This is a topic that is surrounded by controversy. Parents are always worried about potential harm to their child, caused by Fluoride in the toothpaste and drinking water. So lets try to get the facts straight.

Over the past 6 decades, many countries have taken up drinking water fluoridation as a major public health initiative to help in prevention of tooth decay. The addition of fluoride into the toothpastes is another product of robust research. Presence of fluoride in oral hygiene aids such as tooth pastes and mouth rinses has been proven to strengthen teeth and help keep dental cavities at bay. Despite strong evidence of positive effects of adding fluoride to drinking water, and tooth pastes, there are many myths about fluoride that continue to make rounds. Some of these myths have become misinformation which are difficult to shake away. These include, fluoride isn’t natural, adding it to our water supplies doesn’t prevent tooth decay and it causes conditions ranging from cancer to Down syndrome. Let us look at these one by one -

Fluoride is something artificial

Fluoride is a naturally occurring mineral found in rocks that seeps into groundwater. The natural level of fluoride in the ground water varies depending on the water table and the type of rocks and minerals it’s in contact with. Fluoride is found in all natural water supplies at some concentration. Ocean water contains fluoride at around 1 part per million (ppm). Research shows that the optimum level of fluoride in drinking water for prevention of tooth decay is 0.7-1.0 ppm. The type of fluoride commonly found in rocks and the source of the naturally occurring fluoride ion in water supplies is calcium fluoride. Fluoridation of water uses fluoride in compound form like - sodium fluoride, hydrofluorosilicic acid and sodium silicofluoride. Regardless of the original compound, the fluoride ions ultimately dissolve in the drinking water and produce the tooth strengthening effect.

Fluoridated water causes cancer and other health problems

In America, a large number of population based studies were examined for a potential link between water fluoride levels and cancer. Most of these studies were retrospective, that is, they looked at the past experience in the specific population in a region. They mostly compared the presence of cancer in a population, before and after water fluoridation. There were many factors that were not similar for example, age range, population size, ethnicity, natural fluoridation level, duration of exposure etc,. Therefore, extrapolating the findings from these studies onto the entire population was not advisable.

A review published in 1987 by the International Agency for Research on Cancer (IARC), part of the World Health Organization, labeled fluorides as “non-classifiable as to their carcinogenicity (ability to cause cancer) in humans.” While they noted that the studies “have shown no consistent tendency for people living in areas with high concentrations of fluoride in the water to have higher cancer rates than those living in areas with low concentrations,” they also noted that the evidence was inadequate to draw conclusions one way or the other. Therefore, more research is required to establish a direct link between water fluoridation and cancer.

Fluoridated tooth pastes and mouth washes

Children younger than eight should always be supervised while tooth brushing. Products such as tooth pastes and mouthwashes containing fluoride should be kept out of reach of children. The American Dental Association currently advises caregivers to brush with water, and to consult with a dentist before using fluoride toothpaste, for children younger than two years. Use of a pea-sized amount of fluoride toothpaste is recommended for children from two to six years of age.

Other recommendations propose use of a “smear” of fluoride toothpaste (approximately 0.1 gram of toothpaste or 0.1 milligram of fluoride) for children younger than two years and a pea-sized amount (approximately 0.25 g toothpaste or 0.25 mg fluoride) for children from two to six years of age. The Council recommends use of a smear of toothpaste from eruption of the first tooth to age three years followed by use of a pea-sized amount for children aged three to six years. This regimen is intended to maximize the caries-preventive benefits of fluoride while further reducing the risk of developing fluorosis.

Use of fluoride to prevent tooth decay in children and adults is a well established fact. However, it is necessary to keep all the information in mind while using fluoridated oral hygiene aids especially in children younger than eight years old.

Citation

https://www.ada.org.au/

http://www.ada.org/

https://www.cancer.org/cancer/cancer-causes/water-fluoridation-and-cancer-risk.html

Buzalaf MA, Levy SM Fluoride intake of children: considerations for dental caries and dental fluorosis. Monogr Oral Sci.2011; 22: 1-19

Wong MC,Clarkson J,Glenny AM et al.Cochrane reviews on the benefits/risks of fluoride toothpastes.J Dent Res.2011; 90: 573-579