The World Health Organization states “fluoridation of water supplies, where possible, is the most effective public health measure for the prevention of dental decay.” Such a compelling statement demonstrates the global impact that water fluoridation has had since its introduction in the early 20th century.
Despite this endorsement, water fluoridation remains a controversial topical in Canada. The issue has made its way into the media as cities re-examine the decision of incorporating fluoride into their water supplies. We are facing a frequent questioning of the validity of fluoridation by reasonable people wanting to be reassured that policy-makers are abreast of the current evidence on safety and efficacy of fluoridation. The dentist’s task in presenting the science is made more difficult by the extremist tactics used by anti-fluoride organizations who are not interested in an objective assessment of the evidence but rather prefer the fear-mongering that seems to work so well in politics these days.
It is indeed ironic that the beneficial effects of fluoride in drinking water were discovered while studying its negative effects on health. It was while trying to show that fluoride was responsible for unsightly brown spots on tooth surfaces, the tell-tale signs of fluorosis, that the research instead uncovered its beneficial effects in protecting tooth enamel.
This true story highlights that, like any drug, fluoride has the potential to do both good and harm. Through in-depth research fluoride has been shown to have safe and beneficial effects for the public.
In my opinion, the improvements to oral health among Canadians as a result of the high quality of care provided by dental professionals would be undermined by the removal of fluoridation from the water supply.
We encourage all of our patients to become more familiar with the evidence as there is a lot available on the Ontario Dental Association website (www.youroralhealth.ca).
This section provides answers to some of the commonly asked questions regarding the use of fluoride as a preventative oral health measure.
How Does Fluoride Work?
There are three main mechanism by which fluoride prevents caries: (1) By preventing demineralization (the loss of the mineral content of tooth structure); (2) By enhancing remineralization (the process of rebuilding and reinforcing tooth structure); and (3) By interfering with the ability of decay-causing bacteria to form acid.
Fluoride becomes incorporated into the tooth structure and is more resistant to acid demineralization by bacterial acids when compared to calcium. Fluoride also attracts calcium and phosphates to the tooth surface, promoting remineralization and is therefore more resistant to demineralization. Additionally, fluoride directly inhibits bacterial enzymes from creating the acid that is responsible for tooth decay.
How is Fluoride Delivered?
Mass delivery through water fluoridation programs, in-office preparations and at-home regimens are the most common methods by which fluoride is delivered to the general population.
In our dental office, we provide fluoride gels, foams and varnishes as topical fluoride treatment and prevention of dental disease. Daily home use of fluoride toothpastes and mouth-rinses are a main delivery method for fluoride, and its widespread use has largely contributed to the general decline of dental decay.
What are the Effects of Fluoride?
Excessive fluoride ingested during tooth formation can cause permanent weakening and discolouration of the tooth enamel. Thankfully, extensive research has determined the ideal concentration of fluoride in public drinking water to exploit its benefits without placing the population at risk of developing any side-effects of water fluoridation. It is, however, very important to understand that young children who do not have the ability to spit should only use non-fluoridated toothpastes. By age 6-7, most children are able to spit and therefore we recommend the switch to using a pea-sized amount of fluoride toothpaste when brushing their teeth.
At Westmount Dental we often provide fluoride gels, foams and varnishes as a component of our preventive care program to lower the risk of developing decay and to treat tooth hypersensitivity.