Is Fluoride Good or Bad?


Fluoride. 


One of the heavily debated topics of dentistry. 
I have read a lot of information on both sides of the story. I'll start out by saying from the research I've done and the evidence I've seen as a dentist I am pro-fluoride. 
As with most things fluoride is useful in moderation. (For studies and more information on fluoride click here.) Even water can be “toxic” in high enough doses. High levels of fluoride can cause dental or skeletal fluorosis. Dental fluorosis occurs from very high levels of fluoride as a child and results in mottling (spotting) of the teeth (and no cavities). (Click here for more information on fluorosis.) 
My patients that grow up in areas with high fluoride exposure often have NO cavities into their 20's, 30's and 40's. Fluoride is  found naturally in most water sources. The amount and concentration of naturally occurring fluoride in water is due to different types of soils and rocks found around a water source. Fluoride can, and is frequently added to a water source for communities that choose to have it. Patients that grow up in areas of fluoridated water typically have less cavities than those that grow up with no fluoride in their drinking water. (For more information on fluoridated drinking water including the CDC's recommendations click here.)
The issue of skeletal fluorosis stemming from over-fluoridation does not appear to be coming from fluoride in toothpaste and dental application of fluoride. It is usually from work in specific industrial environments and water sources containing much higher natural fluoride than recommended. (Click here for more info on skeletal fluorosis.)
I recommend fluoride toothpaste for all patients and topical fluoride application on a case by case basis depending on tooth sensitivity and cavity risk. 

I respect the opinions of every person and what they would like concerning fluoride treatment. As a dentist, I feel it is good to have fluoride in your toothpaste and I support the addition of fluoride to community water supplies. Fluoridated water has shown to reduce caries in kids and adults by 25% (Click here to read more information on that study). I typically apply fluoride varnish for kids and patients with a high risk of cavities.


~Cyrus M. Larson, DMD



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