No Advantages for Low-Fluoride Toothpaste in Preventing Tooth Decay or Fluorosis

A low fluoride toothpaste from Australia

According to a new presentation at the AADR.

Low-fluoride toothpastes do not reduce the risk for fluorosis but increase the risk for caries in very young children, according to a meta-analysis presented here at the American Association for Dental Research (AADR) 2012 Annual Meeting.

"There is no evidence to support the use of low-fluoride toothpaste in preschoolers," said principal investigator Ana Santos, DDS, MS, PhD, a professor of dentistry at the University of the State of Rio de Janeiro, Brazil.

Recommendations from professional organizations around the world vary widely in the concentration of fluoride recommended for preschool children's toothpastes, with some recommending "low" concentrations — below 600 ppm — and others recommending "standard" concentrations of 1000 to 1500 ppm, Dr. Santos said.

Toothpastes with less than 600 ppm of fluoride are available in many countries, including Europe, Australia, and Brazil, whereas in others, including the United States, fluoride toothpastes must contain a higher concentration.

The debate about fluoride concentrations in toothpaste is intensifying as more fluoride has been introduced in community water supplies and mild fluorosis is diagnosed in more children.

"In Brazil, we are in the middle of a discussion because it's very difficult to convince people that all children should use standard toothpaste," said Dr. Santos.

Toothpaste is a major source of fluoride in young children. "As we know, children tend to swallow a substantial amount of toothpaste when brushing," said Dr. Santos.

Although low-fluoride toothpaste is not available in the United States, some standards-setting groups in the United States are debating whether to allow it, session moderator Clifton Carey, PhD, professor of cariology at the University of Colorado, Denver, who is involved in the discussions, told Medscape Medical News. "The FDA [US Food and Drug Administration] is awaiting clinical data," he said.

Dental caries are bad enough, but if parents fear fluorosis more than tooth decay, then there will be a market for this toothpaste in the United states. But....if it is ineffective against preventing fluorosis, then....

But, I doubt the major toothpaste manufacturers like Proctor and Gamble for Crest and Colgate will want to cannibalize their own market of regular fluoridated toothpastes for such a limited and likely ineffective to prevent tooth decay market.

A niche company or imported toothpaste might be able to gather a foothold.

But, why pay more for fluoride at all, if the amount is ineffective in preventing tooth decay or fluorosis?

Florida's Pinellas County Commission Votes to End Water Fluoridation

An unwise choice, but certainly it is within their elected official's discretion.

Florida's Pinellas County Commission voted on Tuesday to stop fluoridating the community water supply after hearing from residents opposed to government health mandates, according to news reports.

Despite testimony from dentists, the commission voted 4 to 3 to remove the mineral from the water supplied to about 700,000 residents, Tampabay.com reported.

"I don't think the county government should be telling people they have to have fluoride in the water," said Commissioner John Morroni, according to the newspaper.

Dentists and other public health officials said fluoridation, which costs the county about $205,000 a year, results in an overall savings because of the reduced cost of treating caries.

The Centers for Disease Control and Prevention recommends community water fluoridation and has called such programs "one of 10 great public health achievements of the 20th century." However, the agency changed its recommendation January 7, 2011, from a range of 0.7 to 1.2 mg to 0.7 mg of fluoride per liter of water, citing a risk for fluorosis in children aged 8 years and younger. Pinellas currently adds 0.8 mg/L, according to the newspaper.

Pinellas County Utilities estimates that this concentration of fluoride reduces cavities in children by 60%, and in adults by 35%. The utility only began adding fluoride to its water in 2004, but local dentists already were noticing health benefits, Palm Harbor dentist Oscar Menendez, president of the Upper Pinellas Dental Society, told the newspaper. "Over the last 4 years, it's been just an incredible change, an incredible change."

But public opinion has shifted since then, said Morroni, citing opposition to the federal 2010 healthcare reform act.

Reversing its position on fluoride puts the county in opposition to the mainstream of the past 20 years. In 2008, the latest statistic available from the Centers for Disease Control and Prevention, 72.4% of public utility water in the United States was fluoridated, up from 60.5% in 1988.

Opponents said that fluoride could cause brain damage and was part of a dangerous plot. "Fluoride is a toxic substance," Tea Party activist Tony Caso said, according to the newspaper. "This is all part of an agenda that's being pushed forth by the so-called globalists in our government...to keep the people stupid so they don't realize what's going on."

The scientific evidence is very clear that there is a benefit to the dental health with water fluoridation. But, if the local community is against it, then you can lead a horse to water, but you cannot make it drink.

Unfortunately, there will be more pain and suffering from dental disease as the result of tooth decay.

Calgary Council Votes to End Fluoridation of City Water

In Calgary, Alberta Canada, this issue has been debated back and forth for a couple of decades now. The pendulum has now swung back against fluoridation.

After passionate and sometimes rancorous debate, Calgary city council voted 10-3 Tuesday to eliminate fluoride from the city's drinking water, rejecting pleas to send the matter to plebiscite or an expert panel.

The decision also went against the advice of Alberta Health Services, which has advocated for fluoride and maintains evidence shows it is safe and improves dental health. The vote left Calgary's chief medical officer "very disappointed."

And one local dentist worries that without added fluoride in the water, cavities in children will rise in coming years, and tooth problems will have to be treated more aggressively.

But the decision did thrill a number of anti-fluoride activists at the meeting, who have argued the compound should not be forced on people.

"It's been a battle," said Fay Ash. "It's about freedom, it's about choice and it's about people taking ownership of their own health, not having it imposed on them."

Now, the studies can commence whether fluoridation has been effective in reducing dental disease in Calgary and what will be the effects in the withdrawal of fluoride.

Unfortunately, this will take many years.

I foresee that more cities in Canada and the United States will decide to end fluoridation programs. Let's see what happens - I think I know.