Is Fluoride right for your Child?
With much of Europe electing to not fluoridate drinking water supplies, and more and more studies looking into whether or not fluoride, as it is currently being used, has the benefits we’ve all grown up hearing about, the fluoride debate is alive and well.
The Facts and Benefits of Fluoride
Many people don’t realize that fluorine, the element from which fluoride is derived, is naturally occurring in the ground, surface and ground water, and food. The human body itself contains about 2.6 grams and 95% of that in bones and teeth.
For years, particularly in North America, the support behind fluoride has been studied and claims that the right amount of fluoride can help remineralize and strengthen tooth enamel that has been damaged by acid, and prevent the development of cavities (dental caries).
Maintaining fluoride amounts in saliva “has been found to inhibit bacterial enzymes, resulting in reduced acid production” (Vitamins-Nutrition.org), but the World Health Organization warns that these optimum fluoride levels need to be maintained while reducing the possibility of dental fluorosis, which can happen in children and parents if exposed to too much fluoride.
Rethinking Fluoride Use
What is prompting new questions about the effectiveness or necessity of fluoride, particularly the fluoridation of drinking water, is an increasing body of evidence that claims of better rates of oral health really can’t be attributed to fluoridated water on its own. In a figure released in 1999, the Centers for Disease Control link an increase in fluoridated water to a decrease in occurrences of decayed, missing (because of caries), or filled permanent teeth (DMFT) among children aged 12 years in the United States from 1967 to 1987. The claim was that because of fluoridated water, the latter half of the 20th century experienced better oral health.
When compared to World Health Organization Data released in 2004 comparing (DMFT) between unfluoridated and fluoridated countries during the same time frame, there was actually no difference between countries with fluoridated water and those without. All countries showed a decline in DMFT rates regardless of fluoridated water. This really throws into doubt all the comparisons between children who drink tap water versus those who only drink well water.
Further adding to the debate are recent studies in India and other countries in the last 10 to 15 years which have provided conflicting evidence to the claim that “fluoride ions bind with calcium ions, strengthening tooth enamel as it forms in children” (UNICEF) and support the idea that this is an assumption rather than fact.
Another aspect of the argument includes difficulties in maintaining an “optimum” level of fluoride where fluoride levels in certain areas, particularly mountainous and coal-producing areas, can be already high. High levels of fluoride can lead to dental fluorosis in children, which is discoloration of the teeth. Low or insufficient intake of calcium can also lead to increased absorption of fluoride beyond what is necessary and deemed beneficial for oral health. An increasing number of studies are actually showing an increase in dental and skeletal fluorosis. “[M]ore than 700 communities in the USA were thought to have water supplies that contained at least twice the recommended optimum level of fluoride” (World Health Organization). In many UNICEF supported countries, efforts are being made to defluoridate water or reduce the amount of fluoride in ground and surface water to reduce the levels of fluorosis that are increasing.
A study conducted by the Faculty of Dentistry at the University of British Columbia, Canada, in 1994 found that “the prevalence of dental fluorosis [in North America] now ranges somewhere between 35% and 60% in fluoridated communities and between 20% and 45% in nonfluoridated areas, depending on the influence of different local conditions. While the increase has occurred primarily in the very mild and mild categories of dental fluorosis, there is also some evidence that the prevalence is increasing in the moderate and severe classifications as well” (PubMed.gov).
Fluoride Debate Conclusions
Overall, the dentistry community still advocates for the use of fluoride in minimal amounts, and studies have shown that such amounts are effective in reducing cavities, although it can’t be said that fluoridated water or even topical application of fluoride by itself is the only causal factor in reducing cavities. Better oral hygiene practices, increases in calcium intake, better nutrition and regular dental checkups combined with use of fluoride work together.
While the ADA continues to advocate the use of fluoride toothpastes even with children under the age of 2 following specific protocols to avoid overexposure, many parents opt to use a non-fluoride “training” or toddler toothpaste until such time as the child is able to spit to avoid them swallowing too much. Still many more are taking a European approach and opting for fluoride-free toothpastes for the whole family. This is a personal choice, but must be made with the knowledge of what other sources of fluoride may be available.
It is important to find out what the naturally occurring levels of fluoride are in your water and in other sources around you. For example, studies in other parts of the world have found that mountainous or areas with large deposits of coal can have higher concentrations of fluoride. The Fluoride in Drinking-Water document cited below includes information on which areas of the United States have actually tested with relatively high amounts of fluoride in the ground and surface waters.
Talk with your dentist about what levels are effective for maintaining oral health, and discuss all the possible sources that you and your baby could be exposed to.
Darlene Oakley is a freelance writer for EmpowHER.com.
“The Benefits of Fluoride” by Dr. George Obikoya. The Vitamins & Nutrition Center. Web. Feb 10, 2012. http://www.vitamins-nutrition.org/vitamins/fluoride.html
Fluoride. American Academy of Pediatric Dentistry. Web. Feb 10, 2012. http://www.aapd.org/publications/brochures/floride.asp
Fluoride and Infant Formula: Frequently Asked Questions. American Dental Association. Web. Feb 10, 2012. http://www.ada.org/4052.aspx#whatisfluoride
Tooth Decay Trends in Fluoridated vs Unfluoridated Countries. Fluoride Action Network. Web. Feb 10, 2012. http://www.fluoridealert.org/health/teeth/caries/who-dmft.aspx#figure1 & http://www.fluoridealert.org/health/teeth/caries/who-dmft.aspx#universal
UNICEF’s Position on Water Fluoridation – Fluoride in water: An overview. NoFluoride.com. Web. Feb 10, 2012. http://www.nofluoride.com/Unicef_fluor.htm
Fluoride in Drinking-water. World Health Organization (2006). Web. Feb 10, 2012. http://www.who.int/water_sanitation_health/publications/fluoride_drinking_water_full.pdf
Risks to oral health and intervention. World Health Organization. Web. Feb 10, 2012. http://www.who.int/oral_health/action/risks/en/index1.html
Do Adults Benefit from Fluoridation. FluorideDebate.com. Web. Feb 10, 2012. http://www.fluoridedebate.com/question08.html