The benefits, safety and importance of fluoride for your oral health

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Tooth decay is the number one preventable, chronic health problem of children in the United States. Severe dental disease in children often requires the use of general anesthesia and possible hospitalizations which can cost well over $20,000 and is not always covered by insurance, even with a dental plan.

If left untreated, dental decay can become irreversible which can lead to severe infections and tooth loss. For children, it can compromise their ability to eat well, sleep well and concentrate and succeed at school. It also impacts their self-esteem and social development.

Dental disease has also been linked to long term negative cardiovascular effects in adults like increased risk for stroke and heart attack and significantly raises the risk of pre-term labor in pregnant women.

According to the American Dental Association (ADA) and the Centers for Disease Control and Prevention (CDC), fluoride use is one of the single most effective measures children and adults can take to dramatically reduce dental disease risk.

Fluoride is a naturally occurring mineral found in soil and water. Ninety-nine percent of fluoride ingestion is deposited in the bones and teeth and thus strengthens the surface of the tooth, or enamel. This strengthening of the tooth significantly reduces or stops the development of cavities from forming, thus reducing the likelihood of severe dental issues such as tooth loss and infection.

Fluoride was introduced in 1945 and has since been critically studied for its risk, benefits and safety when it comes to ingestion and use in adults and children. Study after study has shown that when used in appropriate and recommended amounts, such as in swishes, toothpaste and regulated water systems, fluoride is very safe with almost zero risks.

In some cases, too much fluoride can cause fluorosis, which is a white streaking of the tooth caused by the mineralization of the enamel. This mild condition is not harmful to the tooth but can be visible causing esthetical changes. About 25 percent of people exposed to high levels of fluoride may have mild to moderate fluorosis.

Numerous studies have been conducted on the safety of fluoride ingestion for pregnant women and the effects on fetal growth and 70 years of data show zero effects on fetal development when exposed to recommended levels of fluoride, even in drinking water.

However, it is important to know that too much of anything can be harmful to us. Taking too much vitamin C or even Tylenol can be toxic, for example, and high levels of fluoride can also have negative effects.

The toxic range of fluoride is 5-10mg/kg. Using my weight for example — 125 pounds or 56.7kgs — I would have to ingest 283.5 mg of fluoride to cause harm. Compare that with the recommended levels in drinking water, which is 0.7mg/L. I would have to drink 405 Liters of fluoridated water in one sitting to reach toxic levels. On the low end of this, a 15 pound infant would have to drink 48 liters of fluoridated water in one sitting to be at risk for toxicity.

Therefore, it is important to know that there is a safety range of effectiveness with fluoride — just like anything else — but the ranges of toxicity are almost impossible to reach for adults and children ingesting recommended amounts of fluoride. These safety ranges are monitored closely in our oral health products as well as in municipal water supplies, which have strict regulations to ensure safe levels in drinking water. It is also important to know that 99 percent of ingested fluoride is deposited in bones and teeth, and what isn’t deposited is eliminated through urine. Therefore, fluoride does not build up in the body like other minerals such as lead or methylmercury.

To date, 75 percent of the United States municipal water supplies are currently fluoridated to the recommended safe level of 0.7mg/L. This simple supplement to water supplies has been called one of the 10 great public health achievements of the 20th century and is recommended for all communities by the American Academy of Pediatrics, American Dental Association, CDC and U.S. Department of Public Health and Human Services. This act alone has prevented tooth decay by at least 25 percent in both children and adults simply by drinking water. Because it is so beneficial, safe and effective, the United States Department of Health and Human Services has a national goal for 80 percent of Americans to have access to fluoridated water by 2020.

In addition, community water fluoridation has been shown to save money for families and the health care system and the estimated return on investment for a community can be as much as $25 per person or more.

For your oral health, it is recommended that you use toothpaste with fluoride, use a fluoride rinse as directed by your dentist, and drink fluoridated water (Libby, Eureka and Troy do not have fluoridated water systems).

Yet these acts alone are not enough to eliminate your risks for dental disease so it is still critically important that children and adults see a dentist at least once a year for preventative check-ups.

Lincoln County Public Health is collecting data from citizens in Lincoln County about our oral health statistics. If you are a resident in our county, please take this survey to help us compile data. The link can be found at our Facebook page or The results of this survey will be made public once completed.

Do you like reading health articles from the county health nurse? To provide feedback, please contact Lincoln County Public Health at 406-283-2447 or

Riley Black is public health nurse for Lincoln County.

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