When water fluoridation began,
tooth decay was a plague in the western world. The story of this
profound change begins in the 1920's when one of the most
dominant figures in fluoride research, Dr. Dean, first noted
relationships between white spots on enamel, minimal decay and
naturally fluoridated water supplies.
In 1945, in the face of this
plague and in the light of an even larger body of knowledge about
the effectiveness of fluoride against decay, controlled water
fluoridation was introduced in four North American communities.
From that point forward, children born and raised in these
communities saw their decay rates cut by more than half.
As a direct result of these
successes and many others that confirmed them, more than half the
population of Australia, Canada, Ireland and the United States
are currently drinking fluoridated water, a figure that rises to
just about 100% in the city-states of Hongkong and Singapore.
However, adding fluoride to
water is not the only way of deriving its benefit. In the 50
years since fluoridation began, a number of new delivery systems
have been developed and become popular - topical fluoride,
supplements, rinses and toothpaste.
In the past 30 years,
toothpaste has become a far greater source of fluoride in the
world than fluoridated water.
Using fluoride is the most
effective and economical method of protecting the tooth against
decay. When tested for cost effectiveness, it has been calculated
that it costs 100 times more to treat an individual decayed tooth
than to prevent one through the use of fluoride.
What is fluoride? What does
it do? How is it used? How safe is it? Does it do adults any
good? These are some of the questions people ask about
fluoride.
What
are Fluorides?
Fluorides are a large group of
chemical compounds formed when fluorine combines with other
elements. Fluorides are found everywhere - in soil, air, water,
as well as in plant and animal life. That is why most foods
contain some fluoride. It is estimated that we all consume a
baseline level of about 0.3mg of fluoride daily from food and
drink.
How
does Fluoride work?
When the teeth are forming, the
minerals needed are brought to the jaw and deposited in the tooth
buds by the bloodstream. When one of these minerals, fluoride, is
in adequate supply, it is incorporated into the enamel of the
tooth, and the resulting mineral structure is stronger than it
would be without the fluoride. As a result, the enamel will be
more resistant to attack by the acids that form in the mouth and
set the stage for decay.
It is important, then, to get
fluoride to the teeth when they are forming. That means from
birth, when the milk teeth are forming, right through the
development of the adult molars and, in the case of wisdom teeth,
even later.
Adults also benefit from taking
a fluoride supplement. The fluoride you swallow is later returned
to your mouth in the saliva and provides a surface benefit.
Fluoride applied locally in the
form of toothpaste or mouthwash is also incorporated onto the
surface of the tooth, and this makes the tooth structure less
susceptible to decay.
There are two basic ways to
get fluoride:
swallow it - as with
fluoridated water and fluoride supplements, and
apply it topically - as
with daily fluoride toothpaste, mouthrinses, or gel treatments at
the dentist's office.
Systemic
Fluoride
Fluoride taken internally is
systemic - it will be incorporated into the system as building
blocks and some of it will return to the mouth in saliva.
There are several ways of
getting fluoride into the teeth systemically. Fluoridation of
drinking water of an entire community is one way. Where this is
not possible, the drinking water in schools may be fluoridated.
Daily fluoride supplements may be made available as liquid
solutions, in tablet form, and in preparations that combine
fluoride with vitamins.
Topical
Fluoride
This is another way to get
fluoride to the teeth - apply it locally.
- Your dentist may apply it
professionally. One method is to fill a mould of your
teeth with solution or gel of fluoride and place it over
the teeth for a few minutes.
- Daily use of a fluoride
toothpaste is an excellent way to replenish the fluoride
reservoir.
- Using a fluoride mouthwash
is another method.
Fluorosis:
Too Much Fluoride
The cause is too much fluoride
ingested at an early age, while the teeth and bones are forming.
Children under the age of 3 often swallow toothpaste because they
have not yet learned to spit it out when they brush. Swallowing
toothpaste twice a day for a child under 3 years can lead to mild
fluorosis. To ensure that your child is not swallowing
toothpaste, be sure to closely supervise toothbrushing at least
until your child masters the necessary skills.
Health concerns however
persist, particularly over fluorosis and toxicity. Fluorosis is a
condition which principally affects children. It causes spotting
of the teeth in mild cases through to pitting, mottling, grey
discolouration of the whole surface and brittle, cracked teeth in
the most severe cases.
India has a more serious
problem. In some areas the fluoride level in water is so high
that people suffer from skeletal fluorosis, resulting in improper
bone formation, brittle bones, curved spines, and other
deformities particularly of the legs. However, this condition
does not apply to those of us living in Mumbai and NaviMumbai, as
the level of fluoride in our drinking water is negligible.
After going through the above
discussion, let us not lose sight of the most interesting thing
about fluoride: it works.
