As a child, one of the things I hated most was cleaning my teeth. My family still love to tease me about my oral hygiene and remind me how slack I was. The thing is, I am having the last laugh with a completely cavity-free set of teeth at the age of 35.
Given my lack of consistent brushing all those years ago, one of the only things I can connect my good fortune with, is fluoridated water. I have always used tap water in favour of bottled water, and growing up we drank from the tap a lot. Could it be the water that has kept my mouth healthy all this time?
With the latest influx of natural, organic and chemical-free health and beauty products hitting the shelves, I’ve been curious to know why some people opt for a fluoride-free toothpaste and whether going fluoride-free could be detrimental to the health of my teeth and gums. I want to avoid the dentist’s drill at all costs, so I started doing some research.
The Fluoride-free Argument
I had never thought about going fluoride-free so I was surprised to learn that it was even a choice you could make. I was very curious to know why someone might opt for a fluoride-free toothpaste. One of the main reasons might not even be about oral health, but instead, the use of cruelty free brands. Fluoride-free brands are more likely not to test on animals.
Even though fluoride inhibits bacteria’s ability to produce acids that weaken teeth, and remineralises areas where acid damage has already occurred, it’s still a toxin. Overdosing on fluoride can actually cause a type of tooth decay called dental fluorosis, and some studies have noted possible links to osteoporosis, thyroid problems, endocrine problems and cancers. Back in the 50s fluoride was actually used to treat hyperthyroidism, because it is thought to bring the function of the thyroid down. A high enough dose of fluoride, ie ingesting half a tube of toothpaste, could even prove fatal for a young child. Probably the most compelling piece of evidence against the use of fluoride is that instances of tooth decay seem to be dropping at a steady rate, whether or not the area has fluoridated water or not. In 2001 a study conducted by the US Centre for Disease Control stated that increased amounts of fluoride in tooth enamel did not equate to lower rates of cavities.
With fluoride being added to drinking water in many countries around the world, people who have concerns about the health risks of ingesting fluoride may have a hard time avoiding it. People who wish to limit or eliminate their intake of fluoride argue that adding fluoride to drinking water is ‘mass medication.’ Fluoride is not an essential mineral to the body, it’s not added to any multivitamins for example, so aside from its effects on plaque and tooth enamel, it doesn’t have any other benefits. If you want to limit your intake of fluoride in a country with fluoridated water, you would have to use bottled water for all of your drinking, cooking and teeth cleaning. Carbon filters such as Pura Tap and Brita, do not remove fluoride.
Using a fluoride-free toothpaste is another measure to limit the intake of fluoride. Fluoride-free toothpastes are often free of sodium laureth sulfate as well, which is a detergent and foaming agent known to cause skin irritation and often avoided by people who prefer plant based skincare. Instead these toothpastes use gentle abrasives like salt and bi-carb soda, xylitol and sorbitol which neutralises acid in the mouth and helps to stop bacteria from sticking to teeth, and essential oils (peppermint, spearmint etc.) for freshening the breath.
The Argument for Fluoride
There is little doubt that most dentists and oral heath care professionals recommend fluoride as a way to maintain healthy teeth. Fluoride is a naturally occurring mineral and is actually present in water already, the amount is artificially raised in some countries to optimum levels for protecting tooth enamel. When children eat or drink fluoride in small doses, it enters the bloodstream and becomes part of their developing permanent teeth. Fluoride toothpastes and treatments strengthen teeth from the outside and speed up remineralisation. Also, most importantly, acids are less able to damage tooth enamel strengthened by fluoride.
Back in medieval times, when sugar was not widely available, cavities in teeth were rarely seen. In fact, skulls that have been found by archaeologists from that time, where most people ate an entirely grain based diet, often have a full set of healthy teeth. The introduction of sugar had a negative impact on oral health and the discovery of the effects of fluoride on teeth, have made a huge difference worldwide. Fluoride is particularly effective as a preventative to acid attacks and has shown to be beneficial to the forming adult teeth in children.
Over the last few years there has been research into the effects of fluoride being added to water and some speculation as to how effective it actually is in preventing cavities, however there seems to be little doubt that fluoride does have a positive impact when supporting forming teeth in children and when used in toothpaste and fluoride treatments. Anecdotal evidence suggests that children who drink bottled water in favour of tap water, or who use natural toothpastes, have more cavities than children who ingest and apply fluoride topically. Dentists and dental therapists are the ones who see the effects of fluoride every day, and they are certainly still recommending its use.
Although tooth decay seems to be on the decline, even in areas where the water does not have added fluoride, it has been proven that overall oral hygiene is better in areas where natural water fluoridation is higher.
When I first started researching this fluoride-free toothpastes, I reached out to a Dental Therapist for her thoughts, and she is firmly on the fluoride side. I trust her advice as she works with children’s teeth every day and sees first-hand the effects of including, and not including, fluoride via water and oral care products.
But then I saw that the World Health Organisation has reported that millions of people around the world are suffering from side effects of ingesting too much fluoride through high levels in natural water sources. Over 10 million people in China are thought to suffer from skeletal fluorosis. Along with recent studies suggesting that fluoride is not as helpful as originally thought at reducing cavities, it is concerning to me. The US Department of Health and the US Environmental Protection Agency announced in January 2011 that they would like to set the recommended level of fluoride at the lowest end of the optimal range to prevent tooth decay, and to me, that seems like the most reasonable option for artificially fluoridated water.
I have learned a lot about fluoride and fluoridated water and I am definitely thankful to live in country where the levels of fluoride in drinking water (even if they are manually set) are safe.
Nici Perriam is a writer from Adelaide, Australia. Follow her on Instagram to keep up with what she is writing and reading.