Fluoride: boobs and bottles

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.

4 thoughts on “Fluoride: boobs and bottles

  1. Really interesting, thankyou, I was a secret toothepaste eater and have mild fluorosis, but it doesn’t bother me. That said, I might go upstairs and put the toothpaste somewhere a little harder to reach… On a similar note what do you know about mercury? I remember a couple of years ago, there was a big furore in the breastfeeding world because someone had published a paper suggesting that breastfeeding mothers ‘dumped’ heavy metals such as lead and mercury into their breastmilk to the degree that after a year of breastfeeding, a mother would have little left of her previous burden of heavy metals. To my shame I have not read the original paper (as a medic married to a research scientist, that is a bit pathetic, but I’ve been busy changing nappies!) merely noted that the country where it was published changed it’s recommended length of breastfeeding to 6 months instead of the WHO 12months. Having already fed my first for a year, I reckoned any damage was done, there was no proof the babies actually absorbed it from the milk, milk being famed for it’s chelating properties, etc, etc and didn’t think of it anymore. Until a few months ago when I had a big, painful hole in a molar which my dentist won’t fill because of mercury crossing the placenta and I am pregnant again. Can’t argue with that. Can’t afford private dentistry, so temporary filling for me until the baby is out. BUT if mercury gets into breast milk, then does the conventional wisdom of ‘now the baby’s out we can give you a mercury amalgam filling’ hold, if the mercury is going to end up in the milk the baby is drinking anyway? I know the amounts are negligible, and the clinical effect probably irrelevant, but it bugs me that I don’t know the answer and you seem like someone who would find it interesting too!

    1. Indeed – the perfect tits and teeth subject! This is from a while back so will hopefully answer your questions. http://wp.me/p3e3Um-pp

      I presume you’re in the UK, in which you’ll be pleased to know that mercury fillings are now being phased out so you should be entitled to a white filling on the NHS. http://wp.me/p3e3Um-Cw

      If these two blogs don’t answer your questions then please get back to me!!

  2. Thankyou, it does answer the question, and presuming breastfeeding ‘works’ again for me (as an aside, I loved your advocacy bit) I feel it is reasonably clinically indicated to ask for a white filling in a couple of months’ time. Another thought to ponder – do you think it’s possible to do a study to find out whether babies actually absorb the mercury they swallow in breast milk? Milk can be used as a chelating agent, so is it possible that the mercury and other nasties end up in that baby’s nappies rather than sequestered in their little bodies? Hopeful, perhaps, but it does seem that a large piece of the puzzle is missing if we only know about the step that goes mothers body to milk, but not from milk to baby’s body. Hard to measure except perhaps by measuring mercury/lead output. If found in faeces it would suggest it has never been absorbed. Please excuse the ramblings of a mind that is 10 days overdue with her third child and misses to some degree the academic side of her old job, it’s just that I have never been able to engage anyone else in this topic of conversation successfully before!

    1. I love the ramblings of a mind 10 days overdue with her third child – they are brilliant ramblings! I would also love to do a bit of research into the research, if there is any and I will get back to you. Good luck ol’ girl with the new addition!

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