Dr CDR Robert J. Peters

Questions and Answers about Fluoride CDR Robert J. Peters, DC, USN In decades past, tooth decay was for most people, a common occurrence. But over the past fifty years, tooth decay has been reduced dramatically with the introduction of fluoride into community water supplies. The positive impact of fluoride on tooth decay is widely recognized as one of the greatest achievements in the history of public health. What is fluoride and were does it come from? Fluoride comes from the element fluorine, which is the 17th most abundant element in the earth's crust. Fluorine exists only in combination with other elements as a fluoride compound. These fluoride compounds form part of the mineral make-up of rocks and soil. As water passes over these rock and soil formations, it dissolves the fluoride compounds that are present and creates fluoride ions. These ions account for the small amounts of soluble fluoride that is present in all natural water sources. How does fluoride strengthen the tooth and reduce tooth decay? Researchers have discovered that there are several ways through which fluoride aids in reducing the incidence of tooth decay. When incorporated into the tooth's outer enamel layer, it acts to strengthen the tooth so that it is more resistant to the acids produced by bacteria. These acids are responsible for causing the break down of the outer enamel surface, which we commonly know as a cavity. Fluoride also exerts it's influence directly on the bacterial plaque film, reducing the ability of plaque microorganisms to produce acid. Fluoride also acts to repair, or remineralize, tooth surfaces that have been broken down by bacterial acids. This occurs through the uptake of fluoride to restore the mineral rich outer enamel layer. This remineralization process is important because it can reverse the early stages of tooth decay. Topical and systemic fluorides are the two types of fluoride that provide this beneficial effect. What is the difference between topical and systemic fluoride? Fluoride is introduced into the human body in one of two ways, either topically or systemically. Sources of topical fluoride include toothpastes, mouth rinses and professionally applied fluoride gels and rinses. Topical fluoride application allows for the erupted teeth to be bathed in fluoride with the beneficial effect of fluoride being incorporated into the outer surface layer of the tooth. This fluoride-enriched surface gives the tooth a short termed added protection against future acid attacks. Systemic fluorides, on the other hand, are ingested into the body and become incorporated into the developing tooth structures. As this process occurs during the time of tooth development, fluoride is deposited throughout the entire outer surface, providing a longer lasting protection than those applied topically. Systemic fluorides also provide a topical effect, as the ingested fluoride is present in saliva and can become incorporated into the outer tooth surface. Sources of systemic fluoride include fluoridated municipal water supplies, fluoride supplements in the form of droplets or tablets, and fluoride that is present in some foods and beverages. Are all sources of drinking water fluoridated? Community water fluoridation has been around for about 50 years and is a process whereby your local water company adjusts the fluoride content of tap water to the recommended level for optimal health. The recommended level is between 0.7 and 1.2 parts fluoride per million units of water. At these levels, fluoridated water has been proven to reduce tooth decay in both children and adults. If you do not know if your drinking water is fluoridated, call your local water company to find out. Also, most brands of bottled water do not contain fluoride. Make sure that you read the label of ingredients to see if fluoride has been added. If you have children between the ages of 6 months - 16 years and live in an area that does not have fluoridated water, dietary fluoride supplements in the form of drops or tablets are recommended. Your local dentist or physician can prescribe the correct dosage. And one final comment, fluoride is safe and effective when consumed properly. The Centers of Disease Control and Prevention recently released a comprehensive study on fluoride and confirmed that fluoride is a safe, effective and inexpensive method of reducing tooth decay.