Fluoride has become something of a trending topic lately. If you caught any coverage of the US election, you may have heard about the Trump administration’s potential plans to remove fluoride from the public water supply (a decision criticised by many public health bodies).

In an age where we are all more conscious about what we put in our bodies, questioning whether fluoride is necessary for our dental health is a sensible question to ask.

What does fluoride do?

Fluoride is a naturally occurring chemical found in toothpaste and added to the water supply in the UK and several other countries.

It is a mineral that’s been proven to:

• Remineralise weakened tooth enamel. Fluoride binds to the softened enamel layer, making it more resistant to future acid attacks by plaque.

• Slow the loss of vital minerals within enamel

• Slow down the onset of tooth decay

The bacteria in your mouth feed on the sugar and carbohydrates in your diet and produce acids along the way. These acids destroy the minerals fortifying your tooth enamel, a process known as demineralisation.  

Fluoride plays the essential role of remineralising your enamel after these attacks.

Do your teeth need fluoride?

Modern diets are the main reason why fluoride is essential, especially when it comes to preventing cavities. Modern diets are heavily made up of sugar and acids, both of which we know to be harmful to teeth.

Our main message regarding fluoride is that unless you can guarantee that your diet contains absolutely no refined sugar, carbohydrates or acidic drinks, you need to be using fluoride toothpaste. You should be aiming to use a toothpaste that contains at least 1350ppm (parts per million). For kids aged 0–6, 1000ppm fluoride is enough.

When it comes to fluoride in your tap water, the research speaks for itself.

The presence of fluoride in tap water has been proven to:

• Reduce rates of decay in the areas it is added to

• Reduced hospital admissions and general anaesthetic procedures for kids. The main reason why children are admitted to hospital and require general anaesthetic is dental extractions due to tooth decay.

Continuous studies since the 1930s have shown that access to fluoride in drinking water is associated with a reduced level of dental decay.

Are fluoride water and fluoride toothpaste safe?

Countless studies have been conducted around the world to determine if adding low-concentration fluoride to water supplies could ever be harmful to humans.

There has never been any evidence to link the presence of fluoride in drinking water to serious health conditions, though (rare) cases of fluorosis can occur. This is when harmless white spots appear on teeth.

Fluoride toothpastes and rigorously tested to ensure safe levels of fluoride are present. Unless you were to start eating your toothpaste daily (which you absolutely shouldn’t do), using fluoride toothpaste won’t harm your health.

The ethical debate around fluoride – is it forced medication?  

There have been some debates suggesting that the addition of fluoride to the water supply could be seen as forced medication, removing an individual’s autonomy surrounding their health.

With this in mind, some points that we recommend considering would be:

• The addition of fluoride is analogous to the addition of vitamins and minerals in food (for example, vitamin D in bread and iodine in salt).

• There is no obligation to drink tap water.

• The government have a duty to legislate for the population as a whole. Fluoride has time and time again been proven to save the NHS a significant amount of money and provide an overall improvement in the health of the public. 

Of the most recent Health and Care bill (which includes legislation on water fluoridation) Dr Niger Carter of the Oral Health Foundation said:

“We believe that water fluoridation is the single most effective public health measure there is for reducing oral health inequalities and tooth decay rates, especially amongst children. We welcome these proposals and believe they represent an opportunity to take a big step forward in not only improving this generation’s oral health but those for decades to come.”

You can view the full bill on the Gov.uk website here.  

The key points to takeaway

In an ideal world, fluoride wouldn’t need to be added to the water supply or to toothpaste. However, modern diets and habits lead to such an increased risk of decay that it has become necessary to do so.

• Without fluoride toothpaste and fluoride in the water supply, the risk of premature tooth loss would significantly increase

• Only very high doses of fluoride can cause health issues (do go eating your toothpaste!)

• The benefits of fluoride greatly outweigh the negatives for the health of the public as a whole