Fluoride: Good or bad?

Fluoride is a chemical commonly added to toothpaste.

It has a unique ability to prevent tooth decay.

For this reason, fluoride has been widely added to water supplies to improve dental health.

However, many people are concerned about the potential damage of excess intake.

This article discusses fluoride in depth and examines how it can affect your health.

What is fluoride?

Fluoride is the negative ion of the fluorine element. It is represented by the chemical formula F-.

It is widely found in nature, in minimal quantities. It occurs naturally in the air, soil, plants, rocks, fresh water, sea water and many foods.

Fluoride plays a role in the mineralization of your bones and teeth, an essential process to keep them hard and strong.

In fact, approximately 99% of the body's fluoride is stored in the bones and teeth.

Fluoride is also important to prevent tooth decay, also known as tooth decay. This is why it has been added to the community's water supply in many countries (1).

Bottom line: Fluoride is the ionized form of the fluorine element. It is widely distributed in nature and supports the mineralization of bones and teeth. Fluoride can also help prevent cavities.

Fluoride sources

Fluoride can be ingested or applied topically on teeth.

These are some of the main sources of fluoride:

  • Fluorinated water: Countries like the USA The United Kingdom and Australia add fluoride to their public water supplies. In the United States, fluoridated water generally contains 0.7 parts per million (ppm).

  • Underground water Groundwater naturally contains fluoride, but the concentration varies. It is usually between 0.01 and 0.3 ppm, but in some areas there are dangerously high levels. This can cause serious health problems (2).

  • Fluoride supplements: These are available in the form of drops or tablets. Fluoride supplements are recommended for children over 6 months of age who are at high risk of developing caries and live in non-fluoridated areas (3).

  • Some foods: Certain foods can be processed with fluoridated water or can absorb the fluoride from the soil. Tea leaves, especially old ones, may contain fluoride in higher amounts than other foods (4, 5, 6).

  • Products for dental care: Fluoride is added to a series of dental care products on the market, such as toothpaste and mouth rinses.

Bottom line: Fluoridated water is an important source of fluoride in many countries. Other sources include groundwater, fluoride supplements, some foods and dental care products.

Fluoride helps prevent tooth decay

Dental caries, also known as caries or dental caries, is an oral disease (7).

They are caused by bacteria that live in your mouth.

These bacteria break down carbohydrates and produce organic acids that can damage tooth enamel, the mineral-rich outer layer of a tooth.

This acid can lead to the loss of enamel minerals, a process called demineralization.

When mineral substitution, called remineralization, is not maintained at the level of lost minerals, cavities develop.

Fluoride can help prevent tooth decay by (8):

  • Decrease in demineralization. Fluoride can help decrease the loss of minerals from tooth enamel.

  • Improvement of remineralization: Fluoride can accelerate the repair process and help minerals return to enamel (9).

  • Inhibition of bacterial activity: Fluoride is able to reduce the production of acid by interfering with the activity of bacterial enzymes. It can also inhibit the growth of bacteria (10).

In the 1980s, it was shown that fluoride is more effective at preventing cavities when applied directly to teeth (11, 12, 13).

Bottom line: Fluoride can fight tooth decay by improving the balance between the gain and loss of tooth enamel minerals. It can also inhibit the activity of harmful oral bacteria.

Excessive intake can cause fluorosis

Excessive consumption of fluoride for long periods of time can cause fluorosis.

There are two main types: dental fluorosis and skeletal fluorosis.

Dental fluorosis

Dental fluorosis is characterized by visual changes in the appearance of the teeth.

In mild forms, the changes appear as white spots on the teeth and are primarily a cosmetic problem. More severe cases are less common, but are associated with brown spots and weakened teeth (14).

Dental fluorosis only occurs during the formation of teeth in childhood, but the most critical time is less than two years (15).

Children who consume too much fluoride from multiple sources over a period of time have an increased risk of dental fluorosis (16).

For example, they can swallow fluoridated toothpaste in large quantities and consume too much fluoride in the form of a supplement, in addition to ingesting fluoridated water.

Babies who get their nutrition mainly from formulas mixed with fluoridated water may also have an increased risk of developing mild dental fluorosis (17).

Bottom line: Dental fluorosis is a condition that alters the appearance of the teeth, which in mild cases is a cosmetic defect. It only occurs in children during the development of the teeth.

Bone fluorosis

Skeletal fluorosis is a bone disease that involves the accumulation of fluoride in bone for many years (18).

At first, symptoms include stiffness and joint pain. Advanced cases may eventually cause alteration of the bone structure and calcification of the ligaments.

Skeletal fluorosis is particularly common in countries such as India and China.

There, it is mainly associated with prolonged consumption of groundwater with high levels of natural fluoride, or more than 8 ppm (2, 19).

Other ways in which people in these areas ingest fluoride include burning charcoal in the home and consuming a particular type of tea called brick tea (20, 21).

Keep in mind that skeletal fluorosis is not a problem in regions that add fluoride to water for the prevention of caries, since this amount is tightly controlled.

Skeletal fluorosis only occurs when people are exposed to large amounts of fluoride for long periods of time.

Bottom line: Skeletal fluorosis is a painful disease that can change bone structure in severe cases. It is particularly common in some regions of Asia where groundwater is very high in fluoride.

Does fluoride have any other harmful effects?

Fluoride has been controversial for a long time (22).

Numerous websites claim that it is a poison that can cause all kinds of health problems, including cancer.

These are the most common health problems that have been associated with fluoride and the evidence behind them.

Bone fractures

Some tests indicate that fluoride can weaken bones and increase the risk of fractures. However, this only occurs under specific conditions (23).

One study analyzed bone fractures in Chinese populations with varying levels of natural fluoride. Fracture rates increased when people were exposed to very low or very high levels of fluoride for long periods of time (24).

On the other hand, drinking water with around 1 ppm of fluoride was associated with a lower risk of fractures.

Bottom line: A very low and very high intake of fluoride through drinking water can increase the risk of bone fractures when consumed over a long period of time. Additional research is required.

Risk of cancer

Osteosarcoma is a rare type of bone cancer. It usually affects the larger bones of the body and is more common in young individuals, especially men (25, 26).

Multiple studies have investigated the connection between fluoridated drinking water and the risk of osteosarcoma. Most have not found a clear link (27, 28, 29, 30, 31).

However, one study reported an association between fluoride exposure during childhood and an increased risk of bone cancer in young children, but not in girls (32).

For cancer risk in general, no association was found (33).

Bottom line: There is no conclusive evidence to suggest that fluoridated water increases the risk of a rare type of bone cancer called osteosarcoma or cancer in general.

Poor brain development

There are some concerns about how fluoride affects the developing human brain.

One review examined 27 observational studies conducted mainly in China (34).

Children living in areas where fluoride was present in large quantities in the water had lower IQ scores, compared to those living in areas with lower concentrations (34).

However, the effect was relatively small, equivalent to seven IQ points. The authors also noted that the studies reviewed were of insufficient quality.

Bottom line: A review of observational studies, mainly in China, found that water with high amounts of fluoride can have a negative effect on children's IQ scores. However, this needs to be studied much further.

Water fluoridation is controversial

Adding fluoride to public drinking water has been a controversial practice for decades to reduce caries (35).

Water fluoridation began in the USA. UU In the 1940s, and approximately 70% of the US population. UU It receives fluoridated water at present.

Fluorination is rare in Europe. Many countries have decided to stop adding fluoride to public drinking water due to safety and efficacy concerns (36, 37).

Many people are also skeptical about the effectiveness of this intervention. Some claim that dental health should not be handled by "mass medication", but should be treated at the individual level (36, 38).

Meanwhile, many health organizations continue to support water fluoridation and say it is a cost-effective way to reduce tooth decay.

Bottom line: Water fluoridation is a public health intervention that remains a subject of debate. Although many health organizations support it, some argue that this practice is inappropriate and is equivalent to "mass medication".

Bring the message home

As with many other nutrients, fluoride appears to be safe and effective when used and consumed in appropriate amounts.

It can help to prevent cavities, but ingesting it in very large quantities through drinking water can cause serious health problems.

However, this is mainly a problem in countries with naturally high levels of fluoride in water, such as China and India.

The amount of fluoride is tightly controlled in countries that intentionally add it to drinking water.

While some question the ethics behind this public health intervention, it is unlikely that fluoridated water from the community will cause serious health problems.

Reference: https: //www.healthline.com/nutrition/fluoride-good-or-bad


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