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FLUORIDE TOOTHPASTE: Harmful or Helpful?

How many times did you hear people say that Fluoride-based toothpaste is dangerous to your health? 

People are becoming more conscious about their health nowadays. Shoppers are slowly shifting into a more healthy lifestyle. Consumer behavior has changed over the years and they start to pay attention to details that matter: nutritional facts and ingredients. Their choices are now influenced with labels like “natural” or “organic”.

This controversial topic stirs a lot of heat among dentists and patients. But, is Fluoride really toxic?

Over 400 years ago, the first dentifrice in which toothpaste originated was in ancient Egypt. A paste mixture was discovered consisting of green lead, verdigris and incense and was first used to clean teeth. 

What is Fluoride?

Fluoride is a mineral that is found in all natural water sources. It can help prevent tooth decay, which is why it’s added to many brands of toothpastes and, in some areas, to the water supply through a process called fluoridation. 

What is the active ingredient in toothpastes?

Fluoride is the most popular active ingredient in toothpastes to prevent cavities. It can be sourced from animals, plants and other natural sources. Fluoride concentration and requirement depends on the patient’s age. A range of toothpastes are available containing different levels of fluoride. The amount of fluoride in the toothpaste can be seen on the side of the tube and is measured in parts per million (ppm). Toothpaste containing 1,350 to 1,500 ppm fluoride are known to be effective against cavities.

What is the correct Fluoride concentration?

Children under 3 years old

Children under 3 years old already has complete set of temporary teeth. Therefore, they are advised to brush their teeth twice a day with fluoride toothpaste containing at least 1, 000ppm.

Children between 3 to 6 years old

Children in this stage already has mixed set of teeth. Meaning they have a combination of temporary and permanent teeth. They should brush at least twice a day with a pea-sized toothpaste of more than 1,000ppm of fluoride.

Adults

Should brush every after meal or at least 2 times a day with fluoride toothpaste containing 1,350 to 1,500 ppm.

What are other fluoride treatments?

Fluoride mouth rinses

Fluoride mouth rinses has been used in some school-based programmers to prevent tooth decay. Mouthrinse needs to be used regularly for it to be effective and is safe for both adults and children. The American Dental Association recommends rinsing 1 to 2 minutes a day with less concentrated solution, or once a week or once every two weeks with a more concentrated solution. A research done by Cochrane Oral Health concludes that the regular use of fluoride mouthrinse results in large reduction in tooth decay in children’s permanent teeth.

Fluoride varnish

Fluoride varnish is a brown colored paste containing high levels of fluoride painted into the surface of the teeth every 6 months. It works by strengthening the tooth enamel, making it more resistant to decay. From the age of 3, children of all ages should have 2 fluoride treatment a year or more for those at high risk of developing cavities.

Community water fluoridation

The decision about whether to add fluoride to the water supply is regulated by local authorities.  In come countries, such as the United States and the UK , more than 5.8 million people receive fluoridated water. Fluoride has been added to their water system and it brings around 1mg of fluoride per liter of water, which is a level found to reduce tooth decay levels.

Is fluoride safe?

There have been a lot of concerns about fluoride’s link to a variety of health conditions. The risks found so far is not convincing and does not support these  concerns. 

However, a condition may arise when there is too much exposure of fluoride and is called dental fluorosis. This happens when a child’s teeth is exposed to high concentration of fluoride while the permanent teeth is developing. It may appear as a white streak in the enamel surface for mild cases and pitted or discolored in severe cases. 

What is fluoride poisoning?

Although fluoride is safe for dental health at low concentrations, sustained consumption of large amounts of fluoride salts is dangerous.

Fluoride toxicity is where there are elevated  levels of fluoride ion in the body. Sodium fluoride (NaF) is a common fluoride salt and is toxic when consumed at 5 to 10 g. It can produce gastrointestinal discomfort and interferes with bone formation . 

The most common example of fluoride poisoning arise from consumption of ground water that is abnormally fluoride-rich.

Other Sources of Fluoride 

  • Dental Products: Many dental products now contain fluoride, including over 95% of toothpaste. Studies show that a significant number of children swallow more fluoride from toothpaste alone than is recommended as a total daily ingestion.
  • Processed Beverages & Foods: Even if you don’t live in a community that adds fluoride to its water supply, you will still be exposed to fluoridated drinking water. This is because once fluoride is added en masse to water it winds in almost all processed beverages and foods. In the U.S., studies have shown that sodas, juices, sports drinks, beers, and many other processed foods, including infant foods, now have elevated fluoride levels.
  • Pesticides: Due its toxicity, fluoride is used in some pesticides to kill insects and other pests. As a result of fluoride pesticide use, some food products–particularly grape products, dried fruit, dried beans, cocoa powder, and walnuts–have high levels of fluoride. Read more.
  • Tea Drinks: Tea plants absorb fluoride from the soil. As a result, tea leaves–particularly old tea leaves–contain high levels of fluoride. Brewed black tea averages about 3 to 4 parts ppm fluoride, while commercial iced tea drinks contain between 1 and 4 ppm. As a result of these elevated levels, numerous studies have linked excessive tea consumption to a bone disease (skeletal fluorosis) caused by too much fluoride intake.
  • Fluorinated Pharmaceuticals: Many pharmaceuticals are fluorinated, meaning they contain a carbon-fluorine bond. fluorine.” Although the carbon-fluoride bond in most drugs is strong enough to resist breaking down into fluoride within the body, this is not always the case as research has found that some fluorinated drugs, including cipro, do break down into fluoride and can thus be a major source of fluoride exposure for some individuals.
  • Mechanically Deboned Meat: Foods made with mechanically separated meat (e.g., chicken fingers, nuggets, etc), contain elevated levels of fluoride due to the contamination from bone particles that occurs during the mechanical deboning processed. Mechanically processed chicken meats have the highest levels, with chicken sticks containing an average of 3.6 ppm. Read more
  • Teflon Pans: Cooking food, or boiling water, in teflon pans may increase the fluoride content of food. In one study, it was found that boiling water in a teflon pan for just 15 minutes added an additional 2 ppm of fluoride to the water, thus bringing the final concentration to 3 ppm. Read more (Full & Parkins 1975).
  • Workplace Exposure: Fluoride is a common air contaminant in industrial workplaces. As a result, workers in many heavy industries — including the aluminum, fertilizer, iron, oil refining, semi-conductor, and steel industries — can be routinely exposed to high levels of fluoride exposure. In addition to being a significant risk factor for respiratory disease; airborne fluorides can be a huge daily source fluoride intake.

 

Do you need fluoride in your toothpaste?

The answer is yes. According to Dr David Okano, a periodontist for 30 years and currently an assistant professor at the University of Utah School of Dentistry, “Fluoride is the only mineral that can effectively prevent tooth decay”.

There are a lot of budding natural products advertised and seen in toothpaste aisle nowadays. Unfortunately, most of them does not contain fluoride. Brushing with non-fluoride toothpaste results to a fresher mouth without any benefit against tooth decay. This means that even though you scrub off plaque with toothbrush everyday you will still get cavities. 

Fluoride reduces the demineralization process of enamel which is the first stage of tooth decay. In addition, if you have a first stage tooth decay that is not yet full blown, fluoride can be taken up into the demineralized area to help the tooth remineralize. To explain it in the most simplest form, fluoride helps repair damaged enamel and stops progression of cavities. 

For example, if two people with established oral hygiene comes to the clinic, we can expect more carious activity in a person who omits fluoride in his toothpaste. 

Topical fluoride used for brushing is far from harmful and is safe for daily use. You can check how much fluoride your toothpaste has by checking the back of the tube.  At the time of this writing, there has not been any other proven way yet to prevent tooth decay other than fluoride. 

Reference : https://fluoridealert.org

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