Saturday, August 21, 2010

Fluoride benefits vs risks

While I believe that Fluoridated drinking water, Fluoride in toothpaste and periodic Fluoride applications at the dentist office are beneficial, I will address the opposing view as well.

Fluoride and teeth.

Fluoride is incorporated into the matrix of the enamel forming a compound called Fluorapatite. This Fluorapatite is less soluble in acid than the hydroxyapatite normally found in enamel. Consequently the tooth is more resistant to decay.

This Fluorapatite can be incorporated throughout the tooth enamel during its development if Fluoride is present in small quantities during the developing years for the teeth (age 0 to 13). Topical Fluoride can also be incorporated into the surface layers of a tooth by daily use of a Fluoride toothpaste and a supercharging twice a year with a professional application of Fluoride in a dental office.

In the 1880’s it was noted that some people in certain areas of the US and Mexico had a condition called “mottled enamel” as well as less tooth decay. Subsequent studies indicated that a level of 1 part per million of fluoride added to drinking water seemed to reduce tooth e decay by as much as 64% while not causing the mottled enamel (called “dental fluorosis”)

Fluoride in high concentrations excess of 3-5 ppm in drinking water or in the diet can cause dental fluorosis as well as ostiofluorosis. Very high concentrations (14 ppm) and higher can lead to other conditions. Most of the uptake of fluoride takes place in childhood up to 90% uptake. Uptake drops to about 50% or less during adulthood. Fluoride in drinking water is useful in the developing dentition while teeth are still forming. This benefit drops off completely after age 13While there is controversy in the safety and efficacy in the use of Fluoride in drinking water for decay prevention, there is more evidence that it does protect teeth from decay.

History of Fluoride usage.

Fluoride was determined to reduce tooth decay decades ago. It was found to do so when people living in areas where drinking water had higher concentrations of Fluoride also had less decay.

Fluoride was first introduced into public US drinking water in the 1940's. It was met with opposition from the beginning claiming diseases, birth defects, and a Communist plot. The opposition continues even today. Some other developed countries have stopped water fluoridation programs due to studies showed inconclusive proof that it helped reduce decay in the population. Other studies linked fluoride with diseases and conditions in a higher frequency. When viewing all of the studies done to date, it is apparent to me that hardly any were performed in a manner that would show a statistical relevant trend in either direction. Since the newer studies have been undertaken, Fluoride is being incorporated into the lives of most people in developed and developing countries through toothpaste and processed foods. This new development is making it hard to determine to what extent fluoride in the drinking water is having an impact.

The changing picture of tooth decay.

Since the high use of fluoride and dental sealants, and super low dose x-rays, we are seeing a new decay pattern is children and young adults. There is significantly less decay however the decay is harder to detect. The Enamel can look pristine on the surface, but a tiny pit can be decaying below the surface is some cases. A new dental laser “DIAGNOdent” is highly effective in detecting this type of decay. With the aging population retaining more teeth and the myriad of medications (over 3000) that cause reduced saliva flow, we are seeing root decay on the rise in adults. Gum recession and extensive (expensive) restorations can exhibit recurrent and root decay.

Fluoride applications in adults will be more beneficial than ever as more adults retain more of their natural dentition. Topical Fluoride applications and high concentration fluoride toothpaste gels are often needed to reduce this problem.

My Conclusions.

Fluoride has been very beneficial on reducing or eliminating tooth decay, and will continue to be a valuable part of preventive dental care. Of equal value is a reduction in refined sugars and good oral hygiene. Fluoride has saved people from millions of fillings, root canals, crowns, bridges, partials, dentures, extractions and pain and billions of dollars in cost for treatment. It will continue to be used by the dental profession to promote healthier teeth unless any well controlled scientific studies can provide overwhelming evidence that its risks outweigh its benefits. As yet, I have not seen any; however I will keep an open mind.

After reviewing the studies and data available, it is clear that today more people are getting fluoride in the world by consuming commercially produced foods and beverages. These processed foods and drinks are usually produced in plants that use public drinking water as a component. This water will have fluoride in it in most cases. It is also clear that there is less tooth decay in the younger population, though it is on the rise in younger children as they are consuming an incredible amount of products with refined sugar.

Eliminating Fluoride from you diet.

There are many online resource regarding the dangers of fluoride

If you are not on well water, it is difficult to obtain water (including bottled) that does not have Fluoride in it to some degree. Filtering your tap water can eliminate Fluoride, but you must use a special (check with the manufacturer) filtration system.

Your comments are welcome

Phillip C. Neal DDS

Crystal Lake Dental Associates

280 B Memorial Court

Crystal Lake Il 60014

815 459 2202


  1. More than 3,000 professionals (including over 270 dentists) urge the US Congress to stop water fluoridation citing scientific evidence that fluoridation, long promoted to fight tooth decay, is ineffective and has serious health risks. See statement:

    Also, eleven Environmental Protection Agency employee unions representing over 7000 environmental and public health professionals called for a moratorium on drinking water fluoridation programs across the country, and have asked EPA management to recognize fluoride as posing a serious risk of causing cancer in people.

    Approximately, 80 US communities rejected fluoridation in 2008 & 2009

    -- On April 12, 2010, Time magazine listed fluoride as one of the "Top Ten Common Household Toxins" and described fluoride as both "neurotoxic and potentially tumorigenic if swallowed."

    -- Water fluoride chemicals boosts lead absorption in lab animals’ bones, teeth and blood, was reported by Sawan, et al. (Toxicology 2/2010). Earlier studies already show children’s blood-lead-levels are higher in fluoridated communities, reports Sawan’s research team.

    -- State University of New York researchers found more premature births in fluoridated than non-fluoridated upstate New York communities, according to a presentation made at the American Public Health Association’s annual meeting on November 9, 2009 in Philadelphia.

    -- New York State Department of Health dentist J. V. Kumar published national statistics in the July 2009 Journal of the American Dental Association which show similar cavity rates regardless of water fluoride content, However, dental fluorosis rates increased along with water fluoride levels. See analysis “Fluoridation No Benefit; Definite Harm,” by Kathleen M. Thiessen, Ph.D., SENES Oak Ridge, Inc., Center for Risk Analysis here:

    -- The National Kidney Foundation dropped its fluoridation support replacing it with this caution: “Individuals with CKD [Chronic Kidney Disease] should be notified of the potential risk of fluoride exposure.” (3)

    -- Researchers reported in the Oct 6 2007 British Medical Journal that fluoridation never was proven safe or effective and may be unethical. (4)

    -- “A qualitative review of ...studies found a consistent and strong association between the exposure to fluoride and low IQ,” concluded Tang el al., in "Fluoride and Children’s Intelligence: A Meta-analysis” in Biological Trace Element Research (5)

    -- Scientific American editors wrote in January 2008, "Some recent studies suggest that over-consumption of fluoride can raise the risks of disorders affecting teeth, bones, the brain and the thyroid gland"

    -- A study in the Fall 2008 Journal of Public Health Dentistry reveals that cavity-free teeth have little to do with fluoride intake. Researchers report, "The benefits of fluoride are mostly topical…while fluorosis is clearly more dependent on fluoride intake."

    -- Research published in Biological Trace Element Research (April 2009). indicates that blood fluoride levels were significantly higher in patients with osteosarcoma than in control groups. (13) Osteosarcoma, a rare bone cancer, occurs mostly in children and young adults

    -- All infant formula, whether concentrated or not, contain fluoride at levels that can discolor teeth - even organic, according to research published in the October 2009 Journal of the American Dental Association. (16)

    -- A Tennessee State legislator, Joey Hensley, who is also an MD is urging all Tennessee Water Districts to stop fluoridation, reported a Tennessee newspaper on 11/29/08. At least 30 Tennessee water districts have already complied with his request.(6)

    Fluoride Action Network http://www.FluorideAction.Net

  2. A fantastic read….very literate and informative. Many thanksLawrenceville dentist


About Me

My photo
Born in the Midwest. Married with 6 children and 3 grandchildren. Attended Maine West High School, Harper Jr College, Northern Illinois University, the University of Illinois College of Dentistry. Practice in Crystal Lake, Illinois.