WORCESTER, Mass. — It is considered one of the greatest public health discoveries ever.
Around the turn of the last century, dentists in the U.S. and Italy noticed that a distinctive discoloration of teeth — known as mottling — was accompanied by a lack of cavities.
That mottling was traced to an excess of fluoride in water. Researchers later found that lowering the fluoride levels stopped that dental discoloration — while maintaining the compound’s cavity-fighting power.
And thus was born the practice of adding fluoride to municipal drinking water — a practice that began eighty years ago in Grand Rapids, Michigan — and spread rapidly in the following decades. Five years ago, the Centers for Disease Control and Prevention set as a goal of its Health People 2030 campaign, 77% access to fluoridated drinking water in the United States.
Enter Robert F. Kennedy, Jr.
Tuesday, the HHS Secretary announced plans to end government recommendations to fluoridate drinking water. Kennedy cited an analysis by the federal National Toxicology Program which found, with moderate confidence, that excessive ingestion of fluoride could lower IQs in children. But that possible side effect was seen at fluoride levels double what the government considers safe – and the analysis could not find evidence of such harm at recommended fluoride levels.
Kennedy’s proposal is the culmination of a larger and longer campaign to eliminate fluoride from drinking water. The Fluoride Action Network lists 500 communities worldwide that have rejected fluoridation over the last 35 years. They include large cities, such as Portland, Oregon, and many, many smaller towns.
“There is proven benefit when it comes to the teeth from fluoride,” said Monica Anand, DMD, owner of Westwood Dentistry. “The concern is that as a society we’ve just overdone it.”
Anand said one of the concerns is the high reactivity of fluoride, which is chemically known as a halogen. That group of compounds combines readily with other molecules to form salts and acids.
“Topically, fluoride strengthens the teeth,” Anand said. “If there is excessive fluoride in your bloodstream it can actually affect your health systemically.”
And, as Anand points out, anything that goes in the mouth, gets absorbed to some extent or another.
But the Massachusetts Dental Society is firmly in fluoride’s corner.
“There have been studies over the last 75 years that have shown the safety and efficacy of fluoride,” said MDS Vice-President Steven Spitz, DMD. “There is not one study showing the opposite. No one’s getting rich having fluoride in the water. In fact, we’re just trying to protect the public.”
Spitz called RFK Jr.’s campaign against fluoride as extremely shortsighted, given the link between oral and systemic health.
“The Massachusetts Dental Society remains in complete support of fluoride,” he said. “It is widely recognized as a public health benefit thanks to the critical role it has in preventing tooth decay.”
Still, some aren’t sold on fluoride. For those patients, Anand recommends toothpastes and mouthwashes which contain hydroxyapitite — a compound found in human and animal bones.
“It’s an alternative to fluoride that can help strengthen your teeth without having to worry about excessive exposure to fluoride,” Anand said. “Hydroxyapitite is a natural mineral of what your your enamel — your teeth — are made of.”
Products containing hydroxyapitite are likely to be more expensive than those containing fluoride — and while the compound is proven to help teeth overcome small cavities, some feel more study needs to be done to see how it stacks up against fluoride.
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