According to the World Health Organization, the introduction of fluoride toothpastes was the single factor most responsible for the massive reduction in dental caries seen in many countries during the 1970s and 1980s. In addition, the U.S. Centers for Disease Control hails fluoridation of drinking water as one of the 10 great public health achievements of the 20th century.
What is fluoride?
The CDC defines fluoride as the ionic form of the element fluorine, the 13th most abundant element in the earth's crust that is also found naturally in water. Fluoride reduces the prevalence of dental caries by encouraging repair of early damage to enamel caused by acids produced by the breakdown of sugar by plaque bacteria.
Water fluoridation: Are we getting too much?
In response to findings from the National Academies of Science report recommending that the Environmental Protection Agency update its health and exposure assessments to take into account bone and dental effects of fluoride and to consider all its sources, the EPA and the U.S. Department of Health and Human Services released an announcement on January 7, 2011, stating that scientific assessments will guide them in making a determination of whether to lower the maximum amount of fluoride allowed in drinking water. “The new analysis will help make sure that people benefit from tooth decay prevention while at the same time avoiding the unwanted health effects from too much fluoride.”
Even though fluoride is found naturally in water supplies, additional fluoride is added to many water systems. The CDC estimates that nearly two-thirds of the U.S. population receives drinking water from municipalities that add fluoride to their water systems. But the fluoride in your drinking water is not the only source. According to the Environmental Health Perspective Journal, fluoride is an additive in fruit juice, soda, infant formula, and cow’s milk. Incidental ingestion of soil or toothpaste can also contribute to over-ingestion of the element. On the other hand, the American Academy of Pediatric Dentistry claims thatinfants fed formula reconstituted with fluoridated water are not at risk of getting too much fluoride.
What is the risk of too much fluoride?
Too much fluoride can result in defects in tooth enamel. During the years of tooth development, a child may face a condition called enamel fluorosis if he or she ingests too much fluoride, says theAmerican Academy of Pediatric Dentistry.Enamel fluorosis can be mild and appear as tiny white specks or streaks that are often unnoticeable but in more severe cases, the appearance of the teeth is marred by discoloration or brown markings. A more dangerous risk currently under investigation by the EPA is a finding that prolonged, high intake of fluoride can increase the risk of brittle bones, fractures and crippling bone abnormalities.
What can you do?
The Environmental Working Group provides these suggestions for keeping a balance between reaping the benefits of dental health that fluoride provides and avoiding the risks of fluorosis:
- Children should brush at least twice daily with a fluoridated toothpaste and floss once a day under parental supervision.
- For young kids who aren't yet capable of spitting out toothpaste, use a non-fluoridated toothpaste like Orajel Toddler Training Toothpaste.
- The American Dental Association recommends avoiding the use of fluoridated mouth rinses for children under six years of age.
- Check fluoride levels in your water by calling your local water company or the Chester County Department of Health.
- Watch your child's toothpaste use. A pea-sized amount on the brush is plenty for fluoride protection. Teach them to spit out the toothpaste after brushing.
- If your water's fluoride level is above 1.2 ppm, you can reduce it using a reverse-osmosis or water-distillation unit.
- When discussing fluoride with your pediatric dentist, make sure to consider all your child's potential sources of fluoride to determine a balance.
- Don’t avoid fluorides altogether! Fluoride prevents tooth decay. It is an important part of helping your child to keep a healthy smile for a lifetime.
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