The Fluoride Question

What is Fluoride?

From a dental perspective, fluoride is an element that has been associated with strengthening the mineral of teeth.

Teeth are composed of a substance called calcium hydroxyapatite. Bone is also made of the same mineral. When fluoride comes into contact with teeth, it changes the mineral in that area to calcium fluoroapatite. Because this has a harder crystalline structure, it is more resistant to acid breakdown, and therefore more resistant to tooth decay.

Topical Fluoride

This means fluoride placed directly on the area where it is needed, such as fluoride toothpaste and the fluoride that is applied to your teeth by your dentist or dental hygienist. Topical fluoride alters the crystalline structure of the tooth at surface level. This is very effective at making the job of tooth decay much harder for oral bacteria to initiate. It is simply much more difficult for the bacterial acid to break through the outer surface of the tooth to produce a cavity. Fluoride toothpaste and professionally applied fluorides are cornerstones of modern preventive dentistry.

Systemic Fluoride

This means fluoride which is ingested, such as fluoride tablets or water fluoridation. Fluoride ingested during early childhood has the effect of allowing the teeth to be constructed, from the start, with a higher proportion of fluoroapatite compared with hydroxyapatite. So the teeth are stronger from the inside out. The problem with systemic fluoride is when there is too much: This occurs commonly with young children sucking on toothpaste tubes, using too much toothpaste, or swallowing instead of spitting. The result is a condition called dental fluorosis. The teeth are proportionately too high in fluoroapatite and the result is the cosmetic problem of mottled tooth colour.

The Water Fluoridation Debate

There is a definite divide in the world community regarding water fluoridation. Those against it cite the toxicity of fluoride and the questionable ethics of mass medication of the water supply. The opposing view is that water fluoridation has been recognised as one of the most significant health achievements of the 20th century, significantly reducing rates of tooth decay while keeping fluoride exposure below generally accepted toxic concentrations.