DENTAL HEALTH: Get to the root of a bright smile

Published: 2009/07/01 09:51:40 AM

Too much fluoride could prevent you from smiling as brightly as Hollywood film star Halle Berry.

Picture: WENN



YOU may remember your mother insisting you take fluoride tablets for healthy teeth. I remember raiding my mother’s medicine cabinet and chewing on those little white tablets as if they were sweets. I also recall eating blobs of my favourite-tasting toothpaste after brushing.



Sadly though, when my adult teeth grew, I ended up with something called enamel fluorosis — a consequence of excess fluoride ingestion and which required me to have my teeth capped “Hollywood-style” (like US actors Halle Berry, Denzel Washington and Tom Cruise, to name but a few) to hide the results (mottling and discoloration).



Enamel fluorosis is an example of what can happen if you take in much too much fluoride, but research suggests that even small amounts (like those found in water supplies) are a health hazard for both children and adults.



Regulations to fluoridate water supplies were originally implemented to help deliver the mineral (which is said to assist with healthy tooth development) to the population at large. According to Karl Lubout, a water quality specialist at Rand Water, our water does in fact contain a very low concentration of fluoride at just 0.2 parts per million.



He says: “We don’t believe that water is the right vehicle for fluoride transmission and at the same time, fluoridated water is bad for the environment.”



Not all of SA is serviced by Rand Water, however, and some areas, especially borehole sources of water, can contain very high levels of fluoride, says Lubout. Fluoride supplements, toothpastes and dietary sources are additional vehicles through which we ingest fluoride.



Dr Orlando Rojas, a Pretoria- based holistic dentist, believes we should not be taking in any fluoride at all, that it is not an essential mineral to dental health, and that there are safer and more effective ways to prevent tooth decay. However, the majority of South African dentists (and dentists worldwide) continue to prescribe fluoride treatments as well as toothpastes.



The fluoride issue remains a contentious one, but the anti-fluoride movement has been gaining some ground recently.



A 500-page review of fluoride’s toxicology was released in 2006 by a panel of experts appointed by the National Research Council (NRC) in the US. The NRC concluded that the safe drinking water standard in the US for fluoride of four parts per million was unsafe and should be lowered. The panel reviewed a large body of literature in which fluoride has a statistically significant association with a wide range of adverse effects in both adults and children. These include an increased risk of bone fractures, decreased thyroid function, lowered IQ, arthritic-like conditions, dental fluorosis and, possibly, osteosarcoma (bone cancer). In fact, up to 32% of Americans suffer from some form of dental fluorosis, according to the report.



Later that year, the American Dental Association made a policy change recommending that only purified, distilled or demineralised water should be used to prepare infant formula during the first 12 months of life. They also urged that children under two years of age stay away from fluoride toothpastes, supplements and mouth rinses unless prescribed by a dentist.





It is not just the safety of fluoride that is under scrutiny though, but also it’s effectiveness.



Another 2007 report issued by the International Academy of Oral Medicine and Toxicology concluded that fluoride added to the public water supply, or prescribed as controlled-dose supplements, in addition to causing adverse effects, delivers no discernible health benefit. The Fluoride Action Network, a US-based organisation made up of environmentalists, scientists and medical professionals, issued a statement in 2008 calling for an end to all fluoridation worldwide.



Despite the hype, Dr Norman Cahi, a Sandton dentist, still prescribes fluoride in his practice. Cahi does not believe fluoride to be a poison, especially since we can and do ingest it through many dietary sources including soya, dairy products and tea, he says.



Cahi also says that since local water supplies are very low in fluoride, we may be lacking in this mineral (he says, the recommended safe and optimal levels are one part per million).



Up to 50% of dental disease can be arrested by using fluoride at therapeutic doses, says Cahi. He delivers and prescribes topical and systemic fluoride to children and adults at risk for dental decay. He also often recommends a fluoride- releasing dental sealant for children aged five to seven years at high risk for dental decay.



Cahi does not believe that fluoride is for everyone though, and says that a thorough case history should be taken before deciding whether or not a patient actually needs therapeutic fluoride. For example, he says a child fed on soya infant formula mixed with fluoride-rich borehole water would not need to be treated.



It is also necessary to look at how much toothpaste a child may be swallowing, says Cahi, as many children under eight tend to swallow large amounts. Parents and other carers should educate children on proper rinsing and spitting-out methods to prevent excessive swallowing of fluoride toothpaste, he says.





– Ashleigh Caradas is a dietician in private practice. She also consults to corporates. Visit













Preventing tooth decay — alternatives to fluoride



Dr Orlando Rojas, a Pretoria-based holistic dentist, offers advice for preventing tooth decay, without the use of fluoride toothpastes, gels or fluoridated water. He says general health and dental health cannot be separated. His tips include:



– Eat properly



Nothing beats a good diet and the restriction of refined sugars.



– Brush well



Brushing your teeth properly is also essential to do the trick. An electric toothbrush is best.



– Go natural



He prescribes natural toothpastes free from detergents such as sodium laurel sulphate, fluoride and chemicals.



“Many of them contain natural ingredients and herbs that provide excellent protection against decay and gingivitis,” he says.



To prevent tooth decay, he uses calcium phosphate preparations, which have proven preventative properties.



“I have been using these for my patients and my own children for a long time, even in a controlled manner in lactose-intolerant children without any problems,” says Rojas.



– Floss regularly



This is also essential for people who do not have established periodontal disease. Unfortunately, there is no chemical-free floss available in SA, so at least avoid the fluoridated variety, he advises.



– Scrape your tongue and wash your mouth



Rojas believes that tongue scrapers are great for helping to control bacterial colonisation by reducing oral pH to protect teeth as well. He advocates the use of chemical-free mouthwashes.

One Response to “DENTAL HEALTH: Get to the root of a bright smile”

  1. Find out more about the legal terms of dentistry (e.g. dental hygiene laws; license validity) in Virginia at You will also find great advice on how to find a good dentist, short documentation on preventive dental care, cosmetic dentistry and common procedures. I found it very useful and to speak the truth, you can never be too careful about looking after your health.

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