Recent news surrounding mineral fluoride in drinking water has been making headlines. To cut through the noise, we turned to the experts to break down what fluoride is, how it works and whether it’s safe.
Featured Experts
- Husam Almunajed, DDS is a cosmetic dentist based in New York
- Irene Grafman, DDS is a cosmetic dentist based in New York
What Is Fluoride?
Fluoride is a naturally occurring mineral found in water and some foods.
What Does Fluoride Do for Teeth?
“To prevent tooth decay and cavities, this mineral strengthens the tooth enamel (the outermost layer of teeth), making it more resistant to breaking down caused by bacteria in the mouth,” explains New York cosmetic dentist Husam Almunajed, DDS. “In addition, fluoride prevents tooth decay by inhibiting the activity of bacteria in dental plaque, reducing their ability to produce acid from sugars, which prevents the breaking down of the enamel.”
If tooth decay is caught early enough, fluoride can even reverse a forming cavity by remineralizing teeth. After it was added to public drinking water in the 1940s to curb tooth decay in children, we saw fewer cavities.
“Studies show that water fluoridation reduces tooth decay by 25% in children and adults by strengthening enamel and preventing cavities,” Dr. Almunajed adds. “This widespread introduction of fluoride in water contributed to a marked decline in dental caries (cavities) in the U.S. population.”
Do Dentists Still Use Fluoride?
“These days, fluoride treatments are all custom-planned for our patients,” Dr. Almunajed explains. “Some people are more prone to getting cavities – whether it is lifestyle, diet, genetics, and their oral hygiene habits. So, the fluoride treatments, amounts and quantities are all custom-tailored to our patients. Whether it is having treatments at the office, at home, using an over-the-counter toothpaste, or having a prescription grade toothpaste that delivers a higher treatment level of fluoride, these available treatments are all used at different levels and doses depending on the patient.”
New York cosmetic dentist Irene Grafman, DDS explains that her practice uses fluoride sparingly. “I use it topically,” Dr. Grafman says. “It’s used in a varnish that I apply to the surface of teeth, providing the benefits of fluoride without having to actually ingest it.
What Level of Fluoride Is Dangerous?
High levels of fluoride are considered toxic. In 1986, guidelines from the U.S. Environmental Protection Agency (EPA) established a maximum allowable concentration of 4.0 mg/L fluoride in public drinking water systems to prevent adverse health effects. Most of our water has levels around 0.7 mg/L.
According to the ADA, a 155-pounf man would have to drink about 120 gallons of fluoridated water to reach the acute toxicity, which is 5 mg/kg of body weight.
“Some groups have raised concerns about potential health risks, such as links to bone health or neurological effects,” explains Dr. Almunajed. “However, extensive research by reputable organizations like the CDC, WHO, and American Dental Association has found no credible evidence of harm when fluoride is used at recommended levels.”
“Toxicity is related to dose,” explains the American Dental Association’s page on flouridation. “While large doses of fluoride could be toxic, it is important to recognize the difference between the effect of a massive dose of an extremely high level of fluoride versus the fluoride level currently recommended for public water systems. Like many common substances essential to life and good health—salt, iron, vitamins A and D, chlorine, oxygen and even water itself—fluoride can be toxic in massive quantities.”
That said, there are dentists that prefer to err on the side of caution. “We have other ways to ensure dental health at this time,” explains Dr. Grafman. “If you are concerned about the impact of this mineral on the body, I think you can achieve the same level of oral health without this mineral under the guidance of a qualified dentist.”
Should We Get Rid of Fluoridated Water?
Currently, the ADA does not recommend any change regarding the level of fluoride in our water or in our dental health products.
