Fluoride, Too Much of a Good Thing?

We have all heard that it is possible to have too much of a good thing. While this may not be true about chocolate or our favorite TV show (at least that’s what we’d like to think!), it is especially true about fluoride. Fluoride, a natural mineral, has been associated with tooth decay prevention, particularly if consumed from an early age. However, consuming too much of it may result in negative consequences for both children and adults.

You might be asking yourself, “Where do I even get fluoride?” Well, you probably consume it every day without even realizing it. You can find it in toothpaste, mouthwash, drinking water, and many processed foods. While small quantities of fluoride are often naturally present in water sources, the U.S. Public Health Service has been adding fluoride to potable water since the 1950s in order to help Americans achieve healthier smiles. However, this increases the average American’s daily fluoride intake without them really being aware how much they are consuming. Moreover, education around how much one should consume is lacking.

Fluoride has many benefits. Whether you get it as a treatment at the dentist or in your daily oral hygiene regimen, you are fighting off plaque and reducing the frequency of cavities. It keeps your teeth healthy for longer and saves you time and money at the dentist. However, it is important not to overdo it. By brushing too much with fluoride toothpaste and otherwise consuming excessive fluoride, you might actually get the opposite of the pearly white smile you’re looking for and permanently harm your teeth in the process.

Dental fluorosis, particularly common in adolescents, is a typical result of getting too much fluoride. Fluorosis causes tooth discoloration marked by white or brown spots or streaks and can alter tooth structure by creating pits that are noticeable to the naked eye. Fluorosis most often occurs in children ages eight and under, and it affects their “adult” set of teeth, which are growing under the gums. According to the Centers for Disease Control and Prevention (CDC), between the years 1999 and 2004, “41% of American adolescents [had] some form of fluorosis – an increase of over 400% from the rates found 60 years [prior].” It is important that parents are aware of dental fluorosis, its implications, and the importance of monitoring the fluoride intake of their children. The severity of cases range from mild to severe, and the damage done to the enamel is permanent. However, depending on its severity, there is treatment available for tooth discoloration. Options include micro-abrasion for mild cases and composite bonding for extreme cases.

There are different implications for adults that consume too much fluoride. For example, some studies show a connection between excessive fluoride consumption and health risks related to vital organs such as kidneys and the brain. Since kidneys excrete fluoride and other substances, it is possible for fluoride to build up over time, particularly in older people, increasing the risk of skeletal fluorosis, which affects bones and joints. Additionally, over 300 studies, including one by the Harvard Review, consider fluoride a neurotoxin – a chemical that damages the brain, especially while it is still developing. The National Research Council has stated that fluoride could potentially contribute to dementia as well.

In addition to the risk of fluorosis and damage to vital organs, if children or adults ingest too much fluoride it can be toxic. This is why the FDA mandated a poison control label on toothpaste. Symptoms of fluoride toxicity include headaches, nausea, vomiting, and abdominal pain.

What can you do to prevent negative consequences from excessive fluoride intake? First, understand the intake that is appropriate for you based on your gender and age. The American Dental Association (ADA) has accessible guidelines for all age groups available at http://www.ada.org/en/public-programs/advocating-for-the-public/ fluoride-and-fluoridation/fluoride-clinical-guidelines. The more aware you are, the more you can protect your and your family’s dental health. Second, understand where your water comes from and how much fluoride it contains. If it contains above recommended amounts of fluoride, you can take steps, such as buying bottled water or using a filter, to reduce your fluoride intake. Third, eat fresh foods and reduce or limit your consumption of processed foods. Food prepared with fluoridated water increases your fluoride consumption. By educating yourself and understanding more about the advantages and disadvantages of fluoride, it is possible to get the right amount to limit adverse effects and help keep teeth healthy and pearly white.

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