I am in favor of removing fluoride from the public drinking water supply in the USA. Not because I deem it to be harmful per the evidence, but rather I believe that we should all have a choice. The USA caries index is lower than most European countries(95% do not use fluoride anymore). The only European country that has a lower caries index is Belgium. I should note, however, that most of the European countries have very comparable caries rates and the ones that are higher are only slightly higher. Today, we have fluoride in our tpastes as well as many mouth rinses,food products, supplements, topical applications and many other sources. Tablets can also be purchased to fluoridate our own water if anyone chooses to do so. Fluoride if used properly has been shown to be very safe time and time again in legitimate study after legitimate study and has been shown to reduce tooth decay across populations to varying degrees based on other factors. Even in naturally occurring water, fluoride(CaF2) is usually present. The current recommendation for drinking water is 1 ppm of silicone type fluoride. As of 2013, about 74.6% of public water supplies in the USA are fluoridated per CDC stats. You can call your local water utility to find out the amount in your drinking water. Many I have noticed are 0.7 ppm. The addition of this amount of fluoride in water is one of the greatest achievements in public health in the 20th century, according to the CDC. Topical fluoride should be used with caution for people with moderate to severe decay only. It has the potential to cause fluorosis in developing teeth(neonatals and toddlers are more vulnerable). Study after study suggest the application of topical fluoride is not a factor systemically but benefits many substantially. We do need more studies on possible reproductive effects in my opinion. I still would not leave a rx tube of fluoridated tpaste laying around with small children in the house. There have been cases of small children dying from ingesting whole tubes. The WHO has a lot of information about this subject as well as the ADA, university studies, AAGD, CDC, and of course the US Public Health Service. Among 1st world countries, generally dental caries have been trending down significantly over the last four or five decades, regardless of whether or not fluoride is placed into the public water supply. Among these countries, those with fluoride in their water supply do have a very slightly lower caries index. The only significant health detriment linked conclusively to fluoride in water at recommended levels is fluorosis as mentioned above. Severe fluorisis only occurs in less than 1 percent of the population. With a fear of fluoride also comes the possibility of the psychological effect which is hard to measure. Is fluoride worth the cost to benefit anymore in the USA to put it in our water supply? Maybe not anymore. Is fluoride safe at recommended levels? It sure appears so. There have been many class action suits against local water utilities and almost all have been settled in favor of the water companies due to lack of evidence showing causation beyond fluorosis. To my knowledge, this issue has never made it to the federal level or even state level of last resort due to the lack of evidence. Maybe someday they will find a link. Do I think that rx fluoridated tpastes help people with a high caries index? Absolutely, but what is more important is improving oral health care and sugar intake. If nothing changes, then nothing changes. Fluoride is not a substitute for better oral hygiene. The importance of proper oral hygiene without a doubt is the main reason that in 1st world countries dental caries are trending down, regardless of whether or not they put fluoride in their water supply.
Posted on: Thu, 01 Jan 2015 04:43:57 +0000
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