Fluoride has been a highly debated and controversial topic in society and in dentistry since it started being added to most community public drinking water supplies in the 1950's. This blog is not about changing your mind but to provide some information about what it is, what it does and help you make a decision on how much is right for you.
What It Is and How It Works
Fluoride is a mineral naturally found in nature. It exists naturally in seawater, ground water and in ground deposits. It was notice in the mid 1800's that being raised in areas of the country that had high levels of fluoride naturally in the ground water had an effect on your teeth. These people tended to have ugly brown spots BUT less tooth decay. Over the next one hundred years the relationship between fluoride in water and tooth decay was studied and developed. In the 1950's fluoride was added to community water supplies as a public health initiative with the goal of reducing tooth decay in the broad community.
In adults, fluoride acts to remineralize teeth enamel after acids dissolve the outer layers of them. Acids are constantly dissolving our teeth throughout the day and they come from things we eat and drink and acids are produced by the normal bacteria in our mouth. If fluoride is available, it will remineralize your teeth and make them harder for acids to dissolve.
In children, fluoride also can be incorporated into the teeth from the beginning when they are being developed in the jaw. These teeth are also more resistant to acid demineralization.
People's Hesitation To Fluoride
People in general don't like being forced to do anything without a choice. When it was decided that fluoride would be added to community water supplies, people felt they were forced to take something. I think this is the understandable driving factor behind the controversy. The arguments against fluoride are numerous and vary from conspiracies to legitimate concerns. Early on there were claims that it was the government trying to control the population. Recently the concerns include the source the fluoride comes from, is it actually effective, risks of overdose, and the overall risk of fluoride to people health, mental health in particular. These risks have all been examined and help determine the amount put in the water. What sticks in my mind when I an discussing fluoride in water is we add 0.7 ppm (parts per million) fluoride to the water and an average glass of iced tea has 3 to 5 ppm fluoride.
My Guidance
I believe fluoride is a safe and effective additive that unquestionably reduces tooth decay. I do not believe the average diet and oral hygiene regimen introduces enough fluoride to cause any health concerns. However, I do understand people that are on the other side of the balance between public health and the rights of the individual. In making the decision on the amount of fluoride exposure that is appropriate for you and your family you first need to weigh your cavity risk.
Adults - If you are someone that has had a lot of dental work in the past, has a high sugar and acid diet, or poor oral hygiene then fluoride can be useful to you as part of your cavity prevention plan. In fact, I often prescribe a high fluoride toothpaste for patients who are a high cavity risk. If you've had minimal dental work, maybe one or two cavities in your teens or twenties, then increased fluoride may not be as important to you and you may choose to drink an alternative source of water or use non fluoride toothpaste.
Kids - Children are naturally a higher cavity risk than adults for several reasons. I am often asked when young parents should start using fluoride toothpaste. I used it from the beginning on my kids. If you choose to do this make sure you are using the slightest smear, a rice grain size amount of toothpaste. Some dental organizations recommend starting at 2 years old since at that age they can start to spit it out. Again I encourage you to think about your child's cavity risk. When used properly fluoride can help prevent cavities.