Decay rates have dropped dramatically in the past 5 decades in "westernized countries"
"Since the 1960s and 70s, however, a continuous reduction (in tooth decay) has taken place in most 'westernized' countries, it is no longer unusual to be caries-free... During the decades of caries decline, a number of actions have been taken to control the disease, and the literature describes numerous studies where one or several factors have been evaluated for their impact. Still, it is difficult to get a full picture of what has happened, as the background is so complex and because so many factors may have been involved both directly and indirectly. In fact, no single experimental study has addressed the issue of the relative impact of all possible factors, and it is unlikely that such a study can ever be performed."
SOURCE: Bratthall D, Hansel-Petersson G, Sundberg H. (1996). Reasons for the caries decline: what do the experts believe? European Journal of Oral Science 104:416-22.
The influence of fluoride is definitely a major factor. The problem however is knowing just how much fluoride a person is actually getting. Fluoridation of the public drinking water is banned in many European countries and the decay rate has still dropped dramatically. These same countries have fluoride available to them in fluoride supplements, toothpaste, rinses, and possibly in processed foods and drinks from places where the water used is fluoridated.
Anti-fluoridationists have made a lot of claims against the use of fluoride which I will not cover, but it is true that fluoride (as are many other chemicals and compounds), is toxic in sufficient doses.
It is also true that teeth with fluoride incorporated in them during development or subjected to regular proper fluoride treatments have significantly less decay when all other conditions remain the same.
Mild dental fluorosis can be a cosmetic problem ,and should not be taken lightly. I support a lowering of the level of fluoride in drinking water if it will help prevent fluorosis.
The tooth decay process and fluoride
Tooth decay is a very complex process involving bacterial plaque, saliva, a nutrient source, time, and the tooth. It can be slowed, stopped and even reversed through several methods. One method is to make the tooth less susceptible to acid attack by incorporating fluoride into or onto the tooth. Fluoride is a negative element which bonds strongly to other positive compounds like those in teeth. In this way it helps prevent the tooth from dissolving in the acid formed by bacteria.
I respect the right of parents to choose a fluoride free lifestyle since we are bombarded with chemicals whose ultimate combined effects are hard to determine. Allergies and other inflamatory conditions are on the rise, and much is unknown about some of the causes.
Everything we do as a preventive measure is based on risk versus benefit. If the decay fighting effects of fluoride helps children have more decay free dental visits, I think it is worth it.
I welcome your comments.
Phillip C. Neal DDS
Crystal Lake Dental Associates
280 B Memorial Court
Crystal Lake, Illinois 60014
815 459 2202