Fluoride in our toothpaste
There is some controversy whether our drinking water should contain fluoride. The American Dental Association supports adding fluoride to our drinking water, this process is referred to as water fluoridation. There is also controversy regarding the need for fluoride in our toothpaste. The American Dental Association will only allow their seal to be placed on toothpaste that contains fluoride. Let’s cover fluoride today.
Fluoride is a mineral found in your teeth and bones. It is also found naturally in soil, water, and in some foods. In addition to being used in dental products fluoride can also be found in pesticides and teflon.
Fluoride is added to the municipal water supply as several studies have shown that it can reduce the prevalence of tooth decay in the local population. The World Health Organization, Center for Disease Control and Prevention and the American Dental Association are stand behind water fluoridation.
There is no doubt that tooth decay has declined over the years since fluoride had been added to the water. Are the lower rates due to the fact that we have better overall dental hygiene? Do we brush our teeth more and see the dentist more often? Does everyone need fluoride in their drinking water or should water just be placed in areas where there is poverty, little education and poor dental hygiene? These are all questions that surround the fluoride debate.
The EPA has set a maximum amount of fluoride allowable in drinking water of 4.0 mg/L, there are concerns for levels over this amount which we will discuss later. A fluoride content of 0.7 ppm is now considered best for dental health.
Fluoride in our toothpaste
There are different types of fluoride .What type of fluoride is in our toothpaste?
According the the ADA,
“Sodium monofluorophosphate, sodium fluoride and stannous fluoride (these are the only agents included in the FDA monograph1 as ingredients that help prevent caries). Fluoride strengthens teeth to help prevent tooth decay and remineralizes tooth enamel in the early stages of tooth decay.1 All ADA-Accepted toothpastes must contain fluoride.”
Fluoride can help prevent enamel breakdown when teeth are exposed to acid. Acid can occur even if we are not eating food that are acidic. Sugar combines with bacteria in your mouth which can lead to tooth decay.
The American Dental Association (ADA) states that fluoride,
- reduces tooth decay by 20 to 40 percent
- protects against cavities
- is safe and effective
- saves money on dental treatment
How does fluoride work?
Fluoride helps protect againist demineralization:
Fluoride has been shown to help strengthen the enamel, this is referred to as remineralization.
FDA fluoride toothpaste labeling requirements
In 1997 the FDA required that all fluoride containing toothpaste be labeled.These requirements can be found on the FDA website. Children were swallowing too much fluoridated toothpaste and developing enamel fluorosis.It’s recommended that children ages 2 and under not use fluoride toothpaste at all. Keep fluoride toothpaste out of reach and supervise your children when they brush their teeth.
Just on the side,
contaminated fluoride toothpaste has also been found in some imported toothpaste. You can read more about this in this New York Times article.
Why do some people oppose fluoride in our toothpaste and drinking water?
International Association of Oral Medicine and Toxicology (IAOMT) is an association that collects data to support the ill effects of fluoride exposure. An in depth report that you can be found here
This is a summary of the report and do understand that these findings are again controversial.
Their findings supported that fluoride increases the risk of,
Dental fluorosis-Dental fluorosis is a condition where white streaks are found on the teeth’s enamel. This usually occurs from high concentrations of fluoride during childhood. Most agree on this one, hence the FDA labeling requirements.
Skeletal fluorosis Long-term exposure to high level of fluoride can cause a condition known as skeletal fluorosis. Fluoride builds up in the bones leading to pain and increased risk of fracture.
“reactions to fluoride, including fluoride used in toothpaste, have
been linked to acne and other dermatological conditions.” Source -IAOMT report
The report suggests that even low concentration of fluoride (2 mg/L) increase the risk of heart disease.
Their reports suggests that there is a risk of lower fertility rates and early puberty in girls
Their report suggest that excess fluoride may damage the parathyroid gland which leads to low calcium levels, this will increase the risk of fracture.
According to the IAOMT report, “On the basis of information largely derived from histological, chemical, and molecular studies, it is apparent that fluorides have the ability to interfere with the functions of the brain and the body by direct and indirect means.”
One study showed lower cognitive function in children if the mothers were exposed to higher levels of fluoride. “In this study, higher prenatal fluoride exposure, in the general range of exposures reported for other general population samples of pregnant women and nonpregnant adults, was associated with lower scores on tests of cognitive function in the offspring at age 4 and 6–12 y.”
“The immune system is yet another part of the body that can be impacted by fluoride. An
essential consideration is that immune cells develop in the bone marrow, so the effect of fluoride
on the immune system could be related to fluoride’s prevalence in the skeletal system.” source -IAOMT report
Does fluoride cause cancer?
Most studies do not support any association between fluoride exposure and cancer development.
According to the American Cancer Society,
“Some of the controversy about the possible link stems from a study of lab animals reported by the US National Toxicology Program (NTP) in 1990. The researchers found “equivocal” (uncertain) evidence of cancer-causing potential of fluoridated drinking water in male rats, based on a higher than expected number of cases of osteosarcoma (a type of bone cancer). There was no evidence of cancer-causing potential in female rats or in male or female mice.”
The American Cancer Society did a detailed article on the available literature. Click here to read that article.
Summary of fluoride in our toothpaste
It is clear that fluoride helps protect our teeth from tooth decay. What is not clear is how much fluoride do we need to help prevent this decay.
We are exposed to fluorides on a daily basis. It is found in our drinking water, toothpaste and mouth rinses. If we are drinking water with fluoride, brushing our teeth with fluoridated toothpaste and rinsing with a fluorinated dental rinse is it too much? It is recommended that we brush twice a day, what about people who brush more than that or use more than a pea sized amount of toothpaste? Are they exposed to too much fluoride?
The answer to these questions is unclear.
What do you think of fluoride in our toothpaste?
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