Everyone was shocked to hear that CPW removed fluoride from our drinking water about a year ago without informing the public. I always encourage patients to drink water, especially fluoridated water to prevent decay. Not being made aware of the removal of fluoride was very troubling.
In this blog, I will not address the politics of removing the fluoride. My medical and dental colleagues are not in favor of this, and I do not believe CPW has done a very good job justifying the removal of fluoride.
With that being said, I would like to explain how fluoride prevents cavities. Cavities are caused by bacteria that produce acid. The acid dissolves the enamel (outer layer of the tooth) and makes its way into the softer live part of the tooth (dentin). If left untreated it eventually makes its way into the innermost part of the tooth (pulp). Once bacteria have reached the pulp you have two choices, a root canal or an extraction.
Many years ago, scientists discovered that people who were exposed to water with naturally occurring fluoride had very little dental decay. Through studies, a therapeutic concentration of fluoride was worked out and we started water fluoridation. This made such a dramatic effect in reducing dental decay, that the CDC recognized water fluoridation as one of the 10 great public health achievements of the 20th century!
What does the fluoride do? Teeth begin developing in the jaws at birth and before they erupt much of the tooth has already formed. It is during this time when the tooth is developing that the fluoride does its magic. The fluoride becomes part of the tooth. The fluoride makes the tooth more resistant to the acid. Fluoride makes the tooth harder.
Fluoride toothpaste, rinses and drinking fluoridated water after the teeth have developed has less effect on cavity reduction. The ingestion of fluoride, in the proper amount, during tooth development, gives the maximum benefit. Most real scientific studies say that fluoridation reduces cavities by 25%. I personally believe it is much higher in patients that actually consume water instead of Coke. In 25 years of practicing I have seen many 12-year-old patients that have never been to the dentist and have zero cavities.
I find it ironic that the generation that has benefited the most from fluoride is denying our children the same benefit. It seems we have not learned from history and I predict we will see a large increase in dental decay in a few years. This will complicate Orthodontic treatment as teeth will be lost prematurely and patients will be more prone to decay during treatment. It is going to take the medical and dental providers time to come up to speed with prescribing fluoride supplements and treating this type of decay. Most doctors practicing today, including myself, were not around prior to water fluoridation. Ask your grandparents about dentistry in the 50’s and 60’s. If you have concerns about water fluoridation, I urge you to speak with CPW and your dentist.
For more information on fluoridation please visit https://www.cdc.gov/fluoridation/index.html
Thanks for reading!
Dr. Ernest McCallum