Nothing has done so much to combat tooth decay as adding fluoride to the nation’s water supply. Since October is National Dental Hygiene Month, this is an appropriate time to learn more about this cavity fighter.

Bottled Water Risk


The American Dental Association (ADA) credits fluoridation of community water supplies for reducing tooth decay. However, the popularity of bottled water – which may or may not be adequately fluoridated – is raising ADA concerns that consumers are not getting appropriate amounts of fluoride. Dentists are reporting a surge in cavities coinciding with bottled water’s popularity.

The U.S. Food and Drug Administration (FDA) does not require bottlers to list the fluoride content and the Centers for Disease Control (CDC) recommends contacting the manufacturer to ask what the level of fluoride is. There may be other reasons to curtail bottled water consumption as tests have revealed it sometimes contains traces of fertilizer, industrial chemicals and medications, making it no healthier than tap water. Water filters can sometimes help with this problem, although fluoride is also something that can be removed by their use. Water filter brands may disclose on their labels if they remove fluoride.

Before fluoride, older people were often toothless or nearly so. Today, with life expectancy approaching 78 years, fluoridation – along with good oral hygiene – has turned both smiling and eating into satisfying old age activities.

Fluoride occurs naturally in water. But ever since the 1950s, when communities starting adding more fluoride to their drinking water supplies, the incidences of tooth decay and cavities have dramatically decreased.

In babies and young children, fluoride strengthens developing teeth, making it harder for plaque acids to dissolve tooth enamel. For everyone else, fluoride helps teeth naturally repair themselves by reversing low levels of decay before cavities have a chance to form.

As important as fluoride is in maintaining good dental health, be careful about getting too much. Children under the age of 6 are particularly susceptible to enamel fluorosis – white spots on the teeth – if they have more fluoride in their systems than they need. Toothpaste contains fluoride, a common source of this problem if children are swallowing toothpaste instead of spitting it out. Supervise your children when they brush their teeth. If your child does develop enamel fluorosis, cosmetic treatment will improve the appearance of the teeth. Your dentist can help you with resolving this situation.

[Janet Lubman Rathner]