Thursday June 7, 2007 

Dear Dr. Mady: I recently read an article and have heard that our bodies have no use for fluoride and that it may not be all that good. Is that true and should I stop getting fluoride treatments for myself and my kids when we go to our dentist for check-ups?—Susan in St. Clair Beach


Dear Susan: Fluoride is a mineral that develops naturally in all sources of water. The element known as fluorine is where the fluoride ion comes from. It is an extremely abundant ingredient in the earth’s crust and in nature, it is never seen in it’s free state. It exists only together with other elements as a fluoride compound.

Minerals in the enamel of our teeth help to keep it strong. These minerals come and go from enamel on a daily basis. If we lose minerals, it is called demineralization and strengthening with minerals is known as remineralization. Demineralization occurs as an early stage of tooth decay from bacterial plaque build-up and the acid attack it makes on our teeth when we don’t practice good oral hygiene and for other reasons. Remineralization occurs when minerals such as fluoride, calcium, phosphate are re-deposited into our teeth through food, drinks and saliva. If a tooth becomes too demineralized beyond the point of return, no remineralization of that particular tissue can occur and a cavity results.

In answer to your question, fluoride is excellent for our teeth. It strengthens them and makes them more resistant to the acidic factors in plaque that cause caries (decay). Acid is formed when the bacteria in our mouth and in plaque breaks down carbohydrates and sugars from the foods and beverages that we eat. Fluoride also has the ability to even reverse tooth decay if it is in its very incipient or early stages.

Fluoride is provided to us in mainly two ways, systemic or topical. Systemic fluoride represents the fluoride ingested through our bodies and later becomes incorporated into our teeth. Examples of systemic fluorides are the fluoride in water, dietary fluoride (drops, lozenges or tablets) or even from some of the foods that we consume. Systemic fluoride is an excellent source because it is constantly delivered through our saliva. This is why elderly people who take numerous medications tend to be more prone to tooth decay. Many medications have the characteristic of causing dryness of the mouth, especially during sleep. If the oral cavity is dry, then there is no saliva there to wash away the bacteria or to deliver fluoride to our teeth.

Topical fluoride is the type that is applied directly to your teeth to be soaked up like a sponge. The most common topical fluoride is the one that your dentist or hygienist gives you in a foam tray or to rinse with when you have your check-ups and cleanings. Topical fluoride is also applied through toothpastes and mouthrinses. Stronger forms of topical fluoride can be prescribed by your dentist if you have a problem with rampant or constantly recurring tooth decay.

Fluoride is healthy for teeth at any age, but it is most needed between the ages of six and sixteen. The rationalization behind this is because this is the most common time for eruption of primary and permanent teeth and they need to be strengthened the most at that time. Adults benefit from fluoride also because fluoride is as important in strengthening teeth that are forming as it is in fighting and preventing decay in mature adult teeth. Adults that also benefit from fluoride are those with Sjrogen’s Syndrome (severe dry mouth), those on meds, as previously stated, individuals on radiation therapy, gum disease patients with root recession, people with many dental restorations and individuals with orthodontic braces.

I have seen patients for dental treatment both in jurisdictions where there is and is not community water fluoridation and have seen the differences in decay rates. Community water fluoridation is a safe and inexpensive method of fighting tooth decay. As a result of the great availability of this source of fluoride and many others, including topical fluoride given at your dentist’s office, decay rates in our country have significantly decreased from what they were decades ago.

I personally feel that community water fluoridation is one of the greatest public health achievements of our time. It is very unfortunate that many people, including yourself have been misinformed about fluoride and fluoridation. Fluoride is an excellent nutrient and like any nutrient, it is safe and beneficial to all of us when used appropriately.

This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5



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