Matthew Vogel, DMD
With fluoridating the public water supply still a debate in some major cities – your cosmetic dentist in Gresham, Oregon can all still remember the intense debate that proceeded the vote of whether to fluoridate the water in Portland – and many rural communities relying on well water that doesn’t contain the compound, fluoride supplements continue to play an important role for individuals looking to maintain and improve their oral health.
Oral bacteria referred to as plaque produces substances that slowly erode away at tooth enamel, increasing an individual’s risk of developing tooth decay and gum disease. Fluoride intake, whether through the water supply or by using toothpaste that contains the compound, helps to offset the effects of harmful plaque by remineralizing tooth enamel.
The addition of fluoride to most public water supplies – a practice that dates back to 1945 when Grand Rapids, Michigan became the first city in the word to fluoridate its water – has helped to greatly reduce the number of children and adults suffering from cavities, with some estimates suggesting by as much as 40 percent. The Centers of Disease Control and Prevention even lists water fluoridation as one of the ten greatest public health initiatives of the 20th century.
So while the benefits of fluoridated water seem clear, the use of fluoride supplements by individuals living in communities without access to enhanced water has once again been called into question by a new study.
According to researchers at the Cochrane Oral Health Group, the use of fluoride supplements fail to reduce the prevalence of tooth decay in either primary (baby) teeth or permanent (adult) teeth. This latest study renews concerns over the effectiveness of fluoride supplements, which are routinely prescribed to children living in communities without access to fluoridated water. Further contributing to the confusion is the CDC’s continued support of fluoride supplements as an effective alternative delivery method.
While opponents of fluoridating public water supplies have long pointed to the availability of fluoride supplements as an alternative to what they view as forced medication, questions surrounding their effectiveness has existed for decades.
A study conducted by the Robert Wood Johnson Foundation in the early 1980s found no evidence suggesting the use of fluoride tablets successfully reduced an individual’s risk of tooth decay. Over the last thirty years, a number of other trail studies have found some benefits of using fluoride supplements, but generally to various degrees of effectiveness when compared to fluoridated water.
In a review of these studies, the Cochrane Group found a clear or partial bias existed among researchers whose findings were reported, making the evidence each study put forth questionable to some degree. Comparatively, more research continues to emerge that finds no direct evidence between fluoride supplements and a reduced risk of tooth decay.
A 2008 study published in the Journal of the American Dental Association was one of the latest to once again question the viability of supplements in preventing disease. So while the supplements continue to be used frequently, their benefits may not be as clear to parents as previously thought.
For parents of children living in communities without fluoridated water, the best practices towards reducing their kids’ risk of tooth decay may be the old standards of brushing and flossing daily.
Parents need to ensure their children brush at least twice daily – preferably once in the morning and again in the evening – using a toothpaste that contains fluoride, and to schedule regular appointments with your dentist in Gresham, Oregon. If you have any questions regarding whether your children are receiving enough fluoride to protect the health of their teeth and gums, make sure to talk with your dentist.