What Fluoride is Right for You?

I received a very nice letter from Joe in Amesbury a couple of weeks ago regarding one of my columns. In addition, Joe shared some information about a fluoridation issue in Amesbury as well as what he has done to combat the problem. I would like to share some of this information as well as add some comments on community water fluoridation.
One of Joe’s concerns was Amesbury’s decision to stop fluoridating the town’s water supply due to “concern for the quality of the fluoride that was being purchased from China”. Why the fluoride was being purchased from China is a topic for a different discussion.
Because of this decision by Amesbury, Joe took the matter into his own hands. Joe says that he has been participating in the Tufts University School of Dental Medicine “geriatric” program for a while. One of the benefits of this program is a particular “kit” that is made available for purchase which includes a prescription high-fluoride toothpaste, re-mineralization paste, floss, anti-cavity mints (xylitol), and a prescription mouth rinse. I commend Joe for realizing that dental care should go beyond the basics, especially as we age.
I would bet you would think that I was a proponent of public water fluoridation given my profession. I am not. In fact, I think it is unethical, unnecessary, ineffective, unsafe, inefficient, and unscientifically promoted. Although there is not enough space in this column to go into this in depth, let me give you an example of each.
Public water fluoridation is unethical because it violates an individual’s right to informed consent to mass medication. It is okay to put substances in the public water to make it safe, but not to medicate, and especially not a heavy metal that accumulates in the body. Public water fluoridation is also unnecessary because people, including children, can have healthy teeth without being exposed to systemic fluoride. This is different than topical fluoride which I will explain at the end of this column.
Public water fluoridation is ineffective as research has shown that fluoride’s benefits are primarily topical and not systemic. Countries that have halted water fluoridation generally do not see increases in decay. It is unsafe as systemic fluoride accumulates in the pineal gland and in bones, making them more brittle. Also, where the fluoride comes from is an interesting topic of discussion.
Public water fluoridation is inefficient for many reasons, one being that more and more people drink bottled water (which is loosely regulated) and most of the public water ends up washing dishes, in the shower or watering the lawn. If ingestion of fluoride did make sense there are better ways to make it available to people who want it.
Lastly, public water fluoridation is unscientifically promoted. As stated by the US Centers for Disease Control, “Laboratory and epidemiologic research suggests that fluoride prevents dental caries predominately after eruption of the tooth into the mouth, and its actions primarily are topical for both adults and children”. I am a big proponent of topical fluoride such as the fluoride found in toothpaste. And, as we age, the decay rate often increases which is a great reason to be on a prescription level toothpaste.
You’re doing just the right thing, Joe.