There are few breakthroughs in dental medicine that can compare to the effectiveness and poetically simple discovery of fluoride for the use of caries prevention. We know through education and experience that fluoride is an indispensable component of our fight against tooth decay. As dental professionals, it can be easy to take for granted this ally in dental health that we rely on so heavily. But we can’t be complacent, because fluoride is under attack, once again. There is a whole new generation of anti-fluoride advocates, and they are determined to remove it from dental products, dental offices, and public water supplies. Why has fluoride come under scrutiny, yet again, and why are we seeing this resurgence of anti-fluoridation efforts?
The Reason for the Anti-Fluoride Revival
I think the answer lies in the rise of modern technology, especially social media, over the last decade. It is important for us, as medical professionals, to understand how technology has affected the flow of information to our patients and the public. We often hear the term “The Information Age” used to describe this point in our history. While it is true that people have immediate access to vast amounts of information, via the internet, I sometimes like to think of this as “The Misinformation Age.” The internet has delivered us into an environment where anyone, anywhere, with a computer, can post essentially any information that they choose. This has led to the dilution of accurate information and sources of information. Because it can be difficult to decipher legitimate sources of information, especially in complex scientific fields such as medicine and dentistry, the public is being subjected, unknowingly, to large amounts of inaccurate information.
Regarding fluoride, small factions of anti-fluoridation proponents have always existed, but previously had little influence over the public because they had few avenues to communicate with large numbers of people. Well, times have changed! They now have access to large audiences, and there is no governing body to monitor the information being presented. How are patients supposed to wade through all this material?
Educating Patients About the Benefits of Fluoride
As dental professionals, it is our job to educate our patients and help them understand the difference between a legitimate source of evidence-based information and illegitimate sources. This can be a difficult task, but it is important for us to remain vigilant educators in the operatory, it is one of our most important responsibilities as dental clinicians. It is unfortunate that one of our most effective resources for dental public health, fluoride, has been a frequent target of false data and misinformation on the internet. This may be due to the controversial history that fluoride use has unfairly suffered.
The use of fluoride for caries prevention has had a long and sometimes divisive past. After fluoride’s cavity prevention properties were discovered in the 1930’s, it was studied for decades to determine the proper concentrations and delivery methods1. It was added to water supplies in test cities which led to many of the conspiracy theories surrounding fluoride. Because fluoride is toxic in high doses, there were many false theories that the government was “poisoning” the water supply. Other theories surrounded false side effects of water fluoridation including cancer, bone disease, and lowered IQ’s, among others. In the 1960’s water fluoridation was widely implemented across the United States and fluoride conspiracy theories flourished nationwide.
Public Concerns About Fluoride
In response to the public’s concerns about the safety and efficacy of fluoride, government agencies, universities, and private organizations conducted decades worth of research and studies on the subject. Eventually, scientific data prevailed, and fluoride came to be recognized as a safe and effective preventative tool in the fight against tooth decay. It is known as one of the greatest achievements in public health2. To this day, there have been no valid scientific studies to indicate that fluoride administered properly in the right doses is harmful. In fact, fluoride is one of the longest-running, most well researched, public health contributions in modern medicine with over seventy years of research and data to prove this point3.
However, our patients are becoming confused by the contradictory information being presented online. The individuals and organizations that perpetuate anti-fluoride messages have become very sophisticated at presenting their theories. One, high-profile, anti-fluoride organization is called The Fluoride Action Network. They have gone to great lengths to spread their anti-fluoride beliefs, including the presentation of incorrect data and statements.
The Fluoride Action Network website presents misinformation as fact and is very official in appearance. To the uneducated eye, this website would raise many concerns regarding the use fluoride. They have even gone as far as to bring lawsuits against the EPA for the removal of fluoride from drinking water by citing studies that have been deemed invalid by the dental and scientific communities. Because these issues are so complex and involve vast amounts of scientific data, scientists and the dental community are constantly having to reinforce to lawmakers and the public the efficacy and safety of fluoride.
In addition to their other efforts, anti-fluoride proponents also circulate false information via social media sites. These messages appear on social media feeds and are not traceable to any reputable source. Patients see these messages and take them for fact. I’m sure most of us have had patients in our operatories citing something they read on Facebook as a reason to not give their child a fluoride treatment.
Initially, I was indifferent to the misinformation being spread about fluoride, but as it continues to grow, the more concerned I have become about the damage it could do. Fluoride is one of the greatest public health achievements in history, and it should worry us as dental health professionals to see it being discredited this way. Especially considering that fluoridation of public water supplies and dental products is such a simple and cost-effective way to protect against tooth decay to everyone across all demographics. That means that unnecessarily losing this important resource would most greatly affect the most vulnerable people in our society.
The problem of misinformation being spread on the internet is widespread and is only going to grow larger as technology advances, which is why it is even more important for us to recognize and address the issue now. By arming ourselves with reputable data from reliable sources such as The American Dental Association, The World Health Organization, and The Centers for Disease Control, we can confidently educate our patients regarding the safety and effectiveness of fluoride, and be a much needed, trustworthy source of information in this confusing “Information Age.”
1) “Fluoridation Facts.” Fluoridation Facts: History of Water Fluoridation, 2005, www.ada.org/~/media/ADA/Member Center/FIles/fluoridation_facts.ashx.
2) “Community Water Fluoridation.” Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 21 Feb. 2018, www.cdc.gov/fluoridation/index.html. Water Fluoridation one of ten greatest public health achievements.
3) “Fluoride in Water.” American Dental Association, American Dental Association, www.ada.org/en/public-programs/advocating-for-the-public/fluoride-and-fluoridation. Water Fluoridation is safe based on seventy years of research.