There are three camps of people. There are people who relentlessly sing the praises of fluoride, people who are entirely indifferent to fluoride, and people who think that fluoride is inherently dangerous. As with most polarizing situations, the truth is somewhere in between. Fluoride may not be the most evil substance in the world, but that doesn’t mean you need it. It may be the culprit for certain illnesses, but that doesn’t mean that everyone who uses fluoride will get sick.
In order to come to an informed and unbiased conclusion about fluoride, you need to understand the risks and benefits. When you have all the information, you’ll be able to make an education decision regarding whether or not fluoride will fill a necessary role in your oral care routine.
What is Fluoride?
Fluoride comes from a naturally occurring and vastly abundant mineral called fluorine. Fluorine is in just about everything. The earth is made of fluorine. It’s in mountains, hills, boulders, soil, and even the air we breathe. It also naturally occurs in the bone and tooth material.
Fluoride compounds, like sodium fluoride, sodium monofluorophosphate, or hexafluorosilicic acid are used for oral health purposes. Sodium refers to salt. These fluorides are salts derived from the element of fluorine. They’re microscopic particles capable of penetrating the human tooth.
Foods and Drinks that Contain Fluoride
Fluorine is the 13th most ample element in the crust of the earth. Almost everything that comes from the earth contains at least trace amounts of fluoride. Every body of water contains a small amount of naturally occurring fluoride. Small amounts of fluoride naturally occur in shellfish and crustaceans that we eat. Oysters, shrimp, and crab retain enough fluoride to pass it on to humans and animals when we eat them.
Plants grown outdoors in soil tend to draw up small amounts of fluoride through their roots, leaving traces of fluoride in fruit and vegetables. Some crops, like coffee and tea, do a better job of retaining that fluoride.
Any food or drink you prepare with tap water will also contain fluoride, because small amounts of the mineral are added to the water supply as a public health measure. Dentists and regulators worked together to determine an ideal amount of fluoride to add to tap water in an attempt to improve the overall dental health of Americans.
Any time you brew coffee, make instant oatmeal, boil pasta or potatoes, or add water to the slow cooker for soup, you’re fluoridating your meal.
How Fluoride Works on Your Teeth
Fluoride works on the enamel of your teeth. Tooth enamel is made of a mixture of calcium and phosphate compounds. When bacterial disturbance or erosion begins, fluoride in your saliva will wash over your teeth and replenish mineral loss. Ideally, this process will take place in real time. Fluoride can bond with calcium and phosphate in your teeth, creating a stronger substance known as fluorapatite. Fluorapatite is strong enough to fortify teeth against decay.
Like with all great things, there’s a catch. Calcium and phosphate in your mouth work best when your oral PH is around 7. The things you eat and drink can impact the PH of your saliva, depending on how alkaline or acidic those foods are. You may not experience the benefits of ideal fluoride function if your saliva is too acidic for the necessary compounds to form.
Is Fluoride Safe?
Small amounts of fluoride are recognized as safe, and are recommended by the American Dental Association. The CDC has studied fluoride in the public water supply and has declared fluoride to be safe and effective for preventing cavities.
The bigger question is this: if the ingredient has been deemed safe by dentists and the CDC, why are so many people trying to avoid fluoride? How can fluoride possibly be safe if we know that fluoride related illness exists?
The key to using fluoride safely is moderation. Many things that are otherwise safe for us can be dangerous when present or ingested in very large amounts. Fluoride is no exception.
Even Natural Ingredients Require Moderation
Doctors press the need for people to incorporate plenty of fruits and vegetables into their diets. No one argues that eating healthy is unsafe. Beautiful, ripe fruits also have drawbacks. Peaches, cherries, apples, apricots, pears, and plums are packed with antioxidants and vitamins. They also contain small amounts of a compound that the body readily converts to cyanide, an extremely deadly poison.
Pears, bananas, onions, grapes, carrots, and spinach contain formaldehyde, the same chemical used to embalm human corpses. Most fruits containing cyanide also contain arsenic, the active ingredient in rat poison.
People cannot and should not stop eating fruits and vegetables. They’re necessary for our health. It would take vastly more than one plum or one carrot to cause poisoning - hundreds of fruits or their seeds would need to be ingested within a short period of time in order for the effects of the poison to take hold. Since we don’t grossly overeat filling fruits, chances are slim to none that we will ever encounter fruit poisoning.
Fluoride is different. Since fluoride is present in most fruits and vegetables grown from the group, tap water, and everything we prepare with tap water, it can be difficult to know how much fluoride we’ve ingested. You’d know if you ate 150 apples and their seeds. On the average day, you likely have no idea how much fluoride you’ve ingested. There’s no real way to tell if you’ve had more than enough fluoride, since it’s odorless, colorless, tasteless, and microscopic.
Like with fruit, you would need to ingest a massive amount of fluoride to experience any negative side effects. It’s slightly more possible to overload on fluoride, and it’s happened to people before. Their circumstances were likely different from yours, but they serve as living proof.
Dental Fluorosis and Skeletal Fluorosis
As we’ve established, high concentrations of fluoride live in the dirt. In countries where people don’t have access to clean drinking water straight from the tap, people rely heavily on groundwater to drink, cook with, bathe with, and clean with. Since this water hasn’t been filtered and processed to remove contaminants, this water contains as much formaldehyde as the earth sees fit.
Ingesting a lot of formaldehyde over a long period of time leads to conditions like skeletal fluorosis. Fluoride builds up in the bones, and rather than strengthening them, it weakens them. Deposits of excess fluoride will begin to calcify tendons and ligaments, severely restricting range of motion.
Skeletal fluorosis is most common in India and China, two of the most populated countries in the world. Many smaller villages depend on well water that exceeds the recommended daily limits of fluoride.
Dental fluorosis is slightly more common. As many as one in every four Americans experiences dental fluorosis. The condition is caused by ingesting too much fluoride throughout childhood, resulting in teeth with a yellow or brownish color that are unusually hard. Many children’s toothpaste manufacturers formulate their products without fluoride in an effort to prevent dental fluorosis from occurring.
Weighing The Risks and Benefits
One of the best reasons to avoid fluoridated toothpastes or mouthwashes is that you don’t know how much fluoride you’ve consumed. You may have ingested more than enough over the course of the day. You can’t watch your fluoride intake the same way you’d watch your sugar intake or count calories. You’ll never really know if you’ve had too much.
If you’re already eating fruits and vegetables that contain fluoride, drinking tap water, or preparing meals with tap water, you’re getting fluoride by other means. Since fluoride finds its way into almost everything, many people feel as though that may be enough.
Since fluoride is not the only source of reparative minerals for your teeth, using an alternative will reduce the risk of overexposure to fluoride. Some naturally occurring mineral and calcium compounds, like those found in sea coral, will serve a function similar to fluoride without putting you at risk. You also won’t inadvertently ingest more sea coral minerals in your everyday life, eliminating the possibility of overexposure.
Fluoride, like all natural things, is safe in moderation. The problem is that most people do not have the tools to measure or moderate their fluoride consumption. It may be wise to avoid using fluoridated products unless your dentist specifically recommends that you do so. He or she will be able to tell if you’re getting enough fluoride by evaluating your teeth.
If you’d rather play it safe, use an alternative remineralizing toothpaste. Fluoride free toothpastes don’t pose any risk to your health. Many people feel that switching to fluoride free dental products is a “better safe than sorry” option.
What you choose to brush your teeth with is ultimately up to you. As long as you understand what fluoride is, how it works, and what it does, you can make an educated determination.
Source 1 - cdc fluoride
Source 2 - cyanide safety in fruit
Source 2 - skeletal fluorosis