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  • Dr. David Alfaro

What is fluoride?

There is a very strong anti-fluoride sentiment here in Nelson and it is a discussion that we have every day in the office with patients who present with tooth decay. We rarely see people who have had zero fillings in their lives; dental caries is extremely common and has a large biological and financial burden. Fluoride skeptics often state that they have heard that fluoride is bad for your health and that there are other products that are just as good at fighting tooth decay. How much of that information is myth? And how much is reality?

Let’s talk about fluoride.

There are people out there that are automatically going to say that I am part of a “medical establishment” and that I am biased against natural remedies because I am a dentist. Some people even believe that dentists are getting paid off to say fluoride is good as part of some conspiracy.

Well I am biased! I am biased towards evidence based health care. This does not mean that I automatically dismiss the xylitols and colloidal silvers and neem mouthwashes… means that I go and look for clinical trials proving safety and efficacy and then make clinical decisions based on real information. Don’t you want that out of a healthcare provider? Or should I believe some blog that says that chewing on bark fights cavities, or that spilanthes will strengthen teeth, without actually searching for human evidence? I have researched many products I had never heard of until I moved here.

So what is Fluoride?

By Giovanni Dall'Orto - Own work, CC BY-SA 2.5 it,
Fluorite (image cc Giovanni Dall'Orto)

Fluorine(ide) is a naturally occurring element and exists on the periodic table just above Chlorine. It is extremely electronegative and is very reactive. One of the common compounds that is used in dentistry is Sodium Fluoride (NaF), which is a salt like Sodium Chloride (NaCl). Fluorite is not some strange human created chemical compound; it exists naturally in soils and in drinking water sources.

Is Fluoride a poison?

Whenever I bring up Fluoride on social media, someone will chime in with "Fluoride is the same poison that is found in sarin gas!" This to me shows either a lack of understanding of basic chemical principles, or a willingness to deceive people. I do not know which is worse.

The chemical formula for sarin gas is C4H10FO2P, so yes, there is a fluoride molecule in this substance. Going back to highschool chemistry, however, you have to recall that the properties of a chemical depend on the elements involved and their three-dimensional arrangement. Changing one thing creates a totally different chemical with different reactivity and toxicity profiles.

H2O is water that is essential for life. H2O2 is hydrogen peroxide, which is toxic. So are hydrogen and oxygen poison? No.

Can you see how this fluoride and sarin gas argument really makes no sense?

When we look at the toxicity of fluoride as a dental product, we need to look at the chemical compounds that are routinely used (sodium fluoride, sodium monofluorophosphate and stannous fluoride) and the effects of the accumulation of fluoride in the tissues.

The next time you see that sarin gas argument, please just shake your head and move on.

Why do dentists recommend fluoride?

Fluoride Mechanism of Action (Y.R. Souror)

Enamel is made up of a mineral called hydroxyapatite, which is a substance that dissolves at a pH of around 5.5. When we eat sugars we feed the bacteria in our mouths, which in turn make acid as a byproduct. If we do not brush away the bacteria, or feed them sugar too frequently, the teeth lose minerals and tooth decay happens.

Fluoride chemically reacts with hydroxyapatite changing it to a different crystal: fluorapatite, or fluorohydroxyapatite. These substances are much more resistant to acid attack. Some reports indicate that the pH required to dissolve these fluoride containing minerals is around 4.5. This is a HUGE change.

Fluoride therefore physically makes your teeth more resistant to demineralization. None of the other dental products on the market actually do this; they either help remineralize teeth, or help fight bacteria. No, not even Vitamin K2.

Does fluoride actually fight tooth decay?

Yes. Simply yes. Fluoride is the most effective way of fighting tooth decay. There is nothing proven to be more effective. And it is safe.

There are hundreds and hundreds of clinical trials (on humans) proving that fluoride helps fight tooth decay, with minimal adverse outcomes. Most systematic reviews put the effect at over a 25% reduction in tooth decay rates. For some people this may seem like a trivial amount, but on a global scale, where anyone with teeth is at risk of tooth decay, this is a large impact in a very simple product. No other anti-tooth decay medication even comes close.

For those people who want to do their own research, start with these over 65 articles:

But what about my pineal gland?

What about IQ?

What about fluorosis?

This topic is huge. People could spend a whole career researching fluoride, so we will tackle all of those one by one.

For now, just know that fluoride works to fight tooth decay and it is a naturally occurring substance and nothing works better. We will get to the conspiracy theories in upcoming articles.

Thanks for reading!

Dr. Dave


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