If you were to go to a dentist’s office, you might find a wide gap between those who are against the use of fluoride treatments and those who wish to have them.
But many of the arguments against fluoride are rooted in fear of how it was originally discovered and later introduced into the United States water supply. Coupled with the fact that fluoride is most beneficial during a child’s early and teenage stages of development, the question of whether fluoride is good for you and your children comes up quite often.
Dentist Nathan Janowicz, DMDbreaks down the code on fluoride and its somewhat complicated history, as well as how it’s used today.
Fluorine conspiracy
A quick internet search will reveal many conspiracy theories about fluoride and how it worked its way into the US water supply. very of theories to be sifted through. But at the core of each, you’ll find a real fear that fluoride might be poisonous.
“Some people ask not to have fluoride treatments when they come in for their routine dental care out of fear that the fluoride will harm their body,” says Dr. Janowicz. “But like anything else, even things that are produced naturally in your body, fluoride is fine, fine, and recommended in small amounts.”
It’s true that you can have too much fluoride, but in most cases, it causes unwanted cosmetic problems that we’ll get to here in a moment. But according to American Dental Association, to experience true fluoride toxicity with severe or life-threatening illness, one would need to drink 5 liters of water for every kilogram of body weight. For a 155-pound adult, that means you should drink about 120 gallons of water at one time.
“You would have to drink so much water, you would die of excess water before you die of hyperfluoridation,” says Dr. Janowicz.
The national recommended limit for fluoride in drinking water is 0.7 milligrams per liter. If you have a well water system, you want to make sure you follow up with annual testing to ensure your water quality is up to par. But 73% of U.Sthat work is already done for them.
So how did we get here and why are people under the misconception that they have been misled about the benefits of fluoride?
The history of fluoride
According to the U.S Centers for Disease Control and Prevention, the story of fluoridated public water began in 1901, when a Colorado dentist began noticing an unusual brown stain, or mottled enamel, on the teeth of several of his patients. These same teeth, although stained, were somehow less vulnerable to cavities and tooth decay. The suspected root cause of their condition was some unknown substance in the local water supply.
By 1942, dentists had identified the cause of enamel as fluoridation, or excessive exposure to high amounts of fluoride during the developmental years as children. But because of its cavitation-resistant properties, fluoride seemed like it could be a beneficial ingredient in water supplies, as long as it could be controlled at low concentrations so it wouldn’t lead to fluoride.
In 1945, this theory was put to the test by adjusting the fluoride level to safe amounts in the public water supplies of eight cities throughout Michigan, New York, Illinois, and Ontario, Canada. As you might expect, there was some skepticism about fluoride because so much was previously unknown about the element and because these eight cities were used for a test run to see how healthy it could be if controlled.
But over the course of 13 to 15 years, cavities among children in those communities dropped by 50 percent to 70 percent, proving that fluoridation worked to slow or stop tooth decay.
By 1962, water fluoridation had become widely used in the US because of the benefits of fluoride. This continues to be true today.
“Fluoridation is one of the easiest ways to prevent decay in a community at large,” notes Dr. Janowicz. “By fluoridating our water supply, we can address a public health issue at the source instead of taking everyone to a clinic to individually fluoridate them.”
The benefits of fluoride
A breeding ground for bacteria, acid and saliva, your mouth is in a constant state of natural decay and repair. Some of the bacteria that live in your mouth create acid as they fill up with the leftover food and drink you consume throughout the day. This acid then builds up in your mouth and removes important minerals from your enamel, the protective outer layer of your teeth. To replace what is lost, your body removes calcium and phosphate from your saliva and deposits them in your enamel to keep your teeth protected.
So, where does fluoride help in this process? Well, there are two types of fluoride:
- Topical fluoride: Found in toothpaste, mouthwashes and gels, topical fluoride coats the enamel of your existing teeth.
- Systemic fluoride: Found in water and foods such as raisins, shellfish, and wine, systemic fluoride is ingested or ingested.
Both types of fluoride work in different ways, but have the following benefits:
Prevents tooth decay
When you use topical fluoride, it is absorbed by your tooth enamel. This fluoride is stronger than the original minerals that were lost due to acid and bacterial build-up.
“We put a fluoride varnish on the teeth after cleaning visits, and that’s not swallowed,” says Dr. Janowicz. “It just sits on the surface of your tooth and is absorbed into the tooth to prevent localized cavities.”
Systemic fluoride, left over from drinking water and other foods, is found in your saliva, which constantly bathes your teeth throughout the day. This systemic fluoride acts as a coating similar to topical fluoride. Most importantly, systemic fluoride is incorporated into the actual structure of your teeth as they develop from the age of 6 months to 16 years.
“Ingested fluoride is beneficial for teenagers and children as their adult teeth develop because that’s where it actually gets incorporated into the developing tooth,” adds Dr. Janowicz.
Protects against cavities
If you don’t brush or floss your teeth, the combination of bacteria, acid and saliva forms a sticky film called plaque along the surface of your teeth. This plaque, which eventually hardens into hard-to-remove tartar, causes concentrated caries, or permanent damage, in the form of tiny holes, fissures, or lesions called cavitiesover time.
That’s why it’s important to brush your teeth twice a day. And if you use toothpaste or mouthwash that contains fluoride, you’re not only cleaning your enamel of any existing cavity-causing bacteria, you’re also strengthening your teeth.
“If you keep slathering your teeth with fluoride, they will retain their strength, but if you stop using topical fluoride over time, it will become less effective,” warns Dr. Janowicz. “Once a cavity gets to the point where it needs treatment, it’s too late for fluoride or anything else to reverse that cavity.”
Acid resistant
The root cause of cavities is all that acid in the plaque. If your teeth have a strong foundation from systemic fluoride and a strong outer layer from topical fluoride, you have twice the protection needed to stop this acid in its tracks before it creates cavities or causes unwanted sensitivity in your teeth
“When fluoride is absorbed into the tooth, it makes it more resistant to acid erosion as well as tooth decay,” says Dr. Janowicz.
Fluoride at home
Drinking fluoridated water is good, especially for children 3 to 16 years old whose teeth are still developing and need this systemic fluoride. As an additional measure, Dr. Janowicz advises fluoride treatments during six-monthly cleaning appointments for children ages 3 to 16 and adults with tooth decay or sensitivity issues.
“For people who had radiation or a condition like Sjogren’s syndrome which causes dry mouth and makes them more susceptible to tooth decay, we can make trays that they put fluoride gel in at night to help strengthen their teeth to protect them from tooth decay,” explains Dr. Janowicz. “You can get fluoride in your toothpaste and mouthwashes with fluoride in them, and we also have prescription fluoride gels, toothpastes and mouthwashes to help prevent tooth decay in high-risk populations.”
In general, Dr. Janowicz recommends brushing with fluoride toothpaste twice a day and using fluoride mouthwash once a day. He recommends the same treatment for children who are old enough to rinse mouthwashes without swallowing, usually 6 years and older.
“There are lots of do-it-yourself fluoride alternatives online, but nothing has been clinically proven to strengthen your teeth or to be a real fluoride alternative.”
