The Muddied Debate About Fluoride

Gateway Garden Center

by Rachael Ling

What Is Fluoride?

Fluoride is a mineral found naturally in the environment, such as in water, soil, plants, rocks, and air. It is also found in your bones and teeth. From an application standpoint, fluoride is most well-known for improving dental health. More specifically, it is used to strengthen tooth enamel, the outer layer of your teeth, and help prevent cavities. Most of us are familiar with fluoride in relation to it being found in OTC (over-the-counter) dental products such as toothpaste, mouthwash, and even fluoride-coated dental floss. In addition, fluoride is added to public water supplies in the United States and many other countries. This process is called water fluoridation.

Did you know not every city in the United States adds fluoride to the water supply? The CDC has a tool you can use to establish if and how much your local water supply fluoridates the water:

How does fluoride prevent cavities?

When bacteria in your mouth break down sugar and carbs, they produce acids that eat away at the minerals in your tooth enamel. This loss of minerals is called demineralization. Weakened tooth enamel leaves your teeth vulnerable to bacteria that cause cavities. Essentially, fluoride helps to remineralize your tooth enamel, which protects the teeth from developing cavities.

Did You Know? According to the Centers for Disease Control and Prevention (CDC), the average number of missing or decaying teeth in 12-year-old children in the United States dropped by 68% from the late 1960s through the early 1990s. This followed the introduction to and expansion of fluoridated water in communities and the addition of fluoride to toothpaste and other OTC dental products.

Does fluoride use or consumption have any adverse side effects?

While fluoride is a naturally occurring compound, it can still cause unwanted side effects when consumed in large doses, such as in the case of dental fluorosis. Dental fluorosis happens when an individual consumes too much fluoride while the teeth are still forming under the gums (typically in young children who are still waiting on all their permanent teeth to come in) and manifests as white spots on the surface of the teeth. While maybe an aesthetic concern, it’s an entirely benign condition. Since children are more likely to swallow toothpaste which contains significantly more fluoride than fluoridated drinking water, parents can reduce the risk of this occurring by supervising young children when they brush their teeth.

There are also claims that fluoridated water causes low IQ in children, kidney disease, arthritis, bone cancer, neurologic symptoms, etc. However, to date, no studies can prove any causal relationship to these assertions. Researchers argue that if any of these outcomes are associated with fluoride, it is not the result of the typical fluoridation of the public water systems. Instead, it is more likely a result of accumulated environmental exposure. Fires, explosions, and even large natural geologic deposits such as in parts of Africa, India, and Asia can contaminate a water supply and lead to excessive fluoride accumulation in nearby drinking water.

There is a cohort of people whose opinions lay somewhere in the middle. They acknowledge that general, everyday exposure to fluoride in the form of preventative dental health products is relatively innocuous. Rather, their concerns lay with the “additional” cumulative exposure to fluoride found in the environment in the form of industrial pollution. At high levels, fluoride does possess the potential to be toxic. Fluoride has applications for things other than dental health and is also used in medical imaging scans, as a cleaning agent, in fertilizers, and to make Teflon, steel, and aluminum. Through different forms of emissions, fluoride has become a source of environmental pollution and has been found in the air we breathe, natural water sources (lakes, ponds, streams, etc.), soil, and even in some of the foods we eat in amounts higher than would be found naturally in the environment. Scientists have noted this manufacturing byproduct accumulating in large amounts in the tissues of both land and aquatic life. They are actively studying long-term implications to plant and animal species that are particularly sensitive to it and the ecological ramifications on a larger scale.

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“Many Western European nations do not partake in the fluoridation of drinking water.”

Interestingly, many first-world countries do not partake in the fluoridation of drinking water. This is not from concerns of fluoride consumption per se but out of principle. The Food & Drug Administration accepts that fluoride is a drug, not a nutrient, when used to prevent disease. Therefore, by definition, many may argue that fluoridating water is a form of mass medicating, so to speak. For this reason, most western European nations have rejected the practice — because, in their view, adding a drug to everyone’s water supply violates the basic medical tenet that each individual has a right to “informed consent.” However, despite the refusal to fluoridate public water supplies, fluoride is still widely accepted as a beneficial ingredient in OTC dental products and dentist offices to prevent dental caries.
Who might benefit from supplementing fluoride?

Those who primarily drink bottled water or live in a house with well water might benefit from supplementing their drinking water, especially if they incur a number of cavities despite the use of fluoride toothpaste and attendance of preventative dental visits. In addition, dentists may go one step further and apply in-office fluoride treatments or encourage the use of prescription-strength fluoride mouthwashes to use at home to manage long-term dental health.

Interested in reducing your fluoride intake?

Many individuals may choose to use bottled water as their primary drinking water source, while others look to go a step further and avoid all fluoride, including in the water used for cooking. In this instance, consumers can opt for a whole house, point of use, or standalone filtration system. Take note: make sure to do your research since fluoride removal requires specialized filters, and the average water filter will not filter out fluoride. Finally, there is a slew of OTC fluoride-free products readily available at local stores should your family prefer to go that route.

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