News
Dental Tribune | March 17-23, 2008
ADA
From Page 1
ridation continues to be effective
in reducing tooth decay by 20 to 40
percent,” he says.
“The single most effective public health measure to prevent tooth
decay is community water fluoridation. Community water fluoridation
is a valuable measure to prevent
tooth decay because optimally fluoridated water is accessible to the
entire community, individuals do
not need to change their behavior
to obtain the benefits of fluoridation,
frequent exposure to small amounts
of fluoride over time makes fluoridation effective through the life span
in helping to prevent dental decay,
and community water fluoridation is
more cost effective than other forms
of fluoride treatments or applications.
He notes that fluoridation is
achieved by using chemicals that
have been carefully tested and
approved. To ensure public safety,
additives used in water fluoridation
meet standards set by the American
Water Works Association and NSF
International.
The three fluoride additives used
in the U.S. for water fluoridation
(sodium fluoride, sodium fluorosilicate, and fluorosilicic acid) are
derived from apatite, which is a
type of limestone deposit used in
the production of phosphate fertilizers, he explains. All three additives produce the same fluoride ions
when dissolved in water. The choice
of chemical depends on the cost
for the particular water treatment
plant and the volume of water being
treated.
In response to charges that fluorine or fluoride can be harmful or
even toxic, Pollick says every chemical element or ion has its own level
of toxicity, even elements commonly
thought of as beneficial, such as oxygen. “Remember that all substances
are potentially toxic,” he says. “What
distinguishes whether a substance is
toxic or beneficial is the dose.”
He adds that fluoride was introduced to toothpaste in the 1950s and
now accounts for more than 90 percent of the toothpaste market. “Fluoride is now a household word and
recognized as an effective tool in the
prevention of cavities,” he says.
Generally accepted scientific evidence has also not shown any association between water fluoridation
and blood lead levels. “Scientists
from the Environmental Protection
Agency (EPA) have reviewed the
basic science that was the foundation for the claim that silicofluorides
leach lead from plumbing systems
and found that many of the chemical assumptions made and statistical methods utilized in the original
ecological study were scientifically
unjustified,” he says. “They went
on to state that the research was
inconsistent with accepted scientific knowledge, and the authors of
the original studies failed to identify or account for these inconsis-
tencies. EPA scientists concluded
that ‘no credible evidence exists to
show that water fluoridation has any
quantifiable effects on the solubility, bioavailability, bioaccumulation
or reactivity of lead or lead compounds.’”
Pollick says parents concerned
about their children receiving too
much fluoride should discuss their
concerns with their dentist, pediatrician or family doctor. Although ADA
supports community water fluoridation as “the single most effective
public health measure to prevent
tooth decay and improve oral health
over a lifetime,” parents and caretakers should consult with their
pediatrician, family doctor or dentist
to find the most appropriate water in
their area to use in infant formulas
for children less than a year old.
The ADA says parents and caregivers should ensure that young
children use an appropriate sized
toothbrush with a small brushing
surface and only a pea-sized amount
of fluoride toothpaste at each brushing. Young children should always
be supervised while brushing and
taught to spit out rather than swallow toothpaste. Many children under
age six have not fully developed their
swallowing reflex and may be more
likely to swallow fluoride toothpaste
inadvertently. Parents and caregivers
should consult with their pediatrician, family doctor or dentist before
allowing a child under two years of
age to use a fluoride toothpaste.
Although fluoride mouthrinses
have been shown to help prevent
3
tooth decay for both children and
adults, the ADA does not recommend fluoride mouthrinses for children under six years unless recommended by a dentist or other
health professional because children
under age six may be more likely
to inadvertently swallow a fluoride
mouthrinse.
Children in nonfluoridated communities should only receive dietary
fluoride tablets or drops as prescribed by their physician or dentist
based on the dietary fluoride supplement schedule approved by the ADA,
the American Academy of Pediatrics
and the American Academy of Pediatric Dentistry. Supplements are not
recommended for children under six
months of age.
John Hoffman
AD