The history of fluoride's connection to public dental health is fascinating.
For the better half a century, trace amounts of fluoride have been added to drinking water across the country to prevent cavities. And now, toothpaste manufacturers are required to add fluoride to their products in order to earn the ADA's Seal of Acceptance. The ADA's Seal signifies that a tube of toothpaste contains fluoride and does not contain sugar.
The ADA also requires that any product bearing its seal be tested for effectiveness against plaque and gingivitis at regular intervals throughout its shelf life.
Natural Fluoridation in Colorado Springs
The early 1900s were a time of great change in Colorado Springs, Colorado. The city was growing quickly, and people were moving in from all over the country to get away from the hustle and bustle of big cities. Unfortunately, some of these new residents brought bad habits with them—like drinking too much soda (it was everywhere), smoking cigarettes (it was popular), and eating sugar (it was everywhere).
The dentists in town noticed a strange pattern when they looked at the teeth of their patients: many had something called "Colorado brown stain" without tooth decay. Today we understand this condition as fluorosis—caused by too much fluoride exposure while the adult teeth develop. In those days, locals were getting it because of the high levels of naturally-occurring fluoride in the water supply.
Dentists wanted to find out if there was a way to keep the cavity-preventing qualities of fluoride without the teeth-staining effect. The test case was Grand Rapids, Michigan—where fluoride was added to the drinking water over several years. And what happened? Over that same period, childhood tooth decay plummeted by an astonishing 60%, with only a few mild cases of fluorosis and no other adverse effects! This was huge news.
Modern Water Fluoridation
In 1945, Grand Rapids, Michigan, was the first city to fluoridate its drinking water.
The results were so dramatic that communities across the country quickly followed suit. Today, over half of American communities get the dental health benefits of fluoridated drinking water.
It might not make a massive difference in the dental health of someone who can afford regular dentist visits, but it's a game-changer for poor communities.
It might seem odd that adding fluoride to water could make such a difference. Still, it's similar to how we add iodine to salt to prevent goiters, bake with enriched flour to help digestion, and drink milk with added vitamin D to prevent childhood rickets.
Finding the Goldilocks Zone of Fluoride
The fluorosis of Colorado brown stain proved that too much fluoride is harmful, but no fluoride leaves teeth vulnerable to decay. The CDC recommended level of fluoride in drinking water is 1.2 parts per million. That's a tiny amount, but it makes a massive difference in dental health. However, to prevent fluorosis, parents should be careful only to use small amounts of fluoride toothpaste to clean the teeth of their babies and toddlers, and everyone should spit it out rather than swallow it.
What Does Fluoride Do for Our Teeth?
So what makes fluoride so good at preventing cavities? It's a fundamental building block in tooth enamel. When we eat and drink a lot of sugary or acidic things, minerals are pulled out of our tooth enamel, weakening it and leaving it vulnerable to erosion. Preventing demineralization is why it's important to limit sugar consumption. Still, we can fight for our teeth on the other side of the equation with remineralization by brushing with fluoridated toothpaste and drinking fluoridated water.
Come to Us With Questions About Fluoride!
To learn more about the role of fluoride in toothpaste or drinking water, don't hesitate to ask us or check out sources like the ADA or CDC. We want to ensure our patients have all the information they need to feel confident in their dental care and understand why we put so much emphasis on daily dental hygiene habits.