The fluoride question, whether or not it is safe for children and adults alike, is not always easy to find the answer to. We’ve collected the current data on the subject in order to paint a clearer picture.
What Is Fluoride?
This fluoride question is an easy one to answer. Fluoride is a mineral, found naturally in small amounts in soil, water, and some foods. As the nutritional requirements of fluoride have not been established, there is not currently a Recommended Dietary Allowance. When fluoride is ingested, most of it is absorbed in the gut and subsequently stored in the teeth and bones. Excess fluoride that is not absorbed is excreted in urine. The effects of fluoride, good or ill, are felt most profoundly in children.
Where Is Fluoride Found?
Fluoride is naturally occuring, and is found in unexpected places. People can consume it in foods that absorb it from the soil, things like coffee, black tea, raisins, oatmeal, potatoes, and the shells and muscles of shellfish.
Most people are exposed to fluoride in their toothpaste and drinking water. It may be in the water naturally, introduced by the bedrock or loose soil, or added on a city-specific basis. The EPA has a current enforceable drinking water standard of 4.0 mg fluoride per liter, though they recommend a non-enforceable concentration of 2.0 mg/L to be on the safe side as regards children.
In addition to toothpaste, fluoride is sometimes an ingredient in mouthwash, dental varnishes, gels, and restorative materials. As these are applied only to the exterior of teeth, they do not contribute significantly to the total intake of fluoride, unlike vitamin supplements and pharmaceuticals. Fluoride can even be found in industrial emissions and pesticides.
Is Fluoride Good or Bad for the Teeth?
This is the most significant fluoride question, is fluoride safe for teeth. The answer is entirely dependent on the amount of fluoride involved and the method of exposure. Sometimes called nature’s cavity fighter, fluoride is an excellent resource for strengthening tooth enamel. It remineralizes enamel, preventing cavities and other tooth decay. In this way, it can extend the lifetime of teeth.
Teeth are not the only beneficiaries. Fluoride can strengthen the skeleton in general. This helps minimize the risk of skeletal fluorosis, a sometimes crippling condition that causes tenderness and pain in the joints.
Why Do People Avoid Fluoride?
There are some people who consider fluoride questionable, refusing it at the dentist office and protesting its addition to the city water supply. This hesitancy stems from the conflicting data about fluoride which is widely available. For all its benefits, fluoride is toxic if ingested, proportional to the amount consumed.
Perhaps the most common downside of excessive fluorination is dental fluorosis, affecting the appearance of the teeth. Too much fluoride in the system can cause discoloration in the form of white spots in the enamel or even pitting. Children under eight are most at risk.
In its most severe toxicity, excessive fluorination can lead to skeletal fluorosis. The condition, though rare, has terrible symptoms. In addition to bone loss, fluorosis can cause tenderness and weakness in the joints, nausea, vomiting, diarrhea, and abdominal pain. Again, this will only occur if fluoride is ingested in excess, and it is more likely if the fluoride is allowed to accumulate in a person’s system.
Most fluoride questions affect children more than adults. This is because their bones and teeth are still forming, and fluoride concentrations, no matter what they are, are more significant considering their small body weight. Children younger than eight are at increased risk of overexposure, which can lead to pitting, discoloration, and other cosmetic dental problems.
Monitor Your Fluoride Intake
If you have fluoride questions, it is better to err on the side of caution. It is wise to know how your city handles fluorination to know how much you are regularly exposed to. If your tap water’s fluoride levels are low, your dentist may recommend that your or your children take fluoride supplements. In taking these, make sure you follow the prescribed dose exactly.
If your regular fluoride levels are high, your dentist may recommend that your children drink bottled water (this includes making baby formula with water that is not from the tap). No matter what your fluoride levels, it is highly important that you prioritize regular dental visits, especially for young children. Begin within the first six months after the child’s first tooth emerges or after the child’s first birthday (whichever comes first).
It is also important to remember to monitor fluoride ingestion at home. Young children, especially younger than six years old, have difficulty managing their swallowing reflex, and the primary source of fluoride intake for a child—in addition to water—is swallowing toothpaste. Wait until children are two years old before using toothpaste with fluoride. While the child is small, parents should supervise tooth brushing sessions, keeping the dollop of toothpaste pea-sized per CDC recommendation. Make sure children spit out the paste and rinse out their mouths well.
If you have further fluoride questions, you can always ask your dentist.