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:
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.