Previous | Next | Full Copy

7) U.S. Dentists "Unaware" of Recent Fluoride Research

When water fluoridation was first introduced en masse in the 1950s, dentists argued that fluoride needed to be ingested by children -- while their teeth are developing -- in order to be effective. This argument, which also underpinned the introduction of fluoride drops and pills, was based on the belief that ingested fluoride would accumulate in developing teeth and make the “fluoride-enriched” teeth stronger for life. Over the past 30 years, however, this theory has been put to the test and almost unanimously rejected by dental researchers (Featherstone 2000; Fejerskov 2004). A new theory has taken its place: Fluoride’s primary benefits do not come from being swallowed, but come instead from being applied topically to the outside of the tooth while in the mouth.

While the Centers for Disease Control (CDC) was late in coming to terms with this new paradigm on fluoride, it finally came on board in 1999. According to a 1999 report issued by the CDC, fluoride's actions "primarily are topical for both adults and children." CDC repeated this position again in 2001, stating: "fluoride's predominant effect is posteruptive and topical."

The implications of this new consensus are as obvious as they are important: If fluoride has little benefit when swallowed, there is no need for a fluoride chemical to ever make it past the mouth and into the bloodstream. As noted by the recent Nobel Laureate in Medicine, Dr. Arvid Carlsson, “in pharmacology, if the effect is local, it's awkward to use it in any other way than as a local treatment. I mean this is obvious. You have the teeth there, they're available for you, why drink the stuff?”

However, despite the fact that CDC is now on record stating fluoride's benefits are primarily topical, a study published in the Journal of Public Health Dentistry reports that most practicing dentists and dental hygienists are not yet aware of this development. According to the study — which surveyed dentists and dental hygienists from Indiana and Illinois -- only a small minority of dental professionals are aware of the new research. In Indiana, for example, only 25% of surveyed dentists correctly identified the topical effect of fluoride, while in Illinois, the respective figure was just 14%. According to the authors:

"Our main findings are a) that in 2005, 4 years following the release of the CDC's sentinel recommendations, a considerable proportion of dental professionals in Indiana still did not understand fluoride's predominant mode of action."

Not only were the dentists behind in their knowledge of fluoride research, but the survey also found they didn't even know basic information about fluoride, such as how much fluoride is in toothpaste or high-fluoride gels. As noted by the authors: "Another important finding was the inability of respondents to correctly identify the concentration of commonly used fluoride products."

This raises the question: If, after 60 years of water fluoridation, most dentists still don’t know how fluoride actually works, or how much fluoride is in the products they prescribe, what else do they not know?  Do they know how fluoride affects other tissues in the body besides the teeth?

NEXT: No Link Found Between (Low-Fluoride) Bottled Water and Tooth Decay

REFERENCE:

7) Yoder KM, et al. (2007). Knowledge and use of fluoride among Indiana dental professionals. Journal of Public Health Dentistry 67(3):140-7.

See also: Top 10 Scientific Developments of 2006