As an oral health consultant, can you please state your position on both ingested and topical fluoride?
J. P. (name removed), DDS, MSc. (epidemiology)
I would be happy to explain my position on fluoride in more detail.
Basically I have “experienced” fluoride since the 1970’s. I lived in a non-fluoridated area of UK at the time and I gave dropper bottles of sodium fluoride to my patients and also put these drops into my own children’s water to drink. I was a confirmed believer and looked forward to the promise of shiny, healthy teeth.
My oldest daughter erupted brown front teeth in the early 1980s and my next daughter had teeth pitted with white spots from slightly less fluoride. My oldest daughter had thyroid issues. I was outraged. In the early 1980s I spent all of my free time at the University of Rochester researching fluoride in their extensive library (it was before the days of the internet). I was intrigued by the fluoride story, and I knew there was probably more! I finally completed my search in 2002 when I googled the following: ALCOA, Proctor and Gamble and Coca Cola. I found the identical Board of Directors in these three organizations. This is fascinating since the ADA is sponsored by Proctor and Gamble and Coca Cola and fluoride is the by product of AOCOA. Need I say more?
I started writing a book about the “upside down” way that dentistry approaches disease – and the fact that few think about risk factors that promote cavities and plaque. Small changes in habit and the use of xylitol can prevent these problems. I guess you could call my book a description of “caries management by risk assessment!”
I had spent the first 15 years of my career wading through fact and fiction (by myself) as a clinical provider. I had been sufficiently observant to discover that it was acidity and dry mouth that damaged teeth – not just sugar as we had been told.
I discovered that careless or incorrect care could damage delicate, healthy biofilm – a covering that exists to protect enamel. I saw how the loss of this layer was the reason that people have caries, sensitivity, erosion, recession and dental damage. Most dentists are still focused on removing all biofilm – they have not yet understood that we need this layer to protect teeth from damage!
The gist of my message is that there is a need to develop healthy biofilm with prebiotics. probiotics and in some cases, the control of oral pH through diet and habits. My advice is to work hard to establish a healthy oral flora as early as possible – preferably before the eruption of molar teeth. In cases where there is no dental damage, and no risk factors for damage – nothing more than maintenance is required. Even tooth cleanings for a child with no calculus or plaque is unnecessary in my opinion.
On the other hand, when damage exists and teeth have been traumatized and filled, or destroyed by disease, then I believe the best solution is to treat the mouth with a sequence of oral care products that stimulate natural healing. The products work topically from the outside of the tooth.
The products that I recommend need to be used in a specific sequence to achieve both reversal of periodontal and gum problems, and (used in the same sequence) they will also reverse and remineralize damaged hard surfaces- even to a substantial depth.
In this sequence I employ the use of a toothpaste that contains silica with sodium fluoride (Crest Cavity Protection) and also a dilute sodium fluoride rinse (called ACT).
I call this program of specific rinses my Complete Mouth Care System and it is combined with daily amounts of xylitol – used in a specific dose and multiple small amounts at the end of meals. The products in the rinse routine are only for topical use and only for use by children and adults with adult teeth, and only for children able to rinse and spit. These mouth rinse products are used topically and I encourage good spitting and also disinfection of toothbrushes.
My experience with this system is that it can reverse dental disease when it is used twice a day as described. There is no ingestion of fluoride – it is used topically for the reversal of disease and the rebuilding of damaged areas. There is no benefit from stronger fluoride gels or applications in my opinion (possible exception is fluoride varnish in specific situations – to avoid sealants).
What I have discovered is that there is an amazing synergistic effect of dilute fluoride rinse and xylitol – it is quite staggering. We have witnessed dramatic changes in oral health in the mouths of all ages. Dilute fluoride used in this specific sequence produces sufficient healing for many patients to avoid the toxicity of fillings completely.
I would therefore defend the use of these specific toothpastes and rinses. I never recommend ingested fluoride. I have actually made a video supporting the anti-fluoridation movement in Austin Texas. I do not believe we should be subject to fluoride added to our water supplies. The amount of fluoride being ingested through this supply is of great concern to me – particularly in the case of infants with formula milk (which is another whole story!!).
Please let me know if you would like more information about my beliefs.
I do have VERY strong opinions about fluoride – most negative, but in the case of one specific toothpaste and one specific mouth rinse – I believe they can work in synergy with xylitol to produce astounding benefits for patients. Here is a link to my chapter on fluoride – taken from my book, Kiss Your Dentist Goodbye:
Ellie Phillips DDS