At the turn of the last century, most Americans could expect to lose their teeth by middle age. That situation began to change with the discovery of the properties of fluoride…
– Oral Health in America: A Report of the Surgeon General
In 1945, responding to research that fluoride seemed to prevent tooth decay, the city government of Grand Rapids, Michigan took a vote and decided to become the first municipality in the world to manually introduce fluoride into the community water supply. They also commenced a 15 year study to determine whether this change would affect cavity rates among 30,000 children. After only 11 years, cavity rates among children born after the change dropped 60%.
Since that time the majority of communities have followed suit and dental cavities are no longer considered a public health problem.
The issue of water fluoridation has become a controversy (in Naples as well), with many claims that fluoride is in fact a health hazard, causes cancer and other diseases, and is a violation of individual rights.
In this article I am going to avoid the controversy (there’s plenty to be found with a Google search) and give a little background on what fluoride is, how it protects against cavities, and give some common sense advice on choices regarding fluoride.
What Is Fluoride?
A chemistry teacher would explain that fluoride is a negative ion (an anion) of fluorine, which is an element you can find on the Periodic Table (F). The term fluoride is also a general term to describe a compound that contains fluoride. Calcium fluoride and sodium fluoride are both examples of fluorides.
Fluoride exists commonly in nature, mostly in the Earth’s crust. Consequently fluoride exists naturally in both seawater, fresh water, and certain foods. In some areas of the country (parts of Colorado, for example) fluoride levels are much higher than in places like Southwest Florida.
Fluoride Slows Down Tooth Decay
Tooth enamel is made up mostly of hydroxyapatite crystals and is the hardest substance in the body. A cavity begins with a bacterial infection, specifically of two common bacteria, in plaque. When these bacteria combine with the carbohydrates in food debris, it produces an acid which can dissolve, or demineralize, the enamel.
This process takes time.
The body, through minerals such as calcium and phosphate, ingested in food and presented in the saliva, has the ability to naturally rebuild lost enamel. However, in many cases and for different reasons, natural processes are unable to stop decay.
The introduction of fluoride into the saliva accelerates and improves upon this natural process of remineralization. Exposure to fluoride, in a dentist’s office, through the water supply, in toothpastes, varnishes and other means, introduces fluoride ions into the saliva. These ions combine with dissolving hydroxyapatite to form a harder and more acid resistant veneer on the teeth.
This is why the dental community is overwhelmingly in support of fluoridation. It gives teeth more protection from the acid that leads to cavities.
Should You Drink Fluoridated Water?
My recommendation is that you not worry about fluoride in tap water. Although I don’t drink gallons every day, I do consume tap water. However, this is a personal choice. If you have concerns, then don’t drink it. This will keep you from ingesting fluoride into the stomach and into your body.
Should You Avoid Fluoride Altogether?
I do not recommend avoiding fluoride altogether. For the reasons explained, fluoride gives your teeth additional protection from demineralization and decay. Fluoridated toothpaste, used twice a day, gives your teeth significant additional protection against demineralization, and gives the body a leg up on protecting teeth. Avoiding fluoride toothpaste deprives you of the benefits that come with stronger tooth enamel, including the potential to keep your natural teeth for a lifetime. Used correctly, fluoride toothpaste is not swallowed and is a sensible middle ground between ingesting fluoridated water systemically and avoiding fluoride altogether.
I also recommend using fluoridated mouth rinses, which are also not ingested, but afford additional protection to the teeth, particularly in hard to reach areas such as at dental crown margins and between the teeth.
The Bigger Picture
As seen by the very first use of fluoride in a public water supply, the protective benefits of fluoride for our teeth are without reasonable dispute. However regular dental checkups and cleanings are also important for optimal oral health and for detecting and treating dental caries which can occur even with the use of fluoride. So make sure to practice good oral hygiene habits and see your oral health care provider regularly.