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Fluoride - the Good, the Bad and the Truth

Updated: Mar 16, 2023

Today's article is brought to you by Dentista Dental Centre, the place to look after your smile - your Dentist in Noranda and Dentist Morley.

The topic of fluoride has been a bit of a controversial one for many decades. Why is there fluoride in water? Should I get a fluoride water filter or a fluoride filter? Is fluoride in toothpaste good or bad? Is getting fluoride at the dentist a scam? The following article attempts to give you firstly the facts... what fluoride is, how it's formed and what it's used for in dentistry. We then go into the advantages and disadvantages of fluoride, and there can be disadvantages! Finally we ask the question... is fluoride worth the possible disadvantages to your health? Find out these questions and more in Dentistas look at fluoride.

What Is Fluoride?

What is fluoride? Fluoride is a mineral... and it is found in many things, but importantly it is found in concentration in your bones and teeth.

Many foods naturally contain the mineral fluoride, which is also available as a nutritional supplement. It is the ionic form of fluoride that slows or reverses the onset and development of tooth decay.

Fluoride may be found in the soil, fluoride in water, plants, and food. Fluoridated water, food and drink produced with fluoride in water, and paste and other dental goods constitute the majority of the fluoride individuals consume.

Common types of fluoride

Common types of fluoride include:

• sodium fluoride (NaF)

• stannous fluoride (SnF2)

Sodium fluoride. Sodium fluoride is a common fluoride salt that is used in toothpastes and mouthwashes. When together the NaF salt is neutral (no charge). NaF dissolves in water, releasing the sodium and fluoride from each other. The Sodium ion is positively charged and the Fluoride ion is negatively charged. These charges allow the sodium and fluoride to interact and bond with other molecules. The fluoride attaches itself to tooth mineral, and makes fluorapatite. Fluorapatite is much stronger and more resistant to acid than regular tooth mineral with no fluoride (hydroxyapatite).

Stannous fluoride. It is an inorganic salt and a fluoride salt, stannous fluoride. For the protection of cavities, stannous fluoride (also known as SnF) is widely found in toothpastes. It may also be used to alleviate oral hypersensitivity. It has been shown that stannous fluoride, despite its similarity to sodium fluoride, is more effective in halting and reversing dental decay than sodium fluoride. Dentists may use it to keep teeth healthy by controlling the composition of dental plaque, which helps to reduce the risk of tooth decay from developing in the first place.

Fluoride treatment at the dentist
Fluoride that is used in the dental clinic

What is Fluoride used for?

Fluoride is primarily utilised to promote oral health in the context of human health. Your water supply may include it (Australia places fluoride in water), as well as numerous over-the-counter (OTC) items, such as toothpaste.

  • fluoride toothpaste

  • mouthwash with fluoride

  • topical applications like tooth mousse

Prescription mouthwash with fluoride may help prevent cavities if you're prone to them. Fluoride concentrations in these rinses are often greater than in over-the-counter choices. It is also possible to get high fluoride toothpaste over the counter at the chemist.

Additionally, outside of human consumption, fluoride is employed:

  • in PET(Positron emission tomography) scans.

  • to remove dirt and grime

  • the use of insecticides

  • manufacturing steel, aluminum and Teflon goods

What are the benefits of fluoride

In Australia, Public water sources have fluoride in water. and commonly toothpaste and mouthwash include fluoride as a preventative measure against tooth decay.

Among fluoride's advantages are the following:

Fluoride Protects your Teeth

For many, fluoride treatments are recognised for their ability to preserve a patient's tooth enamel. The enamel on your tooth might erode if you drink acidic substances often. Teeth become increasingly sensitive to common activities like drinking warm, heated, or cold beverages when the enamel wears away. There are several fruit juices with high acid content. Some of the most well-known ones include lemonade or lemonade soda and a variety of tomato, grape, orange, and apple juices. Having teeth that are exceptionally sensitive might cause discomfort at any time. You may minimise the sensitivity of your teeth by brushing with fluoride toothpaste and having fluoride treatments at the dentist clinic. Using fluoride may help protect teeth and enamel against acids and bacteria that cause them. Fluoride, in particular, protects the enamel against deterioration, hence lowering the sensitivity of teeth. So this is one reason that fluoride is good for teeth.

Fluoride foam dental clinic
Fluoride that is used in the dental clinic comes in a foam

Fluoride Puts Minerals Back In Your Teeth

Your teeth are damaged by acid in more ways than one. In addition, the minerals that make up your teeth are destroyed, causing the structure of your teeth to crumble. Calcium and phosphate, two minerals, are essential for strong teeth. Teeth become weak and damaged as a result of acid erosion of the enamel. Teeth loss may lead to serious health issues, such as tooth decay and gum disease.

Fluoride works by replenishing your teeth's mineral content. Known as remineralization, it is a process that aids in the restoration of injured teeth. Maintaining strong, healthy teeth requires remineralization! This means the teeth's calcium and phosphorus levels are restored when fluoride is used.

Fluoride Prevents Tooth Decay and Cavities

Everyone has bacteria in their mouth. Bacteria are able to make acid by consuming carbohydrates and starches, and this acid damages the enamel. When fluoride treatments aren't used to counteract this process, the acid starts to erode your teeth. Dental deterioration and cavities may be treated with fluoride. A point here for fluoride good for teeth.

You're far less likely to have cavities or tooth decay if you use fluoridated toothpaste and get regular fluoride treatments. When compared to groups that don't use some type of fluoride treatment, studies show that there is a 25% in reductions of cavities! (see a review study from the NIH). It's crucial to keep in mind that dental decay and cavities impact adults as well as youngsters. As a result, getting fluoride treatments on a regular basis should be a top priority for everyone concerned about tooth decay. Community water systems may also include fluoride. Everyone in the family can benefit from fluoride in water.

Fluoride can Save you Money

The expense of dental work is well-known. In the long term, fluoride treatment is the greatest approach to save money. Fluoride is given directly to your teeth's enamel using topical fluorides. Fluoride paste, fluoride mouthwash, tooth mousse and dental office treatments may be used to accomplish this. Fluoride treatments are commonplace during dental cleanings and are usually mostly covered through private health insurance. Value for money in terms of protective effect, it's hard to argue that there bang for your buck than the fluoride treatment that is offered to patients after their scale and clean.

Fluorides that are ingested are known as systemic fluorides. When a community has a fluoride water supply, this treatment may be completed simply with a glass of fluoride water. Dietary fluoride supplements are another way to provide fluorides to the body. This is not needed however in Australia which has fluoride in water.

The best approach to keep your teeth healthy and avoid costly dental operations is to utilise both types of fluoride treatments.

Disadvantage of Fluoride

Fluoride has had many controversies associated with it. Although touted as a miracle of public health, there are some reasons people are a bit dubious about fluoride. For starters, fluoride in water originally in the United States, actually came through as a by- product of fertilizer! The historian Frank Zelko stated that it was conveniently a ‘profitable way to put the use of a waste by-product from the production of fertiliser’ into public water. Unlike pharmaceutical grade fluoride in your toothpaste, the fluoride in water, in the United States at least, is actually untreated industrial waste.

The map below shows the world and those countries which have fluoride in the tap water. Credit for the map is linked by clicking the map. Check out the current maps of Fluoride in water Australia to see when was fluoride added to water Australia.

So as the map shows, really only Australia, Ireland, Singapore, Brazil and the USA put fluoride in water. The majority of Europe however, have chosen to have fluoride free water. The interesting thing to note is that whether there has been fluoride in water or not... the result to caries or dental cavities has declined the same in countries whether they have or haven't used fluoride in water! So there could be an argument that the fluoride in water in terms of dental health has really not been necessary. Does that mean however that you should go out and purchase a fluoride water filter? The vast history of fluoride in water and the lack of any evidence showing that fluoride in water is harming your health however, simply is not there. From this can we state that fluoride in any quantity (ie in tooth paste or at the dental clinic) is safe?

It's crucial to keep in mind that although modest amounts of fluoride are good for teeth, high quantities of fluoride are bad for health with conditions occurring such as fluorosis (the condition of having too much fluoride in the body). White spots on teeth, a mottled enamel, and inadequate mineralization are all symptoms of dental fluorosis. Fluorosis is most often seen in children under the age of ten who have been exposed to excessive amounts of fluoride. Fluorosis is more likely to occur in children between the ages of six and nine, while their teeth are still developing. Thus high quantities of fluoride is bad for kids. As a result, parents and caregivers should take precautions to limit the fluoride-related risks.

Fluorosis-Related Health Issues - Fluoride Side Effects:

Skeletal Fluorosis

Exposure to excessive quantities of fluoride may induce skeletal fluorosis, a condition that affects the bones. Bones become harder and less pliable as a result of this condition, increasing the risk of fractures. The thickening and build-up of bone tissue may also impede joint mobility as a result of the condition, so excessive quantities of fluoride is bad for bones.

Fluoride and Thyroid

The thyroid gland may be damaged by excessive fluoride exposure, leading to an overactive production of parathyroid hormones. Hyperparathyroidism is the medical term for this illness. Deficiency of calcium in bones leads to abnormally high quantities of calcium in the bloodstream.

Neurological Problems

Fluoride exposure prior to birth has been linked to a decrease in a child's cognitive ability. According to a study released in 2017, high levels of fluoride were associated with lower IQ scores. As a neurotoxin, fluoride poses a risk to a child's growth and development, as well.

Fluoride and Pineal Gland

It is possible for the pineal gland to also develop calcium spots as discussed earlier with respect to fluorosis. Fluoride in water, along with pesticides actually accumulates the most in the pineal gland compared to any other part of the body. Thus there is a link between fluoride and pineal gland. The question again is is this coming and being significant from fluoride in water?

How Much Fluoride Should be Given to People:

Fluoride is measured as parts per million (PPM). Currently in Australia the following is considered safe and effective for cavity prevention.

Children to the age of 3 -1000 parts per million

Above the age of 3 - 1350 - 1500 parts per million

In Australia the average toothpaste contains between 1000ppm - 1500ppm. This is deemed as healthy and no risk. Still it is advised that you do not swallow toothpaste. Swallowing this amount of fluoride on a daily or even twice daily basis can lead possibly to fluorosis.

How much fluoride is in the water in Australia? 1.5 parts per million (note the minuscule amount compared to the amount of fluoride in toothpaste)

Topical Fluoride

Most of the dental ways we get our fluoride from are through topical fluoride. The advantage of this is that we don't ingest the fluoride and thus can avoid most of the potential disadvantages of fluoride treatment. The other advantage of this is that we can use much higher doses of fluoride to help with the benefits for teeth. Typical Fluoride treatments include

  • fluoride toothpaste or high fluoride toothpaste

  • Dental clinic application of fluoride

  • tooth mousse application

Fluoride Toothpaste

The one we all know and have probably used all of our lives. Whilst they vary in strength of fluoride, the average toothpaste in Australia has approximately between 1000ppm and 5000ppm. for the high fluoride toothpaste, there are over the counter or even prescription high fluoride toothpaste. These can be dangerous for children due to the risk of fluorosis if swallowed.

Dental Clinic Application of Fluoride

Most dental clinics such as Dentista use a moose application of fluoride. Typically this is added after a scale and clean when your teeth have been cleaned and are able to best absorb the fluoride. Dental moose for in chair fluoride treatment as an average in Australia delivers

Tooth Mousse Application

Tooth mousse is a way for you as a consumer to purchase a stronger fluoride treatment for your teeth, and do so in a topical way in the comfort of your own home. Tooth moose contains approximately 900ppm level of fluoride. Tooth Mousse can be swallowed without too much concern at this level. Remember that we don't just take tooth mousse solely for fluoride, it also has 2 important minerals for teeth, namely calcium and phosphorous.

Tooth mousse as an additional preventative to strengthen teeth
Tooth Mousse is Applied Topically after you Brush your Teeth

Prevention of Fluorosis

Many disorders, including fluorosis, may be avoided by ensuring not too much fluoride is ingested (swallowed). Because ingested toothpaste adds to a child's fluoride intake, parents must take care that their children do not swallow toothpaste during brushing. It's recommended young children that cannot spit use tooth paste with no fluoride. A low fluoride tooth paste (less than 500ppm) is used until about 6 years of age.

There is no need to take fluoride tablets that are swallowed. The beneficial action of Fluoride is topical (i.e. touching the teeth). If you take fluoride tablets while your teeth are still forming under the gum the excessive fluoride can be taken up into the growing enamel. This can cause fluorosis which is white or brown mottling to the enamel.

Fluoride poisoning may be reduced by monitoring the fluoride content of drinking water, particularly if you have small children. Private well owners should get their water tested for fluoride levels at least once a year. Dentists suggest 0.7- 1.5 fluoride per million water units for optimal dental health.

In the end, fluoride is a vital part of the body's ecosystem, but there is a limit, as there is with other things.

fluoride treatment at the dentist
Dr Carla demonstrates how fluoride foam is placed on the teeth. It is important not to swallow the foam due to the high fluoride content

How to remove Fluoride from water

How do you remove fluoride in water? Does boiling water remove fluoride? Is this effective or do you require a fluoride water filter?

Firstly does boiling water remove fluoride? The answer to this is NO. In fact boiling water will actually increase the fluoride content of water. The reason for this is that fluoride won't evaporate as easily as some other substances.. and thus the concentration of fluoride will increase.

ok fine, so then do water filters remove fluoride? Well again, the answer to this is mostly NO. The cheaper carbon filters will not remove fluoride from water. Fluoride filtration is needed in the 0.0001 microns range and requires a pretty significant filter to remove it... remember that 1 millimetre is equal to 1000 microns.

how to remove fluoride from water. how to remove fluoride in water.

If you would like to check out some reverse osmosis water filters that will remove fluoride in water, check ou the link water filter fluoride Australia

Should I ge toothpaste without fluoride? What a non fluoride toothpaste like and do they have any benefit? Fluoride free toothpaste Australia.

water filters that remove fluoride and chlorine australia. fluoride filter.

Conclusion on Fluoride

The general health and cavity level of teeth has improved drastically since the wide spread implementation in the world of fluoride. There is no question that most of the general adult population should be using fluoride treatment when they brush their teeth in the form of fluoride toothpaste, a fluoride mouthwash or tooth mousse. Also essential and one that will cost you very little if you have private health insurance, is to get a fluoride treatment at the dentist when you get your twice yearly check up. These actions will help prevent cavities and improve the overall health of your teeth.

Where waters start to get murky (pardon the pun) is when you go from putting the fluoride on topically to your teeth, to drinking the fluoride in water. All research that has currently been done and a sample size in the hundreds of millions, over decades has shown that the very small amount of fluoride in water that is present in the tap water, does not do any harm to your long term health. Does it do any good though? That is not an easy question to answer, but as we saw in the map and comparison between countries that do and don't have fluoride in water... the results and decline in cavities have been the same. Therefore we must conclude that any benefit of fluoride in water that has been added is very minimal, but at the same time won't do you any harm. We will leave it to you to decide whether you you decide to get a fluoride water filter or remove the fluoride in water by other means. We do not recommend however using a toothpaste without fluoride or not using fluoride in general. There is too great an evidence base with too great a sample size over too great a time period to try to argue that fluoride treatment has not improved the dental health of the vast majority of the world.

Book in your fluoride treatment when you next visit the dentist... it's safe and will help protect your teeth for years to come. If you live in Perth, consider your next check up and clean with the team from Dentista Dental. We will gladly explain anything else you might like an explanation for and have a team with over 50 years experience in the field of dentistry. We operate in the areas of Morley and Noranda and surrounding suburbs. Dentista Dental Centre - where we look after your smile one tooth at a time!

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