The Fluoride War, Part Two

The reason I called these last 2 posts the fluoride wars is because there are such strong feelings on both sides. I have spent time looking at all the websites of the health and dental organizations (Canadian Dental Association, World Health Association, Health Canada, American Dental Association etc...) and they all strongly promote the use of fluoridated water, insisting it is safe and effective. Being a dental professional I was initially inclined to believe these sites. I felt like I was going over to the "dark side" when I would look at the anti-fluoride sites. However now I am inclined to agree with the anti-fluoridation side, if for no other reason than for lack of consent (point 6).  Anyways, here are some key points that I have learned through my research on the dark side:

Pro-fluoridation ads:

Anti-fluoridation ads:

1.       There is no evidence that proves fluoride ingestion is useful in cavity prevention. The original study on which the whole water fluoridation program is based is largely flawed.  It consisted of basically dosing the water of one town with fluoride, and then observing whether or not the rate of decay decreased. There was no “control group”, and the study was preformed soon after WWII. This is significant because life in general got better. There was more access to better food and health care. This was never accounted for in the study. In fact there were many European cities/countries that also experienced a decrease in tooth decay after the war and they were not fluoridated.

2.       An important and often overlooked point, LACK OF FLUORIDE DOES NOT CAUSE TOOTH DECAY.  Cavities are formed when a specific bacteria (streptococcus mutans) in your mouth combines with sugar and produces a spike in acid. The acid erodes the enamel of your tooth, creating a cavity.  Too much dietary sugar is the root cause of cavities.  Diligent plaque control (brushing AND flossing) is also important.  Controlling the amount of sugar you consume (whether it is through drinking or eating) is the key to eliminating cavities. It is a good idea to have the habit of reading the nutritional labels of the food you buy. You would be surprised how much sugar is in most processed foods.  The frequency of sugar consumption is also an important factor. If you are snacking on sugary foods, or sipping sugary drinks throughout the day, you are asking for trouble.  

3.       Dental fluorosis (mottled looking teeth) is considered to be the only “side effect” of ingesting too much fluoride by the pro fluoride side. No thought is given as to how it effects the rest of our body after being absorbed.  It is thought that fluoride may affect our thyroid, reproductive system, and increase the brittleness of our bones.  Some studies suggest it may also increase hyperactivity in kids.

4.       Even if studies did show benefits of fluoride ingestion, it should then be considered a drug and not just dumped into the water system.  We don’t mass dose the population for any other kind of medical condition, so why are we doing it for tooth decay? Fluoride consumption becomes completely unmonitored:  people who drink more water get more fluoride. Fluoride also gets filtered into all foods that are processed with water, so we have no idea how much we are actually consuming.  

5.        BABY FORMULA SHOULD NOT BE MADE WITH TAP WATER, as you will end up over dosing your baby with fluoride. This is bad not only for all the reason stated in #3, but also because fluoride is a great irritator of the digestive system. Ever feel nauseous after the fluoride treatment at the dentist?   There is the thought that too much fluoride in babies may be a factor in some cases of colic. If you formula feed your baby, you must use either distilled water or water filtered via reverse osmosis. (fluoride is not removed during the boiling process and instead becomes more concentrated). Mothers who breast feed their babies do not have the same concerns as the mom’s body filters out almost all fluoride.

6.       And finally (there are other points I have not talked about but since this is a blog and not a bookJ I am limiting myself to these six points), hydrofluorosilicic acid, which is classified as a toxic chemical, is a by product of the phosphate commercial fertilizer industry.  Why is this important? Because this is the source of fluoride that is put in our tap water!!  Even if fluoride does have benefits in water, why are we using a toxic waste product as the source?

So how does fluoride really fit into our system for good oral health? It is a mineral that resides in the microscopic and protective layer covering our teeth. Other minerals such as calcium and phosphorus also reside here. It binds with the tooth structure, and dissolves slower in an acid attack than the tooth enamel. Without getting into details (this blog is long enough!) it can also help with tooth sensitivity.  In other words, fluoride has benefits when applied topically to the teeth, but should not be ingested. 

There needs to be a change in our dental system that sees fluoride as a client specific treatment. Those at higher risk for caries may benefit from a topical fluoride treatment. They will probably also benefit from diet counselling.  You can be proactive when you see your dental hygienist and ask them why they think you would benefit from a fluoride treatment if they are recommending it to you.  You can also request a fluoride varnish instead of the usual mouth rinse, gel or foam treatment. Fluoride varnishes have the benefit of better uptake by the tooth enamel. It also forms an insoluble compound when it comes in contact with saliva, meaning any you might swallow will not be absorbed by your body.

The Fluoride Debate

Well as it turns out I’m not a great blogger.  I was never an English major, so not only does it take awhile for me to think of dental topics that are blog worthy, it also take a while of it rolling around in my head before I finally sit down and write about it. The inspiration for actually turning on my laptop and writing this blog came from the editorial section of the Brampton Guardian.  There were 2 responses to an article written earlier this month about water fluoridation: one against and one for the Region of Peel continuing to fluoridate our water.  I figure it is about time I state my opinion on the matter. I am dividing this into 2 blogs so it won’t be too long. In today’s post I will describe the process I went through that changed my mind about fluoride. Next time I will summarize the important points I learned through this process... doesn’t that make you excited to learn more!J

In school we learned that water fluoridation was the second most successful public health program implemented in Canada (the first being vaccines if I am remembering correctly). I had one teacher who did not think it was so great but declined to really discuss it. So I graduated thinking fluoride is great, and water fluoridation is necessary, in fact the only thing standing between us and a mouth full of tooth decay.

I pretty much felt this way even as I had clients who refused the fluoride treatment, saying fluoride was a toxic substance and they wanted no part of it. I would try to convince them they were wrong, but to no avail. One client referred me to the website www.fluoridealert.org , which I looked at but I thought it sounded too out there, the working of conspiracy theorists and crazy people.

After a couple of years as a dental hygienist I became more interested in the Holistic Approach to dentistry, and started reading lots of books on this subject (that might be another blog entry). I came across a book call “the Fluoride Deception”. This book also sounds like the makings of conspiracy theorists, and honestly I did not know what to think after reading it. I was a dental hygienist in turmoil!  I was reluctant to go against the conventional wisdom I had learned in school, but the book had too many points to just ignore. (I went through a similar process in my previous career as a vet tech coming to the realization that we really over vaccinate our pets, but that is a whole other topic I am not even going to touch right nowJ)

As fate would have it, I received in the mail a pamphlet for continuing education seminars that included one on fluoride. I felt I had spent so much time reading anti-fluoridation literature that it was time to go to a professional seminar and hear what they had to say. I was totally expecting a pro fluoride lecture, and I went with some key questions I was determined to ask so I could find out the truth about the matter.  I was totally taken aback when the lecturer (Dr. Hardy Limeback, a dentist who has had a long and prominent career in dentistry) pretty much confirmed everything I was thinking about fluoride, along with some new points I had never specifically thought about that solidified my feelings about fluoride and water fluoridation.  You can read an article summarizing his beliefs here: www.fluoridealert.org/articles/limeback/ 

There are many groups that are fighting to remove the fluoride from our water. As mentioned before most of Europe has banned water fluoridation and many cities in Canada and the States have been successful at stopping fluoridation in their city. The Region of Peel (where I live) still fluoridates. Just last year in April city councillors voted to keep it in our water. To me it just seems like a pig-headedness refusal to admit they might be wrong. I hope as more citizens speak up they will have no choice but to listen.

While I still think fluoride has a role in our overall dental health, it is not the end all and be all to cavity prevention.  I now believe that the movement to fluoridate our water was motivated by political factors and not because it was really believed to improve our dental health. Stay tuned for next time I will fill you in on the specific things I learned that may help you decide for yourself what side you are on.

 

We are not so unique

Working as a hygienist I pretty much do the same thing every day. Even though I like to address each person's issues with a solution tailored to them, I am still only dealing with a small part of the body so there is a lot of overlapping of information given and received (as a small side note, you have to forgive me when I forget if I've just asked you a question and have to re-ask it - my brain starts to blur the answers together after a while, especially if I am multitasking). This leads to the topic of my blog today: commonalities that make us not so unique! Sometimes I think that some of my clients may feel embarrassed or feel the need to apologize when certain things happen, but they don't realize that it happens to pretty much everybody during a hygiene visit. I felt like highlighting these today...just maybe this will make you feel more relaxed at your next appointment...

My favourite answer to the flossing question "how often do you floss"? "Not as much as I should" I get this answer about 90% of the time from my clients. I think it's funny because it can mean anywhere from never, to every day. So my follow up question always has to be "and how often is that?"

Number one reason for not flossing: "laziness"

Dental dyslexia (my term):  getting mixed up in rights and lefts when you are lying back in the chair (in other words, the hygienist says turn to your left and you turn your head to the right)

the Dental Itch: body parts suddenly becoming itchy because you have to be still. The nose is the most common victim of this phenomena, though pretty much any part of the face or head are susceptible. I even fall victim to this from time to time. Sometimes I even resort to taking my gloves off to address the area of concern.

the Dental diet: I would say about 30% of my clients come to their appointment hungry, while about 40% have just eaten and are apologizing for not being able to brush before the appointment. This is all due to living a busy life...I am just grateful that you are able to fit me in to your schedule!

Well, that is my list for now. The lesson in all of this? Don't be embarrassed at your dental hygiene cleaning. We've pretty much seen and dealt with it all before. And for those truly unique occurances, well you just made our day 100 times more interesting!

Why you shouldn't brush...

So I don't know if this is a cop out entry but I really like this video. Does it make you think twice before brushing (to help out future archaeologists)? Or does it make you want to brush and floss even more?

A little bit about me and this blog

I have a confession to make...I did not grow up loving all things dental. In fact, I was one of those kids that always got lectured by their hygienist to floss more, brush better etc...Another fact: when I was discussing my future university major with a family friend, she recommended I consider dental hygiene (she was a hygienist herself) and I thought to myself, no way, and never thought of it again. So you may wonder how I ended up where I am today.
It's quite simple. I was looking for a career change and a good friend said I should be a dental hygienist. She had a friend who was one, she made good money, could pick her hours, and generally had a good life. What also attracted me to this profession was the little schooling that was required (2 year college diploma). I thought "why not"?, applied that year and started dental hygiene school the next Sept.
I am still not a regular flosser, and yes, I still eat candy without brushing my teeth after. I am a regular person who understands that dental care is not at the top of everyone's priority list. However, I have also come to realize how underestimated the value is of good dental health.
Also, now that I am an Independent Dental Hygienist with my own business, I have the happy task of sifting through all the dental products out there and figuring out which one(s) are really the best, or at least which one(s) I think are the best.
So the purpose of this blog is to (hopefully) help people figure out where in their busy schedule they can fit in dental care, what products would best suit them, and also just interesting dental facts/anecdotes/other.

My final confession for the day...I still do not love all things dental. What I do love about my job is interacting with my clients. Helping them with their (dental) problems, and maybe just teaching them something new.