IN ORDER TO EARN the American Dental Association’s Seal of Acceptance, a tube of toothpaste must contain fluoride as its active ingredient. We also add trace amounts of fluoride to our drinking water across the country to help keep our teeth healthy and strong. So what’s so special about fluoride?
Our tale begins at the dawn of the 20th century in Colorado Springs. Local dentists were seeing so many cases of brown — but not decayed — teeth that they named the strange condition “Colorado brown stain.” They were observing what we now know to be fluorosis, and it was happening because of the abundance of naturally occurring fluoride in the town’s drinking water.
The residents of early-1900s Colorado Springs were clearly getting too much fluoride in their water, but dentists wanted to see if there was a level of fluoride that would help reduce cavities without staining the teeth. Happily, there was! The first town to add fluoride to its drinking water was Grand Rapids, Michigan. It brought down the rate of childhood caries by a staggering 60%, with no adverse effects aside from a few cases of mild fluorosis.
More than half of the U.S. Population enjoys the dental health benefits of fluoridated drinking water today, something the CDC considers to be one of the ten greatest public health achievements of the last century. It benefits everyone, whether they’re rich or poor, young or old, male or female. It might seem strange if you aren’t familiar with it, but it’s about the same as using iodized salt, baking with enriched flour, or drinking milk with added vitamin D.
The processes of remineralization and demineralization are happening constantly in our tooth enamel, and the goal of dental health habits is to make sure that remineralization is winning. For that, we need the raw materials to rebuild enamel, and fluoride is one of them. Brushing with fluoride toothpaste is one way to get it, but the trace amounts in our drinking water ensures an continuous supply of fluoride in our saliva.
We saw in Colorado Springs that it’s possible for fluoride to do more harm than good to teeth when the exposure level is too high. Avoiding fluoride entirely, on the other hand, leaves the teeth more vulnerable to decay. Drinking water only contains up to 1.2 parts per million of fluoride, and we should be spitting out our toothpaste after brushing and only using small amounts of it, especially for children. This is how we hit that Goldilocks zone of cavity protection without fluorosis!
If you still have questions about the fluoride in toothpaste or in drinking water, you can check sources like the ADA and the CDC, or you could ask us! We want our patients to have all the information they need to feel confident in their dental care and the value of the daily habits we encourage.
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