite allegations that fluoridated water causes arthritis, bone cancer, kidney disease and low IQ scores in children, scientists have performed vast studies substantiating that low quantities of fluoride in water are safe. While one study that pointed to higher incidents of bone cancer in males, subsequent studies failed to link the two.

There was a 2017 study conducted in Mexico that indicated a link to low IQs. However, the ADA identifies that the levels of fluoride consumption in Mexico are not commensurate with the U.S. and therefore, the results of this study are unsubstantiated.

Some sources indicate other problems with the thyroid, skin, cardiovascular, reproductive and more which are also inconclusive.

Should I Avoid Fluoride?

The American Dental Association (ADA) continues to assert that water fluoridation is beneficial, that it prevents at minimum 25% of tooth decay in children and adults. The CDC corroborates its benefits deeming it in the top 10 of 20th century public health achievements. Like many substances that are deemed “unsafe” in today’s society, some studies will cite ill-effects while others tout their benefits. Patients who are concerned can decide what’s best for their families.

Before skipping fluoride treatments and toothpastes for you and your family, talk to your dentist about your reservations. While fluoride is a naturally occurring mineral with advantageous benefits for dental health, we respect your choice if you prefer to proceed or abstain from fluoride. We take into consideration your needs and preferences and will advise you accordingly. If you prefer to avoid it, you may opt to drink non-fluoridated bottled water, use reverse osmosis or water filters designed to remove fluoride, and use fluoride-free dental products. Whatever path you choose, we encourage patients to share their concerns. We’re here to support and promote your family’s health.