Last Friday, Dr. Mac Harris, a Davis dentist for 25 years, reported that many years ago he had talked to a number of highly educated and affluent Davis residents and all admitted inconsistently giving their children fluoride tablets. When referring to drinking water fluoridation, Dr. Harris then stated that if such highly educated residents forgot to give their kids fluoride tablets on occasion then, “No government program, public health project, insurance bill or charity will ensure that all children receive this tremendous public health benefit.”

Dr. Harris displays a fundamental misunderstanding of the primary mode of fluoride in caries prevention. The Centers for Disease Control and Prevention has unequivocally stated, “… fluoride prevents dental caries predominately after eruption of the tooth into the mouth, and its actions primarily are topical for both adults and children.” (Morbidity and Mortality Weekly Report, 48, 1999, “Achievements in Public Health, 1900-1999”). Unfortunately, many in the dental health community like Dr. Harris still are not aware of this information and continue to promote ingestion of fluoride pills or fluoridated drinking water.

According to one recent study published in the Journal of Public Health Dentistry, 67(3), 2007 (“Knowledge and Use of Fluoride among Indiana Dental Professionals”), “The majority of dental professionals surveyed were unaware of the current understanding of fluoride’s predominant posteruptive mode of action.” In other words, the majority of the dentists surveyed did not know that topical applications of fluoride (i.e., in toothpastes, mouthwashes and sealants) on the surfaces of existing teeth are the most effective mode of fluoride treatment and not through systemic ingestion via fluoride pills or drinking fluoridated water.

These results were replicated by a later survey published in the Journal of Contemporary Dental Practice, 13(3), 2012 (“Knowledge, Attitude, and Use of Fluorides among Dentists in Texas”). That study reported that, “About 57% incorrectly identified the primary effect of fluoride.” The study further concluded, “Dentists are expected to be knowledgeable about products they use, but this study reflects lack of understanding about fluoride’s predominant mode of action.”

Obviously, many local supporters of drinking water fluoridation are also unaware of how fluoride works topically to prevent cavities. Fluoridaton of drinking water is simply outdated and ineffective as a dental health tool in addition to being excessively costly with too many associated and/or proven health and environmental risks. More information on the efficacy of topical vs systemic use of fluoride in preventing cavities can be found at www.flouridealert.org/studies/caries04.

Alan Pryor

Davis

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