Fluoride: Recommended by dentists and why people are afraid of it

Fluoride has been a topic long debated—especially in the past couple of months. Utah became the first state to ban Fluoride in its public drinking water and Florida followed soon after. Both states cited concerns about the potential health risks of fluoride, particularly for children’s neurological development. What are these concerns, and why are dentists still recommending flouridated toothpaste and applying fluoride to your child’s teeth at their cleaning appointment?

The basics: Fluoride is a naturally occurring salt that is found in rocks, minerals and soils and dissolves easily in water. This is why most natural water deposits will have fluoride in them—some more than others. The fruits and vegetables you purchase at the store are grown with fluoridated water and fluoride can be incorporated in the produce themselves. It’s quite impossible for you to live your life fluoride-free.

Fluoride has two very specific delivery systems that involve your dental health. These are: Systemic Fluoride and Topical Fluoride. Systemic fluoride refers to fluoride that is ingested by drinking fluoridated water. It is involved in helping developing teeth to have the strengthening layers required to sufficiently resist bacterial damage which causes cavities. Topical fluoride refers to the application of fluoride to the teeth. This flouride is spit out of the mouth after sitting on the teeth for an appropriate amount of time. It is found in toothpaste and fluoride applications used by the dentist in the office. This application gives protection to your teeth and lasts until the next application is applied.  

Fluoride, like vitamins, is beneficial in recommended dosages. Too much fluoride can cause a problem, but the appropriate amount is beneficial. US public Health service recommends a fluoride concentration of 0.7mg/L for optimal dental health benefits which minimizes the risk of health concerns. If too much is ingested, it can be bad for your health.  The EPA (Environmental Protection Agency) has set a maximum contaminant level for fluoride in drinking water to prevent adverse health effects. Many community water systems add fluoride to their water to reach the recommended levels. Water is carefully monitored and levels adjusted to maintain the optimal concentration.

There are areas where fluoride is not monitored and if the fluoride levels get too high, this can cause health concerns.  Fluoride easily bonds to calcium and so if an excess is ingested there can be adverse affects on teeth and bone. 

If long term excessive fluoride ingestion occurs in infancy or childhood a condition called Fluorosis can occur. This shows up with of white specks or white lines on the teeth. In severe cases the teeth appear brown and bulky. Interestingly enough, in these cases, the children actually have less cavities because the extra layers that are built up by the teeth is so resistant to them. In some cases, joints in the body can become stiff because of excess fluoride—but the bones will also have less fractures.

Teeth with excess fluoride can have cosmetic defects.

Severe Fluorosis is increasingly rare and there is no instances of it occurring from recommended levels found in tap water.

Fluoride started to be introduced to community water by the government in 1945. Since then the US has seen a significant decrease in overall tooth decay. Sadly though, people still are skeptical about adding anything “unnatural” into our water. 

A couple of studies have indicated a correlation with Fluoride and children’s IQ. A lot of flouride skeptics have held to this idea and that the risks of fluoride outweigh the benefits. Eight different studies were compared in 2023 and showed that in areas with moderate to excessive fluoridation in water, there was an association with lower IQ in children. BUT, they also showed that in communities with optimally fluoridated levels of community drinking water there was NO ASSOCIATION with lower IQ. So as long as the fluoride is at acceptable levels, individuals and children would not have adverse health effects.

If you or anyone in your family has or has had a history of cavities, it is highly advised to use toothpaste with fluoride in it AND recommended to have topical fluoride placed in the dental office every 6 months—don’t wait longer than 12 months in between treatments to give your teeth a better fighting chance at preventing cavities.

The following are the nations leading organizations that offer updated information regarding to our health. Information regarding fluoride can be accessed on their websites.

The National Institute of Health 

https://ods.od.nih.gov/factsheets/Fluoride-HealthProfessional/

Centers for Disease Control and Prevention

https://www.cdc.gov/fluoridation/index.html