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October 21, 2009 | modernhygienist.com Is fluoridated water overrated? Fluoride has always been seen as a safe and effective way to fight caries, but new studies reveal it may be more controversial than we thought. by Lauren Bryant, Associate Web Editor  Photo: Comstock/Getty Images Fluoride is used to fight tooth decay in children. With studies dating back to the 1940s demonstrating its effectiveness as an anti-cavity fighting compound, new studies have been emerging to the contrary. Fluoride benefitsFor more than 60 years, water fluoridation has been a safe and cost-effective way to reduce dental caries. Today, water fluoridation is estimated to reduce tooth decay by 20-40%. As of 2002, statistics from the Centers for Disease Control and Prevention (CDC) show that almost 60% of the U.S. population receives fluoridated water through the taps in their homes. Some communities have naturally occurring fluoride in their water; others add it at water-processing plants.1 Scientific research continues to support the benefits of fluoride when it comes to preventing tooth decay and its safety at current recommended levels of 0.7 to 1.2 ppm. The American Dental Association (ADA), the United States Public Health Service (USPHS), the American Academy of Pediatrics (AAP), and the World Health Organization (WHO), among many other national and international organizations, endorse community water fluoridation and support its benefits to our water systems. 1 Fluoride, like most medications—including vitamins and mineral supplements—can be harmful if too much is ingested. Too much can cause enamel fluorosis, a discoloration or mottling of the permanent teeth. Most cases develop because of inappropriate use of fluoride-containing dental products, including toothpaste and mouth rinses. Sometimes children take daily fluoride supplements but may be getting adequate fluoride from other sources, such as drinking water, which also puts them at risk. 1 According to the article, “Hidden danger in your drinking water and toothpaste,” a study conducted by Dr. John Yiamouyiannis examined the raw data from a study conducted by the National Institute for Dental Research (NIDR). He concluded that fluoride did not appear to have any decay preventing success, as there was little difference in the DMFT values (the mean number of decayed, missing or filled teeth) for about 40,000 children. It did not matter whether they grew up in fluoridated, non-fluoridated or partially fluoridated communities. 2 Although children’s teeth have steadily improved from the 1930s to the 1990s, the improvement is questionably related to the addition of fluoride to the water. A study has yet to be conducted that specifically addresses whether the addition of fluoride affects the quality of teeth, while controlling and accounting for other factors and other sources of fluoride. 2 Fluoride concernsThe most recognized concern with fluoride is the development of dental fluorosis that stems from ingesting too much fluoride. The effects include chalky white spots appearing on teeth to more severe cases that feature colored stains, surface pitting and tooth brittleness. Some say those who aren’t convinced of fluoride’s dangers should still take issue with the level of fluoride added to our water, homecare products and food. The optimum level was set in the 1940s at approximately 1 ppm (equal to 1 mg/l). This was based on assumptions that the total intake of fluoride would be 1 mg/day, assuming four glasses of water were consumed per day. 2 CONTINUED ON NEXT PAGE
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