Beware of what you are drinking from your tap water!

A more balanced view – both ways!

Fluoride is a natural mineral found in water in various amounts, depending on whereabouts in the UK you live. It is said to be useful in helping to prevent tooth decay and fortify your bones, hence its presence in many brands of toothpaste and mouthwash. In some areas it is added to the water supply through a process known as fluoridation. This is due to studies in the early twentieth century establishing a link between tooth decay and the levels of fluoride in the water supply.

As with just about everything in life, it is possible to have too much of a good thing and overconsumption of fluoride does present certain risks. Therefore, it is worthwhile to take a look at how these risks occur and how to ensure your intake of fluoride is at an acceptable level.

It is not recommended to take fluoride at levels above 10 mg every day. The effects of consuming an excessive amount vary and will depend on exactly how much has been taken and for how long. The most common and well-known side effect from excessive fluoride consumption is a condition known as dental fluorosis. It is usually caused by an excess of fluoride consumed during infancy and childhood, while the teeth are being formed. Its most notable effects are the appearance of white lines or flecks of either a white or brown hue appearing on the teeth. Severe cases of dental fluorosis can result in tooth enamel becoming pitted.

Although this sounds unnerving, fluorosis is generally considered a cosmetic matter and it is not believed to cause lasting harm to the teeth. Should you develop this condition and decide to do something about it, steer clear of domestic cosmetic treatments including tooth whitening products. Their appliance can result in your teeth being discoloured further. To protect against the risk of developing fluorosis, aim to brush your teeth no more than three times a day and ensure that you use mouthwash only a couple of times each day as well.

When you do take mouthwash, remember to always spit it out when you have finished. If you are a UK-based reader, you may find it reassuring to know that it’s uncommon for cases of fluorosis to become serious enough to affect the appearance of your teeth. This is because the Drinking Water Inspectorate, also known as the DWI, keeps a watchful brief on the levels of fluoride in our water and swiftly makes adjustments if it falls above or below the expected amounts.

Excessive consumption of fluoride has also been linked to a rare condition known as skeletal fluorosis. This causes the bones to become fragile and the joints to either harden or stiffen. The onset of skeletal fluorosis can increase the risk of sustaining bone fractures. Whilst the condition is rare, its effects can be as minor as occasional pain in the joints and stiffness to as serious as osteoporosis and muscle wastage.

At the time of writing, there are no known cures for skeletal fluorosis, although in certain cases the effects can be reversed depending on how far the condition has developed. It usually depends on the ability to reduce the level of fluorine in the body. If the intake can be stopped, the amount in the bones will decrease and will be passed via urination. It should be remembered that this is a very long and slow process. In most cases, minimal results are seen in patients. Treating the side effects can also be a complex matter. A bone fracture relating to fluorosis cannot be treated via the usual procedures because the bone has taken on very brittle properties. The recovery process will be an extended one and there is no guarantee of a complete healing. Depending on the progression of the condition, drinking de-fluoridated water may help to reduce the effects of fluorosis.

A further risk posed by an excessive fluoride intake is acute fluoride toxicity. This can lead to stomach cramps, nausea, vomiting and diarrhoea. In certain cases, particularly those concerning children, the effects can be life threatening. However, this is a rare condition because the concentration of fluoride in water, toothpaste and mouthwash are too low to lead to an overdose of fluoride.

Most cases of acute fluoride toxicity have resulted in the accidental ingestion of insecticides and rodenticides which have a strong presence of sodium fluoride in them. Other cases have resulted from the constant and repeated ingestion, that is, eating and drinking, of products such as toothpaste and mouthwash.

In summary, fluoride is an essential mineral in the fight against tooth decay and contributes towards the building of strong bones. The most common result of an overconsumption of fluoride is the developing of dental fluorosis which, while unpleasant to look at depending on its severity, is not known to cause lasting damage to the teeth whereas tooth decay does. More serious complaints such as skeletal fluorosis and acute fluoride toxicity are very rare in developed countries and mostly occur through accidental ingestions or where water supplies contain an excessive amount of fluoride.

When you brush your teeth, always remember to spit out any toothpaste which has collected in your mouth when you have finished as repeated ingesting of fluoride-based products can result in complaints such as diarrhoea and vomiting. You will no doubt recall being advised this by your dentist, but always remember to use a pea-sized amount of toothpaste every time you brush. Should you have any questions or concerns regarding the health and wellbeing of your teeth, your first port of call should always be your dentist.

Disclaimer

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