Fluoride: How Much Do We Need?

Drinking water_89973088Every week, I get questions about fluoride. In short, fluoride is important; our teeth and bones depend on it. But how much do we need and where should it come from?

First, a quick primer. fluoride protects tooth enamel from the bacteria in plaque that can build up on and around the tooth. It strengthens teeth and promotes new bone formation. Dentists see it as one of the most important tooth decay deterrents available… along with reducing sugar from our diets and maintaining good oral hygiene habits at home. So, it’s an important part of most dental visits. Fortunately, fluoride is found naturally in the environment, though generally only in trace amounts.

Practice of Fluoridating Water

In the early 1940s, scientists discovered that people in communities with elevated levels of naturally occurring fluoride in their water supply happened to also have significantly better oral health than communities where fluoride was found only in trace amounts. This discovery spawned national interest from public health advocates who pushed to fluoridate community drinking water supplies throughout the United States as a broad measure to improve oral health.

Water fluoridation prevents tooth decay by providing frequent and consistent contact with low levels of fluoride. By keeping teeth strong, fluoride stops cavities from forming and can even rebuild the tooth’s surface. According to the American Dental Association, fluoridation is the most feasible and cost-effective method of delivering fluoride to all members of the community, regardless of age, education, or income—improving lives and saving families money on dental care.

For more than 70 years, fluoridation has shown to be a major factor in lower rates of tooth decay in the United States. So much so that the Centers for Disease Control and prevention (CDC) named water fluoridation as one of 10 great public health achievements of the 20th century. The benefits of fluoride have had an enormous impact generation after generation.

Too Much of a Good Thing?

Today, fluoride is found in a variety of products, including toothpaste and mouth wash. While fluoride is safe in correct doses and usage, too much can cause adverse effects, especially in children. Over exposure to fluoride can cause a cosmetic condition called fluorosis. Most dental fluorosis in the U.S. appears in its milder forms as white spots on the tooth surface, which often goes unnoticed. It can occur when young children (less than 8 years of age) regularly take in more fluoride than needed when their permanent teeth are still developing. As such, dentists don’t recommend fluoride be given to infants, and we suggest children be monitored during brushing so that they don’t ingest toothpaste with fluoride.

To balance the benefits of water fluoridation with the chance for dental fluorosis, the U.S. Public Health Service set guidelines for the optimal level of fluoride in drinking water to prevent tooth decay at 0.7 mg/liter. The recommendation helps ensure an effective level of fluoride to reduce the incidence of tooth decay while minimizing the risk of cosmetic fluorosis in the general population.

The increased use of fluoride products, including fluoridated water, reduces tooth decay by 25% among children and adults. According to the ADA, in communities with water fluoridation, school children have, on average, two fewer decayed teeth compared to children who live in communities without fluoridation.

Fluoridation on the Sammamish Plateau

While the benefits are clear, there is no federal requirement in place to fluoridate community water supplies. States and local communities have the freedom to decide whether or not to fluoridate.

Most water delivered to communities on the Sammamish Plateau are treated with fluoride, but to confirm if your neighborhood is treated, visit the Sammamish Plateau Water and Sewer District for a map of the water treatment areas.

Effective, Safe and Recommended

More than 100 national and international healthcare organizations  recognize the benefits of community water fluoridation, including the American Dental Association.

At Pine Lake Family Dentistry, we recommend drinking fluoridated water and brushing your teeth twice a day with a toothpaste that has the ADA Seal, which means that it has been tested and shown to contain the right amount of fluoride to protect your teeth. Be aware that not all bottled waters contain fluoride.

To learn more about the effects of fluoridation on your specific dental health situation and that of your family members, schedule an appointment with me at Pine Lake Family Dentistry.

–Dr. Chen


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