Researchers recently published a study questioning the effectiveness and safety of water fluoridation based on maternal exposure to fluoride during pregnancy.1 The Academy of General Dentistry (AGD) believes that, according to generally accepted scientific research, fluoride remains safe at the concentrations found in optimally fluoridated water and is a community health measure that benefits children and adults. As oral health professionals, we believe further research should be conducted before the public changes its water consumption habits, especially during pregnancy. We believe that there are too many variables in this study to come to any definitive conclusions, including a lack of funding, a sample size too small to capture true demographics and other environmental or genetic influences.
AGD continues to assert that, when used appropriately, fluoride is safe and effective in preventing and controlling dental decay.
Tooth decay affects more children in the United States than any other chronic infectious disease, according to the Centers for Disease Control and Prevention (CDC). The CDC states that, if left untreated, tooth decay can cause pain and infections that hinder eating, speaking, playing and learning. The problem is pervasive, with 92% of adults ages 20 to 64 having had dental caries in their permanent teeth.2 This number has been found to increase when fluoride is removed from community water supplies.
The controlled addition of a fluoride compound to public water supplies is considered to be the most cost-effective way to prevent cavities and fight tooth decay. The United States Public Health Service has established that the optimal concentration for fluoridation is 0.7 parts per million.3 This range effectively reduces tooth decay while minimizing the occurrence of dental fluorosis. Fluoride helps prevent tooth decay by making teeth more resistant to acids that attack enamel and are derived from bacteria in the mouth and certain foods and drinks. By drinking optimally fluoridated water, all members of society — regardless of income, education or ethnicity — can benefit from better oral health, not just those who have access to dental care.
Despite the fact that good oral health is essential for the overall health of both mother and child, a significant number of women in the United States do not visit a dentist during pregnancy. Dental care during pregnancy is not only safe and effective, but also essential for combating the adverse effects of oral disease. During pregnancy, women should continue brushing their teeth twice a day and flossing once a day.
All water supplies, including bottled water, should have appropriate fluoride levels. Simply put — regular fluoride use throughout life will help protect teeth.
1. Green, Rivka, et al. “Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada.” JAMA Pediatrics, 19 August 2019, doi:10.1001/jamapediatrics.2019.1729. Accessed 21 August 2019.
2. “Dental Caries (Tooth Decay) in Adults (Age 20 to 64). National Institute of Dental and Craniofacial Research, www.nidcr.nih.gov/research/data-statistics/dental-caries/adults. Last reviewed July 2018, accessed 21 August 2019.
3. U.S. Department of Health and Human Services Federal Panel on Community Water Fluoridation. “U.S. Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the Prevention of Dental Caries.” Public Health Reports, vol. 130, no. 4, July–August 2015, pp. 318-331, doi: 10.1177/003335491513000408.