Experts Cut Through the Confusion: Is Fluoride Harmful or Helpful?

Fluoride is a dental care mainstay, whether or not it’s delivered in your toothpaste or a treatment at your dentist’s office. However, over the past few years, it has become the focus of numerous conspiracy theories that raise questions about its use. Although some allege fluoride is harmful, others maintain it is a valuable tool for good dental health. 

But who is right?

Fluoride has been a longtime focus of numerous conspiracy theories over the past several years and has raised questions about its use. Numerous individuals allege fluoride is harmful, but others maintain it’s an effective tool for good dental health. Who is correct? 

What should you know about fluoride and the misinformation encircling it?

What’s fluoride?

Fluoride is an element naturally found in oceans, rivers, and lakes, along with some drinks and foods, according to the American Dental Association (ADA). “It is also added to public water supplies,” said Dr. Michael Kosdon, a dentist at Smiles of NYC. Fluoride is known as ‘nature’s cavity fighter,” stated the ADA. It is often added to dental products — like toothpaste — to protect teeth from cavities.

What does fluoride do?

According to Rebecca Henderson, an associate professor at The Ohio State University College of Dentistry, “Teeth, like bones in our body, are composed of minerals — primarily calcium and phosphate.” 

According to Henderson, bacteria feed on the refined carbohydrates they consume and produce an acid byproduct in the mouth when someone has cavities.

“This acid removes minerals from our teeth, breaking down layers of tooth structure and eventually leading to a hold or a cavity in the tooth surface,” said Henderson. “Fluoride helps to strengthen the tooth surfaces by returning and preserving the lost minerals in our tooth, preventing a cavity from forming.”

According to research, adding fluoride to water reduces the amount of tooth decay in younger children by 35%.

Is fluoride harmful?

According to experts, fluoride is beneficial. The Centers for Disease Control and Prevention (CDC) said it is considered “one of 10 great public health achievements of the 20th century” because of its ability to prevent tooth decay.

But too much fluoride can cause fluorosis, “which presents as white streaks or blotchy white patches on the enamel,” says Kosdon. “These chalky areas are known as decalcified enamel and [in severe cases] are much weaker and prone to cavities.”

In most cases, fluorosis isn’t harmful to your health and is cosmetic. Per Henderson, it is more common when children use several fluoride sources over a lengthy period. That can include using and then mistakenly swallowing toothpaste that is fluoridated and taking fluoride supplements. “Having knowledge of the fluoride level in your community water system and the other amounts of fluoride your child under age 8 is ingesting is the key to preventing dental fluorosis.”

There are online claims that fluoride is poisonous. However, experts say that is a stretch. Excessive amounts of fluoride are harmful, but it remains rare. According to the ADA, you must drink five liters of water for every kilogram of body weight to have fluoride toxicity — a toxic amount of water.

It’s almost “impossible to drink enough water that contains fluoride to actually create any discoloration,” said the University of Pennsylvania School of Dental Medicine dean, Dr. Mark S. Wolff. 

According to the ADA: “Water fluoridation is safe, effective, and healthy. Seventy years of research, thousands of studies and the experience of more than 210 million Americans tell us that water fluoridation effectively prevents cavities and is safe for children and adults.”

Is there anyone who should avoid fluoride?

“I would definitely avoid fluoride in infants younger than six months,” says Kosdon. Using water that is fluorinated in baby formula can also increase the risk for mild fluorosis, said the ADA. Kosdon added that individuals with kidney disease could also need to avoid high fluoride levels.

How can you determine if you are getting the correct amount of fluoride?

According to Henderson, community drinking water systems regulate fluoride at the local and state levels. If you drink water that doesn’t come from a well, you will get at least a percentage of fluoride in your tap water.

According to the CDC, 75% of fluoride intake comes from drinking water that has added fluoride as well as from beverages and food, including fruit juices and sodas made with fluoridated water.

“For adults and children over the age of two, drinking fluoridated tap water, along with following instructions for daily use of toothpaste with fluoride, creates the best chance for the tooth to be strong enough to prevent tooth decay,” says Henderson. “For children under two, a doctor or dentist should be consulted on fluoridated toothpaste.” 

If you aren’t sure about your fluoride needs, consult your dentist for recommendations. But experts emphasize there isn’t a need to be frightened of fluoride. “Public water fluoridation is seen as one of the leading public health measures, saving millions of dollars in dental care and decay and pay in people of all ages,” said Wolff.