Type ‘fluoride’ into Google and you’ll very quickly come across a large number of anti-fluoride lobbying groups. Some of the effects they claim that fluoridation has to humans is an increased risk of down’s syndrome, brittle bone disease, alzheimers and death. The actual known effects of fluoride are quite positive in small, controlled doses which we mainly get through dental products and water fluoridation.
I could bore you with all the research on the positive effects of fluoride but I’m feeling kind, so I won’t. Basically, fluoride ingested when teeth are developing changes the way the enamel is laid down making it harder, more impervious to acid-pooing bacteria and less full of nooks and crannies. So instead of the biting surfaces looking like the crevices of a dried up river bed, they look more like a smooth bowl with less hidey holes for little critters.
When too much fluoride is added into the mix then fluorosis can occur which can alter the appearance of the teeth. Considering fluoride is pretty abundant on earth, it is very likely you’ll come into contact with it regularly through foods, bottled waters, tap water and the obvious, dental products. #1. What does this mean for your boob or bottle-fed baby’s developing gnashers? #2. What does it mean for your toddler (like mine) who loves to suck the toothpaste from the tube when you’re not looking?
Research suggests that very little fluoride passes into boob juice and levels are lower than that found in cow’s milk (and cows don’t even brush their teeth). Therefore, the risk of your infant developing fluorosis if you’re boobing, is almost nil, even if you’re living in a fluoridated area. The risk increases slightly with formula milk, especially if the water used to make up the feeds is fluoridated. Powdered formulas generally contain higher fluoride concentrations than ready-to-use formula and soy-based formulas contain higher concentrations than cow’s milk formulas.
That all sounds rather dramatic for formula users but fluorosis has a number of categories and the increased risk being researched is for ‘mild fluorosis’, which is sometimes barely noticeable white specks on the teeth. For more severe fluorosis to occur, children need to be excessively exposed to fluoride, critically between the ages of 1 and 4, when most infants have weaned onto low fluoride cow’s milk anyway. If you live in an area of water fluoridation and are still using formula milks, especially soy-based ones after 12 months of age, then you can reduce fluoride intake by using bottled water that is labelled “purified” “distilled” “deionized” “demineralised”.
Something that can make the teeth look like they have fluorosis is dehydration. If you notice your little one has white mottled specks on their teeth first thing in the morning, especially if they’ve been a bit bunged up with a cold, you may just be seeing natural speckling in the teeth that becomes more apparent when the teeth are dehydrated. Have another look after they’ve eaten breakfast and had something to drink.
White spot lesions more associated with demineralisation or the early stages of decay can also look very similar to fluorosis. However, fluorosis tends to appear on the incisal edges of teeth whereas decay tends to start at the gumline or at the contact points between the teeth.
Now let’s look at #2 first. Dental products are still the most common source of fluoride overexposures as they’re usually left unsecured on the bathroom sink. “…ingestion of only 1.8 ounces of a standard fluoridated dentifrice (900-1,100 mg/kg) by a 10-kg child delivers enough fluoride to reach the ‘probably toxic dose’ (5 mg/kg body weight).” To me, that sentence may as well be in Japanese. I work in old money so I’ve translated it for those like me. A 10 kilo child is about 1.5 stone – a toddler. 1.8 ounces (approx 50g) equates to about 50ml and looks like this:
Approximately two and a half tubes of sample sized toothpaste. Now, my boy loves the taste of toothpaste but that is a serious amount of toothpaste to consume considering it is very gloopy and overpowering in taste. I used to secretly eat toothpaste (and dog biscuits) but I could only cope with a very small amount. Could this secret toothpaste eating obsession cause fluorosis? Yes, especially if fluoride intake is high elsewhere.
Fluoride has a very valid place in improving the oral health of our little ones and dental fluorosis is really about aesthetics rather than damage. However, I think it’s important we respect the potential harm of fluoride in toothpastes and mouthwashes and keep it out of reach of curious fingers at all times as death by fluoride overdose, although now very rare, is a particularly unpleasant one.
Some parts of the world have naturally occurring fluoride in the water. If you’re unsure, a quick google search should reveal the fluoride status of your hometown.