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To fluoride or not? Exploring the evidence

By – Bad Breath Expert
Posted: May 24, 2016, Updated: June 6, 2016
SUMMARY: There is a sizable debate about the use of fluoride in oral care. Here's everything you need to know.

There exists a debate amongst many consumers as it pertains to their ongoing oral care. One camp stands strongly behind the use of fluoride, especially in toothpaste, finding that it strengthens enamel and better protects teeth. The other group of people, meanwhile, believe that fluoride does more harm than good and can actively destroy teeth. So, then, who's right, and who needs to rethink their dental care regimen? The truth rests amid the heaps of scientific evidence and insight from highly trained professionals.

"Fluoride helps protect teeth by strengthening enamel."

Does fluoride actually work?

Dr. Andrew Weil is a long-standing proponent of integrative medicine and teaches medicine at the University of Arizona. In a column for Prevention magazine, he firmly put his money behind the use of fluoride toothpaste. In his time with patients and countless hours of research, Weil explained that fluoride has far more benefits than any perceived downsides, and it does help to improve tooth enamel and greatly reduce the risk of cavities.

And Dr. Weil isn't alone in his studies. In a 2003 review in the journal Evidence-Based Dentistry, a group of scientists reviewed 74 proceeding studies on fluoride usage. They found that through all of these studies that fluoride had been proven to greatly improve the state of teeth. That's because when ingested, the chemical actually binds with the enamel and creates a protective layer over teeth.

Do we actually need fluoride toothpaste?

Many opponents of fluoride-enriched toothpaste argue that we don't need it because drinking water in many cities has already been treated with the chemical. However, as the Campaign for Better Dental Health pointed out, Community Water Fluoridation works in tandem with fluoride toothpaste to protect teeth as effectively as possible. In fact, in many areas that aren't fluoridated, dentists will also prescribe younger patients with fluoride tablets to better strengthen teeth. The Centers for Disease Control and Prevention also looked into whether toothpaste alone was enough. The organization eventually suggested that all cities have water reserves treated with 0.7 parts per million.

Doesn't fluoride-treated water damage teeth?

The same group of people who think toothpaste should be the sole source of fluoride routinely rail against the risks of CWF. The main criticism is that water fluoridation can lead to a condition called fluorosis, in which teeth become worn down and stained a dark brown color. Some people have claimed that up to 40 percent of children have experienced fluorosis.

However, there is evidence that those figures may be exaggerated; a CDC report from November 2010 found that less than 25 percent of all people aged 6-49 in the U.S. had ever endured any degree of fluorosis. It's also worth noting many fluorosis cases are quite mild in scope, with white specks on teeth that are usually easily treated before teeth are irrevocably damaged.

In fact, in the U.S., cases of severe fluorosis are quite rare, and one 2007 study from Washington state put the numbers at around 3 percent. Following the CDC's 2011 suggestion to limit fluoride 0.7 parts per million, fluorosis cases should further drop over the next few years.

What's the final word on all things fluoride?

This chemical is a powerful way to help protect teeth, so much as it's used in the right context. If ever you're unsure about your fluoride consumption, speak to your dentist or other oral care provider.

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