For most of my life I never really thought much about fluoride or my drinking water. My teeth are in pretty good shape, and the only time I thought about fluoride to any extent was when I taught a college level introductory nutrition class. The text books noted the “benefits” of fluoride in preventing tooth decay, and then always showed the classic brown spots on tooth enamel due to overexposure of fluoride. We discussed that fluoride was delivered to municipal tap water in the Chicago area (our location) and that bottled water was not typically fluoridated. While it may have natural fluoride, fluoride is not typically added to bottled water.
Fluoride is not considered to be an essential nutrient from a dietary standpoint. For the last 70 or so years, it’s role in public health has been one of preventing tooth decay. Once teeth have erupted through the gum, fluoride added to the tooth surface plays a role in preventing tooth decay through remineralization of the weaker spots on the tooth enamel as well as controlling the amount of acid that bacteria of plaque produce. Indeed, I remember even as a young adult having fluoride treatments in the dental office because I had great dental insurance and it was covered. And, of course, there is lifelong use of fluoridated toothpaste.
But, should it be delivered to everyone in tap water when all are not at the same risk for tooth decay?
For the municipalities that deliver fluoridated water, there is no choice in the matter. If you want to avoid ingesting fluoride in the Chicago area, you must find a means to remove it from your tap water or stick with purchasing spring water. Although safety limits are set in terms of public health policies on safe fluoride levels, it is a one-size fits all situation.
According to a recent article in the Indian Journal of Occupational & Environmental Medicine (2018), these points should be considered regarding fluoridation of water and dental health:
- Current evidence clearly suggests that the protective mechanism of action of fluoride is mainly topical. In other words, we do not need to be ingesting fluoride to reap the dental benefits.
- 1% of the population appears to be highly sensitive to fluoride (yes, I am in that 1%).
- Certain subsets may be particularly vulnerable to ingesting fluoride: the elderly, diabetics, the malnourished.
- Once the fluoride is put into the water, what about those individuals that need to inherently consume larger quantities of water? Those individuals might include manual laborers, diabetics, and athletes.
- Interestingly, on the international front, most European countries have rejected water fluoridation. Only Ireland, Spain, and the United Kingdom practice water fluoridation.
While the debate on the pros and cons of fluoridated water will most likely rage on, there are a few other dietary factors that come to mind for preventing tooth decay in the young and old:
- Choosing a healthy diet low in sugar will help prevent tooth decay. Emphasizing fruits and vegetables will stimulate saliva production to help rinse the sugar away.
- Avoiding cariogenic foods like sugar, sticky foods (like raisins), and soda will help prevent tooth decay.
- If indulging in sugary foods, try not to do so all day long. Best to splurge and then brush, instead of exposing your teeth all day long.
- Apply that fluoride through toothpaste, mouth rinse, and in the dental chair.
My last comment will be simply that in the concept of “clean eating”, I see no reason to be putting fluoride into my digestive tract.
Where do you stand on the issue of ingesting fluoride through tap water?