For Feb 21, 2006 Health column:
The Independent
Why Fluoride is Important to Dental Health
By Tareq Khalifeh, DDS

Fluoride has been recognized for 50 years as an important defense against tooth decay. According to well-researched studies, fluoride treatments reduce decay by an astounding 20 to 40 percent. That is why in the United States, as in many countries around the world, up to two-thirds of public water supplies are treated with fluoride to reduce the incidence of dental cavities in populations consuming that water. For every dollar spent by communities that fluoridate their water supply, $38 is saved in dental treatments.

Fluoride is also available in many toothpastes, mouthwashes, in tooth washes used daily at home, or through gels and foams applied by your dentist. These sources of fluoride are important defenses for people living in areas where water fluoridation is not possible, or for individuals getting their drinking and cooking water from wells.

Some people are leery of fluoridation. They cite various studies indicating possible health risks, from neurological and reproductive effects to bone cancer. The American Dental Association warns against giving credence to such reports, citing the importance of looking at the scientific validity of the study methods. According to the ADA, none of the health threats suggested by opponents of fluoridation have been substantiated by scientific scrutiny. What’s more, there is no risk of toxic accumulations of fluoride at the levels commonly used to fluoridate public water supplies or in commonly used oral hygiene fluoride treatments.

For a detailed look at the evidence on both sides of this question, take a look at the lengthy report,
“Fluoride Facts,” available free as a downloadable document at the American Dental Associations Health Topics site.

How Fluoride Works
The fluoride ion comes from the element fluorine, an element found everywhere in the earth’s crust. In its natural state, fluorine combines with other elements, forming fluoride compounds in the minerals present in rocks and soil. As groundwater passes over rock formations and ground, fluoride is released, meaning that small amounts of fluoride are available in all natural water sources. As a result, fluoride is present in all foods and beverages, although concentrations vary widely, depending on the concentrations found in the natural environment that produced the food or water.

Fluoride protects teeth in two ways. In children whose teeth are still forming, the fluoride ingested through food and water becomes part of the tooth structure, and the teeth are continually bathed in systemic fluoride through the saliva. Fluoride applied topically, through ingesting water treated with fluoride, and through fluoride-enhanced toothpastes, washes, lozenges, and dental applications, strengthens teeth already present in the mouth.

Fluoride helps teeth fight decay by repairing or restoring the loss of minerals on the tooth enamel. Loss of minerals in the enamel is what causes cavities. Bacteria present in the mouth produce acids that eat at the surface of the tooth, damaging the natural balance of minerals that make up the tooth’s enamel. When fluoride is present in the tooth enamel itself (as in the teeth of individuals who ingested sufficient fluoride as their teeth were forming), or on the surface of the tooth (from ongoing use of fluoridated water or other sources), the enamel can actually repair or “remineralize” early decay.

Is Your Water Fluoridated?
A quick check of the Center for Disease Control’s website, “My Water’s Fluoride”, shows that many communities in our area that have publicly-supplied water do not fluoridate the public supply. Philmont, Hudson, and Kinderhook, for example, are listed here as having natural fluoride concentrations “below the level considered optimal for the prevention of dental caries (cavities).” And, of course, many residences in this area use private wells for their drinking water, which typically are not treated with extra fluoride.

(Columbia County public water supply safety is administered by the Bureau of Water Supply Protection in Troy, NY. You can find additional information on local water safety at the Environmental Protection Agency’s site.

This makes fluoride treatments and the use of fluoride-enhanced oral hygiene products very important for most people reading this article. You can buy over-the-counter fluoride rinses, which must be used daily for optimum effect. Or ask your dentist to apply a professional foam or gel. These fluoride treatments are safe for children and adults alike, and are an important part of protecting you and your family’s overall health.

Dr. Khalifeh owns the Philmont Family Dentistry located on Rte 217 in Philmont, NY. A graduate of the New York City School of Dentistry, he completed his residency at Albany Medical Center and practiced in Albany until 2004. For more information, call 672-4077.