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UK Against Fluoridation

Wednesday, February 27, 2008

The Tradition Behind Water Fluoridation

The Tradition Behind Water Fluoridation
Another dental tradition that merits our questioning and careful consideration is municipal water fluoridation. During my college days courses included the idea that water fluoridation was the largest single contributing factor in decreasing the decay rate in the United States. There was no reason to even consider other contributing forces and we didn’t. Only after doing research and finding that other industrialized countries have also seen a decrease in dental decay without water fluoridation did the questions start to form. Is this tradition really the magic solution to caries?
Before anyone labels me anti-fluoride, let me assure you nothing is further from the truth. I dispense (on the prescription of a doctor, of course) 1.1% sodium fluoride preparations every day of practice. In-office fluoride treatments are also provided numerous times a day in my operatory – most often in the form of fluoride varnish. Fluoride is found in products available for retail from our practice in Squigle and Spry toothpaste, as well as MI Paste Plus. In fact, you will find some form of fluoride dentifrice in every medicine cabinet in my house.
I am most definitely pro-fluoride – and also very pro-questioning the status quo too. Do you really know what product is being added to your drinking water to provide the optimal level of fluoridation?
At www.pubmed.com, I entered the words “water fluoridation” and set some limits. About 20 of 31 total items actually addressed fluoridation and/or topical fluoride applications. The remaining were either challenging research criteria or addressing sealants, eruption patterns, or the calcium levels in extracted teeth.
Of the 20 usable resources, two attributed a decline in caries solely to community water fluoridation and two others claimed topically applied fluoride was the only factor in preventing tooth decay.
While interesting, these results were not what started my questioning of supplying systemic fluoride by public water. Rather, it was the three sources claiming any source of fluoride will correspond with a decrease in caries and the five references stating education is essential in any long term program of tooth caries prevention. In the opinions of these authors, no amount of systemic or topical fluoride can replace education. Included in the results of my search were also seven studies attributing the decline in dental caries among children to a combination of water fluoridation and topical application of fluoride. Perhaps we need both for optimal effects; although others claim that is tantamount to overdosing.
The finding I found most valuable was a study by Bohannan HM et.al, published in Journal of Public Health Dentistry (spring 1985) stating further research into methods and calculations of date “suggest a probable misinterpretation of results of studies using only historical comparisons.” This raises the question of whether or not fluoride is even the factor responsible for the decline of caries.
Traditions remain – some good and some questionable. It is not my purpose to give answers of which traditions to follow and which to abandon. Ongoing research, education, and healthy debate are essential in providing optimal care. Question authorities, read entire research studies, and study journals to reach your conclusion. However, my Christmas cards should arrive by July. Some traditions will never change.
About the Author
Lory Laughter, RDH, BS, practices in Napa and Sonoma, Calif., in both general and periodontal offices. She is a partner of Dental IQ, a team committed to arranging quality continuing-education opportunities for Northern California. Through her involvement with Dental Hygienists Against Heart Disease and other organizations, she hopes to bring a total health concept to the dental practice. You may contact Lory at momylaugh@aol.com.

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