The Truth About Topical Fluoride

I am limiting my post today to topical fluoride because my previous article addresses systemic fluoride, especially fluoride in our drinking water. I am going to go over the potential benefits of topical fluoride and discuss my personal philosophy on its use. I have covered the negative side effects of fluoride toxicity previously, so I won’t cover them again in this post. For more information on the toxic side effects of fluoride, please my previous post called FLUORIDE IN OUR WATER: AN ANCESTRAL HEALTH PERSPECTIVE.

 In the last 30 years, studies have shown that the maximum anti-caries benefits of fluoride are primarily through topical use and direct contact on the tooth surface. (1) The going theory was that the fluoride combined with the tooth and made it harder and thus more resistant to cavities. We have a better understanding of the process now, and it turns out to be more of a chemical protection than a physical one. Specifically, the fluoride ion replaces the hydroxyl ion in the hydroxyapatite lattice and forms the more acid-resistant fluorapatite. (2) Cavities are formed when minerals dissolve out of the teeth during acidic attacks from bacteria. Topical fluoride can combine with the mineral in enamel (called hydroxyapatite) during these acidic insults, inhibiting demineralization, and speeding up remineralization when the acidity is neutralized. The new mineral formed is more resistant to future acidic demineralizations. (3)

In 2010 Müller et al determined that the layer of altered enamel is so thin bringing into question whether there could possibly be any benefit from such a thin layer. (4) There is another mechanism that I believe explains why fluoride would still be effective, and that is through its effect on cavity-causing bacteria, namely Strep Mutans. Fluoride is taken up by Strep Mutans and interferes with several metabolic functions which result in less acid production. Interestingly, some bacterial cells will mutate to resist the effects of fluoride, but they have slower metabolism and are less cavity-causing. (2)

Fluoridated water is the main source of fluoride toxicity. Up to 51% of children in fluoridated communities suffer from dental fluorosis, which is a sign of fluoride toxicity, and up to 26% of children in non-fluoridated communities suffer from dental fluorosis. The CDC reports that 40 percent of children between the ages of 3 and 6 use potentially dangerous amounts of toothpaste, which is a likely source. (5) Fluoride-containing toothpastes have a warning on their label stating “Keep out of reach of children under 6 years of age. If you accidentally swallow more than used for brushing, seek professional help or contact a poison control center immediately”. There are definite risks for toxicity from the fluoride in toothpaste.

The study of ancestral health has led me to the conclusion that ancient diets and lifestyles kept us decay-free. As a paleo-based functional medicine practitioner, I feel that matching our environment to our genetic heritage, while minimizing risky behaviors is the way to go. Since fluoride is toxic, my first suggestion to those wishing to minimize tooth decay is to eat a nutrient-dense whole foods diet including animal fats and eliminating dense acellular carbohydrate, and brush and floss regularly. You can read these posts to get more details on the diet here, here, here, here, and here. I do have certain situations where topical fluorides are a solid choice in addition to good hygiene and a good diet. In cases of head and neck radiation, severe dry mouth, lack of dexterity and other serious illnesses, topical fluoride is a good choice due to its proven ability to decrease tooth decay.

The ADA currently advises caregivers to brush with water and to consult with a dentist or physician before using fluoride toothpaste, for children younger than 2 years. The use of a pea-sized amount of fluoride toothpaste is recommended for children from 2 to 6 years of age. Other recommendations propose the use of a “smear” of fluoride toothpaste (approximately 0.1 gram of toothpaste or 0.1 milligram of fluoride) for children younger than 2 years and a pea-sized amount (approximately 0.25 g toothpaste or 0.25 mg fluoride) for children from 2 to 6 years of age. (6)

Toothpaste is an optional item for children and adults. If you want to use toothpaste, I recommend staying away from most of the commonly available toothpastes, especially those with fluoride. There are just too many questionable chemicals and additives in most toothpastes for my comfort level. I have DIY articles on this website here and here if you are interested in making your own toothpaste. If you don’t want to make your own toothpaste, I suggest Primal life organics dirty mouth tooth powder. Trina Felber has many great all-natural, holistic dental and skincare products to offer. Use the code DRSOLOMON for 20% off!