A fluoride free practice?

Controversy corner, “What’s going on with fluoride?”

Recently, there’s been a bit of beef on dental Twitter, or one corner of it.

Interestingly, it’s not the first time that I have seen,in the past few months, systemic fluoride being questioned in posts on social media.

Viz this post:

The comments were interesting; look it up and read them.

I’m not the best at critically appraising the quality of research, so I’m not going to comment on that. I did show the paper to a friend who is, and maybe a long bow is being drawn.

What I find more interesting is the debate that’s emerging (in the US?) about the benefits and risks of water fluoridation.

And the growing acceptance of non fluoride toothpastes and even fluoride free dental practices 😲.

I can certainly see an upside for the dentist in promoting fluoride free practice.

I am old enough to remember pre-fluoride days. I worked in the UK where the water largely wasn’t fluoridated. I treated patients in my practice that came from a small town an hour away that wasn’t fluoridated.

Maybe this younger generation of dentists have not seen the caries that we used to see in the whole population, rather than pockets of the population.

I have seen the difference that water fluoridation can make to caries experience.

It’s easy to argue that good oral health habits and using a fluoridated toothpaste, as well as a “good” diet, should be sufficient these days. How effective are we as a profession in changing people’s habits? I think that misses the purpose of public health activities such as water fluoridation. These bring about equity in health rather focusing on individual risk. It raises up the 44% of the population that have not been to the dentist in the past twelve months and the 15% that have not been for five years or more.  

It will be interesting to see where this debate leads the profession, as it will be to see the influence we have, now that there are toothpastes and products entering the market from non traditional suppliers, such as HiSmile and even this one, which is marketed more like beauty a product.

Maybe Dr Ortiz’s question is right, and dentists are beholden to a dogma? Maybe there will be quality research in the future that causes us all to re evaluate?

I think we need to remember the patients we never see; the kids that don’t have a toothbrush at dad’s house and who spend alternate weeks there, and the families that don’t have oral care or a “healthy diet” as part of their daily routine. Would they be the forgotten losers should water fluoridation be rolled back?

Rosie

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