Fluoride : Good or Bad?

by Dr. Nor Ashikin Mokhtar

Warnings about fluoride have been going around for a while now. You may have even received some forwarded emails about this, and wondered what it is all about.

If you think 'fluoride' sounds familiar, it is because you see the word every time you brush your teeth – it is right there on your tube of toothpaste.

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Fluoride is a mineral that occurs naturally in water and certain types of foods. In some places, it is also added to water and dental products like toothpaste and mouth rinses to protect against tooth decay.

So is fluoride really beneficial or is it a toxic additive? Here are both sides of the story.

The Good

According to the American Academy of Pediatric Dentistry, fluoride helps to prevent tooth decay when used in small amounts on a routine basis. It encourages 'remineralisation', a strengthening of weak areas on the teeth. These spots are the beginning of cavity formation.

On the Academy's website, it is stated that fluoride has been documented to be safe and highly effective. Research indicates water fluoridation, the most cost effective method, has decreased the decay rate by over 50%.

Since 1972, the Malaysian government has used the fluoridation of public water supplies as a primary caries prevention programme. According to the Ministry of Health, community water fluoridation is the safest and most cost-effective method of reducing dental decay, and about 60% of the Malaysian population benefit from this public health measure.

However, the Academy acknowledges the danger of too much fluoride, particularly for children. Only small amounts of fluoride are necessary for dental protection, but it can be easy to exceed those safe levels if people consume fluoridated water supply, as well as use fluoridated dental products.

The Bad

Anti-fluoride activists claim that there is still no scientific evidence that fluoride stops tooth decay. There is also no evidence to show the effects of long-term fluoridation on the body, especially the effects of fluoride accumulation over many years.

Excessive fluoride is believed to cause chronic skeletal fluorosis, a condition that can cause bones to become weak and brittle. It is often claimed that it can cause dental fluorosis in children, which is a discoloration of teeth caused by ingestion of excess fluoride during childhood.

Anti-fluoride campaigners have also pointed to isolated studies and anecdotal evidence indicating that exposure to fluoride may be linked to thyroid problems, bone cancers, and hip fractures. Other conditions that have also been linked to excessive fluoride include kidney problems, arthritis, genetic damage and birth defects, and premature ageing.

Without conclusive evidence to back up these claims, it is difficult to pinpoint fluoride as the cause of this wide range of conditions.

The Safe Course

While the pro- and anti-fluoride campaigners fight it out, parents are wondering what is the right amount of fluoride for their children or for pregnant mothers.

The best thing to do is to keep fluoride levels as minimal as possible, especially if you are pregnant. Children, in particular, should not swallow fluoridated toothpaste. Parents should supervise the use of toothpaste carefully so that only a pea-sized amount is used.

Some children's toothpaste come in flavours to encourage brushing, but be aware that this could also encourage them to eat it! So look for 'low-dose' toothpaste or non-fluoridated toothpaste when shopping, and do not leave toothpaste around where very young children can reach them.

If you or your child uses a fluoridated toothpaste, steer clear of other products, such as mouthwashes, that contain fluoride.

Get advice from your dentist or doctor about other methods of oral hygiene to help prevent dental caries.

More info on FLUORIDE here.

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