Fluoride is a polarizing topic, in the health and wellness community it is rightly identified as a toxin, a claim which lies completely opposite of the FDA/ADA who claim it’s the key to keeping our collective teeth “healthy.”
Is it healthy?
What are the major sources of Fluoride to look for?
Is there any amount we should consume?
What are the alternatives?
Fluoride is a toxic substance in anything but very small doses. The current “acceptable” amount by the EPA is less than 1 part per million in drinking water (Thissen). The ADA states fluoride is “healthy” because American tooth decay decreased since the 1960’s when fluoride was introduced into water and other products. However, tooth decay decreased in un-fluoridated countries at the same rate (Connett). Thus the argument can be made that oral health education and an increase in access to dentistry the past century is the real reason the population’s teeth got better, and that fluoride had no real correlation. Fluoride in its elemental form is found naturally in small amounts in the ground and has always been present in water. So the question and dilemma becomes, “Is it really necessary to add 5-10x more?”
Sources of fluoride are abundant and it’s added to most sources of US drinking water (including bottled water), mouthwash, toothpaste, and floss, under the alleged belief that it helps prevent cavities. However, in addition to these “planned” sources of fluoride, we are now also exposed to many “unplanned” sources. These come in the form of perfluorinated (anti-stick/Teflon) products, foods washed or made with fluorinated water, foods grown with fluorinated pesticides, as well as many of our prescription drugs, cigarette smoke, power plant emissions, and industrial pollution in general (IAOMT.org). The result is or can be a toxic fluoride overload to our bodies.
In April 2019, the FDA scaled back the guidelines on fluoride and reduced the allowable amount to be added to water because the old standards were found capable of causing dental fluorosis in forming teeth (USAToday). Fluorosis of teeth and bones is a result of a build-up of fluoride within them, and makes them more likely to chip and break, as well as have irreparable visual defects and marks (MouthHealthy). Interestingly, much of the original research on fluoride showed that it’s benefits were obtained by topical application, and not via drinking it, where very little of it ever touches the teeth (WebMD)
In addition to fluorosis, fluoride is known to have potent negative effects on our thyroids. Fluoride can replace iodine in the thyroid, and a British study found that populations with fluoridated drinking water were twice as likely to struggle with underactive thyroids (WebMD). A study done on school children found significant correlations between water fluoride levels and decreased thyroid hormone production (NCBI).
“THE CHRONIC OVER-EXPOSURE OF FLUORIDE IN DRINKING WATER CAUSES GROWTH DISTURBANCES PARTICULARLY EVIDENT IN ADOLESCENCE AND THEY RESULT IN THYROID DYSFUNCTION”- SMITH & TAFFOREAU
How much fluoride do humans need?
Surprisingly, fluoride is not FDA-approved as a “supplement”. A supplement is something that is required for human development, and your body has no physiological need for fluoride in development. It is instead considered a drug by the FDA and if one desires a fluoride treatment (beyond what is in toothpaste and drinking water), it must be prescribed by a doctor (Fluoridealert.org). You have no innate needs for fluoride, and if you did, there are naturally occurring amounts in most ground water. The three mechanisms the CDC lists that fluoride benefits teeth is by promoting remineralization, decreasing demineralization, and poisons the bacteria that lead to tooth decay.
“ACCORDING TO THE CDC, THERE ARE THREE MAIN MECHANISMS BY WHICH TOPICAL FLUORIDE CAN PREVENT DECAY... ACCORDINGLY, EACH OF THE THREE TOPICAL MECHANISMS CAN FULLY OCCUR WITHOUT A PERSON SWALLOWING A SINGLE DROP OF FLUORIDE THEIR ENTIRE LIFE.”-FLUORIDEALERT
Fluoride supplementation via drinking water, has no real benefits to the teeth, but what about topical use? Fluoride has been the “Gold Standard” for remineralization and demineralization in the dental industry for over 50 years. However, new and recent research shows that the benefits touted by topical fluoride can be achieved using other ways that are not detrimental to your body like fluoride is.
Your tooth enamel is primarily made of Hydroxyapatite, which is made of phosphate and calcium ions, not fluoride. When your mouth becomes acidic due to something like high sugar intake or poor dental care, phosphate is “pulled” from the teeth to restore the lost phosphate in the saliva. If it takes place repeatedly over time, your teeth can become “demineralized” which leaves them susceptible to caries or infections(DentalCare).
When fluoride is introduced into a demineralized tooth, the tooth incorporates a different compound called fluorapatite. Fluorapatite is considered more resistant to future demineralization, but at what cost? If you promote a healthy mouth environment then you don’t need to worry about demineralization, and thus you can avoid the vicious side effects from the high intake of fluoride.
Since fluoride doesn’t naturally occur in teeth or bones, it has never made sense to me to try to force fluoride where it didn’t originally occur. A more reasonable substitute for fluoride therapies are a remineralization paste containing ‘hydroxyapatite’ which is the natural mineral complex of teeth. This paste brushed on at night helps to re-mineralize any areas of teeth that have been ‘demineralized’ during the teeth from acid drinks (soda, energy drinks), plaque acid products, or a naturally occurring acidic mouth.
Remineralization happens naturally in the teeth all the time via our saliva, but it can only occur in the absence of plaque and when our body has the right nutrients (Calcium, Vitamin D, and Vitamin K2). This is why both diet and daily, oral hygiene are so important.
The JAMA, Journal of American Medical Association, has recently (2019) reported a study that concludes mothers exposed to higher levels of fluoride (drinking water) had a significantly higher likeliness of their children ages 3-4 to have a lower IQ by 3-4 points.
Interestingly, many European countries have rejected fluoride in general.
At Indianapolis Dentistry, I had concluded several years ago, that the risk/benefit ratio of fluoride therapies and treatments don’t justify the potential of reduced cavities vs the compromises to our body’s healthy functioning. That is why I have fluoride-free cleanings. This is contrary to many of my professional colleagues and the ADA’s stance, but the science has been pointing this direction for several years.
Dr. Ted Reese, DDS, MAGD, NMD