Peggy Stoor BSRDH

As a hygienist with many years of experience, I’m starting to notice an alarming trend.  I began to be suspicious, when my own children who I fanatically watched the diet and toothbrushing habits of, werefound to have cavities. A small number of cavities, but still! My kids! How could this happen?

According to the Centers for Disease Control, the caries rates (cavities) in children ages 2 thru 5, is onthe rise. This is a trend we have not seen in over 40 years. Many dental professionals are beginning tosuspect that this is, at least in part, due to drinking bottled or filtered water, without fluoride. Fluoride isoften found naturally and may be added to our community water supplies. But, a recent study found thatabout 45 % of parents give their children only or almost exclusively bottled water. The Journal of Pediatric Dentistry reports that figure closer to nearly 70%.  While the correlation between the increase in caries and the decline in fluoridated water consumption hasn’t been sufficiently linked, many are beginning to believe that this is a contributing factor.

Obviously, the eating habits of American children also play a huge role and every time a child has a sweet snack, their mouth becomes acidic.  The number and frequency of these acidic attacks is important in causing tooth decay.  Sweetened juices, high sugar, and high carbohydrate snacks coupled with parents’ reluctance to brush their children’s teeth with fluoride toothpaste also play a large role.

Interestingly, a study by The National Center for Health Statistics found that boys in higher income families had the greatest prevalence of decay.  Is it because parents in higher income families can afford to provide more beverages such as juice, sports drinks, and bottled water believing that they are doing better for their children? Parents trying to promote health may potentially help to harm as these drinks don’t protect from cavities and are often high in sugars.  Just as we need to be aware of the amount of sugar in our fruit and sports drinks, we should also be informed of the amount of fluoride in our bottled and filtered water.

It has been nearly 70 years since the discovery of the decay preventing effects of fluoride. The CDC has recognized water fluoridation as one of the 10 great public health achievements of the 20th century. “The health and economic benefits of water fluoridation accrue to individuals of all ages and socioeconomic groups, especially to poor children”  (Review of Fluoride: Benefits and Risks, 1991, US Public Health Service)

Despite numerous studies from experts in many fields, including the medical establishment, which have proven the safety and efficacy of fluoride, controversy and fears continue among many.  The debate has a very lengthy history and is far too much to detail in these few paragraphs.  Communism, socialism, cancer, mental retardation, and bone fractures are some of the concerns expressed by anti-fluoridationists.  However, in a report on the benefits and risks of fluoride, the U.S. Public Health Service Department states that optimal fluoridation of water does not pose a cancer risk to humans. This is evidenced by extensive human epidemiological data from studies over the past 75 years. While its true that fluoride is found in sources other than water (foods, toothpastes, mouthwashes, and fluoride supplements), the conclusions were that no trends in cancer risk were seen between populations of fluoridated and non-fluoridated communities. These findings were duplicated by the National Cancer Institute in a review of studies and an additional 16 years of research.

Concerned parents have often asked me about the pros and cons of fluoride.  While excessive fluoride consumption is obviously something to guard against, spotty consumption of fluoride poses a great risk for decay.  As in all things, finding a balance is the key. I now advise my patients to find out about their water. Reverse osmosis filtration removes the fluoride as well as the contaminants. While some bottled water contains fluoride, the majority does not. Contact your city’s water supplier and/or research your bottled or filtered water online. This information is readily available and as wise consumers and parents we should be knowledgeable about what our children and we are ingesting.

For young children, ages 2 to 6, please skip the sugar sticky snacks and that bottle of milk or juice at bedtime, drink a little tap water daily, and brush your child’s teeth with a pea size amount of fluoridated toothpaste twice a day. If the child cries or complains, think about how much more difficult and potentially traumatizing decay, pain, and possible tooth loss might be.

Aleccia, J. (2012, March 21). Bottled water may boost kids’ tooth decay, dentists say. NBC News Health. Retrieved July 04, 2013, from http://www.nbcnews.com/health/bottledwater.

Ellwood, R. P., & Cury, J. A. (n.d.). How much toothpaste should a child under the age of 6 years use? 168-74. Abstract obtained from Eur Archives Paediatric Dentistry, 2009 168-74. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed.

Garrison, G. M., MD, & Loven, B., MLIS. (2007). Can Infants/Toddlers Get Enough Fluoride Through Brushing.Journal of Family Practice, 56`(9). Retrieved from http://link.springer.com/article/10.

Hobson, W. L., Knochel, M. L., Byington, C. L., Young, P. C., Hoff, C. J., & Buchi, K. F. (2007). Bottled, Filtered,and Tap Water Use in Latino and Non-Latino Children. Archives of Pediatrics and Adolescent Medicine, 161(5), 457-461.

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McNeil, D. R. (1985). America’s Longest War: The Fight Over Fluoridation. The Wilson Quarterly, Summer, 140-153.

Sriraman, N. K., Patrick, P. A., Hutton, K., & Edwards, K. S. (2009). Children’s drinking water: Parental preferencesand implications for fluoride exposure. Pediatric Dentistry, 310-5. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed.

United States Public Health Service, Department of Health and Human Services (February 1991), Report of The AdHoc Subcommittee on Fluoride. (n.d.). Review of Fluoride: Benefits and Risks.