The controversy over fluoride is not new, but at times it’s hard to make an educated decision when you have so much hype to sift through. Is it helpful or is it poison? Does it cause cancer or prevent disease? Let’s look at the facts, and the recommendations, and see what makes the most sense.
Fluoride is a naturally occurring element, found in most water sources, including rivers and lakes. Originally termed “nature’s cavity fighter”, fluoride helps to strengthen tooth enamel by remineralizing it, to make it more resistant to acid attacks after bacteria has been introduced to the mouth. It is also “bactericidal” which means it kills bacteria. Fluoride has been added to community water supplies for the last 70 years at the rate of 0.7-1.2 parts per million, with the most current recommendation from the Department of Health and Human Services being 0.7ppm.
Studies have shown that children had three times as many cavities prior to community water fluoridation, and currently it is credited with a 25% reduction in childhood tooth decay. Because of these outstanding results, community water fluoridation has been proclaimed one of the ten great public health achievements of the 20th century by the Centers for Disease Control.
Besides being available in the community water supply, there are topical ways to apply fluoride to the teeth to reap the benefits. Any toothpaste with the American Dental Association (ADA) seal has a fluoride content of at least 1000ppm. A typical fluoride varnish applied after a dental cleaning has 22,600ppm. Why the difference in amount of fluoride from the water supply? The water supply is a systemic means of delivering fluoride, and as such needs to be a very minimal amount to deliver benefit and avoid any risks to the body. The toothpaste and fluoride treatments are topical, not meant to be ingested, and work when applied directly to the teeth.
The current recommendations for topical applications of fluoride by the ADA are as follows:
- Brush twice daily with a toothpaste that contains fluoride and has earned the ADA seal. Children 6 years of age and older, use a pea sized amount. Children younger than 6, use a very small smear of toothpaste to prevent swallowing. Remember, this is a topical application, and is not meant to be ingested.
- Topical fluoride treatments in the form of varnishes, gels or foams applied once every six months to anyone with a moderate caries (cavity) risk. Risk is assessed per patient and includes diet, family history, medical history and dental history.
Fluoride has not been shown to cause cancer. Studies done in the 1980’s and 1990’s found that there was no way to correlate fluoridated water with a rise in cancer between populations that were both exposed and not exposed to community water fluoridation. Even in studies done on animals, there was no clear risk associated with fluoridation. Studies as recent as 2011 are still showing the same results. 70 years of clear scientific research fully supports the responsible and repeatable use of both systemic and topical fluorides as a method of cavity reduction in at-risk populations.
Please bring your questions about fluoride to your dentist or dental hygienist. We are always more than happy to help you understand your cavity risk and why fluoride may be recommended to help your specific risk be lowered.
- Paige Tscherpel, RDH, BSDH
Consulted Sources Include:
http://www.mouthhealthy.org/en/az-topics/f/fluoride
http://www.newsweek.com/us-government-recommends-lower-level-fluoride-water-325760
http://www.cdc.gov/fluoridation/fluoride_products/
http://www.ada.org/~/media/ADA/Science%20and%20Research/Files/cavity_prevention_tips.pdf?la=en
http://www.ada.org/~/media/ADA/Science%20and%20Research/Files/report_fluoride.ash
http://m.cancer.org/cancer/cancercauses/othercarcinogens/athome/water-fluoridation-and-cancer-risk
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC180028/