As with most government decided health treatments, fluoridated water gets a lot of bad rep. Generally, these condemnations stem from misinformation and ignorance, but even with all the criticism, fluoride is shown to be incredibly useful at establishing a healthy smile and reducing dental caries across the board – Children and adults!
Some might be asking what exactly about fluoride makes it good for our teeth? Isn’t fluoride potentially dangerous? Does fluoridated water pose a risk to my children?
With all substances, the dose can be the difference between healthy or not. Even too much water consumption can be detrimental to humans.
However, even with 70 years of fluoridation practice across the globe, there still remains a sizable push against the treatment of water and the use of fluoride in toothpaste.
At Treehouse Dental Care, we wanted to make sure our parents have the most up-to-date information regarding fluoride and its uses in the dental industry. As well, what to watch out for if you believe your child has become exposed to too much fluoride.
What Is Fluoride?
Fluoride is a mineral that is found in a variety of environments and organic materials. From both our bones and our teeth to water, soil, food, and even air – fluoride is incredibly prevalent.
When professionals, such as dentists or city officials mention fluoride, they are in most cases concerned about ionic fluoride compounds, such as sodium fluoride found within toothpaste.
It is important to make this nomenclature distinction, as fluoride by itself is rather insoluble and has little to no effect on our teeth. With that being stated, the rest of this article will strictly revolve around the discussion of soluble ionic compounds used to protect our teeth against dental decay.
What Does Fluoride Do for Teeth?
Mechanically speaking, fluoride’s purpose in dental applications is that of repair, and not of prevention. When in contact with damaged tooth enamel, fluoride compounds chemically embed themselves onto a tooth’s surface.
Through a process known as remineralization, an iso-ionic exchange of charges facilitates the crystalline growth of fluorapatite. While not a natural component of human teeth, fluorapatite is a chemical cousin to the hydroxyapatite mineral, which strengthens and remineralizes of our enamel.
Both fluorapatite and hydroxyapatite are hard hexagonal crystalline structures with incredibly resilient properties. Biologists have even found these compounds in the animal kingdom, with fluorapatite in shark’s teeth, and hydroxyapatite in the clubbing appendages of the peacock mantis shrimp.
While the mineralization process is credited for the bulk of our teeth’s protection, there are several other benefits of fluoride treatments being studied.
At certain concentrations (10 ppm or above), fluoride has potentially been shown as an effective antimicrobial agent, however, further research is still being done on this hypothesis. Some critics state that this would be a misnomer, as the investigations only display that fluoride reduces bacterial adhesion to teeth without changing mouth flora.
Is Fluoride Dangerous? What About Fluoridated Water?
The answer to this question is one dependent upon the dose. Fluoride, while varying in its concentration, is virtually found in all water supplies. But, even with possible health altercations connected to high levels of fluoride, the CDC declared water treatments as one of the 10 greatest public health achievements of the 20th century.
Even Canadian health agencies have released figures stating, “The rate of tooth decay has declined in Canada from 74% of children in 1970-1972 to less than 25% in 2007-2009 as a result of a variety of factors, including widespread adoption of community water fluoridation.”
Through rigorous studies, the ADA, WHO, and several other public health agencies have been able to narrow down what an “optimal” level of fluoride is acceptable for water. Carefully trying to achieve dental benefits while avoiding any health concerns, the concentration agreed upon was 0.7 mg/L.
However, this number isn’t flat across the board. Depending upon local environments, this level can vary between 0.5 to 1.5 mg/L due to natural sources of fluoride (crops, fish, etc.).
To put how little fluoride this is in perspective, it is the equivalent to 1 inch in 37 kilometres; 1 minute in 1,000 days; or 1 cent from $14,000.
Naturally occurring levels in surface water, such as lakes and rivers, generally contain fluoride levels between 0.01 – 0.3 ppm. It is rare to ever see above 10 mg/L, but several areas of China and India have measured close, at around 8 mg/L. In fact, over half of India’s groundwater sources have been measured over the recommended levels.
It is doses above 2.0 mg/L where concerns can be legitimized and action should be taken. However, one should know where to receive information on their water fluoridation concentrations.
When living in a city you will have access to public levels of fluoride through government portals. For rural wells and groundwater, samples should be taken to your government officials for testing.
What Are the Side-Effects of Fluoride?
In the case of regular use and safe concentrations of fluoride, users will benefit from strengthened enamel and a reduction in cavity development. The Canadian Health Services estimates that every $1 invested in water fluoridation saves up to $93 in dental treatment costs per person.
On the other hand, if too much fluoride is digested, problems can arise in multiple areas of the body. These cases are however rare in developed countries, and most widespread examples arise from consumption of fluoride-rich groundwater.
Smaller and more acute cases of fluoride toxicity have been reported in congruence with the ingestion of sodium fluoride-based insecticides and rodenticides.
Other uncommon ailments related to excessive fluoride are dental and skeletal fluorosis.
Dental Fluorosis is the hypomineralization of tooth enamel during formation and can be characterized by visual changes, such as white speckles or browning. Affecting mostly children, dental fluorosis is the main reason that daily mouthwash treatments are never recommended for adolescents below the age of 6.
According to Public Health Ontario, acute or mild dental fluorosis is the only adverse effect experienced by the consumption of optimally fluoridated water. But even then, the results from their research defines mild dental fluorosis as “…unnoticeable white specks on teeth…”
Skeletal fluorosis is a more serious disease associated with excessive accumulation of fluoride in the bones. This results in harder, but less elastic bones, increasing the frequency and likelihood of fractures. Other symptoms include impaired joint mobility and pain.
How Do I Limit My Child’s Intake of Fluoride?
If you live in an area where your water reserve exceeds 2.0 mg/L or 2 ppm, you should seek an alternative water supply.
Parents can choose to switch to water bottles, but there are plenty of treatment options one can consider before increasing their plastic waste.
Home water filters are available for a variety of areas in your house, including showers, countertops, under the sink, refrigeration lines, and whole-house systems.
As infants are the most susceptible to dental fluorosis, parents can mix their formula with low-fluoridated bottled water if you are concerned about locally sourced concentrations of fluoride.
For dental applications, parents can choose to switch to a non-fluoride toothpaste, however, this will increase the presence of tooth decay and plaque adhesion.
We do not recommend this alternative unless you have spoken with a professional, as childhood oral hygiene plays a pertinent role in their current and future health.
Ask Your Dentist
If you’re still unsure about fluoride and would like some more information, ask the dentists here at Treehouse!
Our team of dentists will happily clear up any questions you may have about our treatments or day-to-day best tips.