Why Fluoride? The Good, the Bad, and the Facts

If you’ve been to a dentist or shopped for toothpaste, you’re familiar with fluoride. It’s one of those words like “anesthesia” that we don’t think about much, but we are sure a lot better off for having it around. The use of fluoride has resulted in a well-documented decline of cavities and tooth decay. But there are still folks who question its use. Here’s what we know about fluoride as a tool for dental health.

Who started putting fluoride to use for dental health? Fluoride in water started with Mother Nature. Some water supplies have a naturally occurring higher concentration of it. In the 1940s, dentists started noticing that people who lived in those areas had fewer cavities. By the 1960s, the United States Public Health Service recommended adding fluoride to municipal water supplies for the prevention of tooth decay.

Why would I want to put a chemical in my mouth?
Have you ever filled up a kiddie pool and let it sit for a while? Before long, it starts to look like a petri dish that you wouldn’t let your dog swim in, much less a child. There’s a reason public pools use chlorine; without treating the water, swimming in a pool would be a risky activity. You’d literally be playing with E. Coli. Throw in a little cryptosporidium and giardia with your floaty and you’ve got some serious summer fun. Chlorine by itself is a hazardous chemical but in the right concentration, it keeps a swimming pool from turning into a cesspool.

It’s the same deal with fluoride. While you wouldn’t order a tall glass of the stuff at your favorite pub, in the right concentration, its use is considered by the CDC to be one of the greatest public health successes in the 20th century. Need convincing? Walk through a nursing home and interview residents about their teeth. Or, what they remember about their teeth. When your great-grandma was a kid, toothbrushes were a luxury and baking powder might actually be applied with one’s finger in a paste. Brushing your teeth with your finger was more like trying to get fried egg off the bottom of your frying pan. And about as much fun.

Any downside of using fluoride?
Not much. Toddlers use toothpaste without fluoride because they wouldn’t understand that swallowing it should be avoided. Kids ages 2-6 should use a pea-sized amount with adult supervision. Swallowing a little fluoride can trigger a bellyache. Ingesting a very large amount of fluoride can cause other symptoms and should be reported to a doctor immediately.

So what’s the controversy?
Using low doses of fluoride in the water supply has been proven a safe and effective tool in dental health. So if you Google “fluoride,” why will you come up with a bunch of scary websites? Owe believe its because one study about twenty-five years ago involving rats and high doses of fluoride caused some concern about an increased risk of one type of cancer. Since then, epidemiological studies over several decades have not been able to correlate fluoride use with an increased risk of cancer. Not ever. The idea that fluoride dangers outweigh its enormous benefit has survived as an urban myth and a government conspiracy theory despite overwhelming evidence to the contrary. Fluoride is a safe and effective tool in keeping your teeth healthy for life.

  1. https://www.cancer.gov/about-cancer/causes-prevention/risk/myths/fluorid...
  2. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4850bx.htm
  3. Kulig K. General approach to the poisoned patient. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 147. https://medlineplus.gov/ency/article/002745.htm
  4. https://health.gov/environment/reviewoffluoride/majfind.htm
  5. https://www.cancer.gov/about-cancer/causes-prevention/risk/myths/fluorid...