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Tooth Decay typically declines 30-50% in communities that start or continue water fluoridation.*

Facts on Fluoride see: ADA Fluoride Facts 9/05

ADA Statement on Water Fluoridation and Bone Cancer

An unpublished thesis by a Harvard doctoral student researcher, reportedly suggesting a link between fluoridated water and the development of a rare type of bone cancer in adolescent males, has been the subject of recent media coverage. The Harvard School of Dental Medicine has announced that it will conduct an inquiry into charges that those findings were misrepresented by a professor.

The ADA is a longtime advocate of fluoridation as a safe and effective means of preventing tooth decay. It has been cited by the Centers for Disease Control and Prevention as one of 10 great public health achievements of the 20th century. Studies show that fluoridation can prevent between 15–40 percent of decay. The ADA cautions the dental profession, public health officials and the public against drawing conclusions based on a lone researcher's unpublished study. Indeed, the student notes in her thesis that there are several limitations to her study and recommends that the findings be confirmed using data from other studies. For example, she notes that the study may not accurately reflect the actual amount of fluoride consumed by study subjects.

ADA policies on community water fluoridation are based on the overwhelming weight of credible scientific evidence. That evidence stems from extensive scientific research and has been published in refereed (peer-reviewed) professional journals that are widely circulated. The research concludes that there is no association between cancer rates in humans and optimal levels of fluoride in drinking water.

The ADA encourages, supports and welcomes scientific investigations into matters pertaining to oral health. It will continue to monitor this development closely and if necessary will advise the public and the dental profession of any steps that we believe are needed to ensure the public’s safety.

As the leader of a science-based profession, the ADA is open to new scientific information and welcomes the opportunity to address it according to the standards that prevail in the scientific community.

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 Root Caries Prevention Advances

An article in a special supplement to the journal Caries Research reviews the effects of dentifrices with high fluoride contents on the management of root caries. Primary root caries lesions  which are a widespread and often serious problem in older populations, can be difficult to restore. It is generally accepted that fluoride ions promote remineralization of tooth substances and reduce the rate of demineralization. The use of a dentifrice with a high fluoride content may be considered to reverse this condition since more fluoride is required for the remineralization of roots than for enamel.

Woman Dentist Journal April, 2005; 3(4) Author(s) :   Margaret Scarlett  Lynch E, Baysan A. Reversal of primary root caries using a dentifrice with a high fluoride content. Caries Res 2001; 35[Suppl 1]:60-64) ]


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Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States: Here is the study

USDA National Fluoride Database of Selected Beverages and Foods - 2004

Everyone Needs Fluoride

Does Fluoride Benefit Adults?

1)        It reduces the solubility of enamel in the presence of acid.
2)        It exerts an effect on bacterial plaque by reducing their ability to produce acid.
3)        It promotes remineralization of tooth enamel.

        When fluoride is ingested throughout life it is incorporated in enamel and dentin as it is formed.  Unfortunately, fluoride daily intake is usually discontinued by age 10. This is the age pediatricians and dentists feel the crowns of the 2nd molars have formed. The roots do not get adequate fluoride incorporated in the dentin matrix. There is a constant ebb and flow between demineralization and remineralization of exposed teeth. Fluoride improves the remineralization and prevents the loss of tooth structure from the effects of the acid produced by the bacterial plaque.

        Applying topical fluoride directly to the erupted teeth allows the penetration of fluoride into the enamel and exposed dentin. It provides localized protection of teeth not treated with ingested fluoride and replaces fluoride leaching out of the tooth surface. Topical fluorides include toothpastes, mouth rinses, and professionally applied fluoride solutions and gels.

        A 1998 study by the U.S. Department of Health and Human Services has shown a dramatic increase in tooth loss among adults age 35-44. The study shows that 78% of adults 35-44 have at least one tooth lost because of tooth decay. 84.7% over the age of 18 have at least one area of tooth decay per year. Data from the 1988-1991 National Health and Nutrition Examination Survey showed that 6.9% of 18-24 adults and 56% of all adults over the age of 75 have root decay. As we age, there is a decreased salivary flow, exposed root surfaces, and  poorer home care. This greatly increases our risk for root decay. There is data that shows individuals who have consumed fluoridated water continuously from birth have a 31% reduction in tooth compared to adults with no exposure to water fluoridation.
        Adults should have fluoride treatments to maintain their teeth for a  lifetime. Dr. Allan Monack's article 8/04

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Fluoride: Key to Remineralization

For nearly 60 years, fluoride has been the cornerstone of almost all caries prevention programs. Here’s how fluoride actually works:  The surface layers of teeth are continually undergoing a process of demineralization and remineralization brought about by the acid production of mutans streptococci. If the speed of demineralization exceeds the speed of remineralization, a carious lesion will eventually form.

Fluoride plays a significant role in this ongoing process. During demineralization, the acids diffuse into the tooth, dissolve tooth mineral and can lead to removal of calcium, phosphate and carbonate from the tooth. As the acids are buffered by saliva, calcium and phosphate flow back into the tooth. If fluoride is present in the plaque or saliva, it combines with the dissolved minerals and forms a new veneer on the surface of the tooth that is actually more resistant to subsequent acid attack because it contains more fluoride and less carbonate. Hence the prevention of caries.
Source: Dr. Kathy Phipps, June/July 2004 Journal of the AZDA,

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Fluoride Toothpaste Significantly Reduces Childhood Cavities

A review of 50 years of clinical trails (74 studies involving more than 42,000 children under the age of 16)  firmly establishes that in children brushing with toothpaste containing fluoride results in 24% less cavities than does brushing with non fluoridated toothpaste.  This study conferred:


greater cavity reduction by brushing twice a day or more with fluorided toothpaste than only once a day.


brushing with toothpaste containing a higher concentration of fluoride is associated with greater reduction in cavities.


fluorided toothpaste with give greater benefits in  those with higher levels of decayed, missing and filled teeth.


brushing with fluoride toothpaste provides additional reduction of cavities even if children live in areas with fluoridated water supplies.

Fluoride Toothpaste Significantly Reduces Childhood Cavities, pg 44, Dentistry Today 2/03

Fluoride Deemed Effective in Osteoporosis Study

Fluoride, in combination with calcium and vitamin D, increases bone mass and lowers the risk of backbone fractures associated with osteoporosis    .

Fluoride is known to stimulate new bone formation, but concerns about its safety have limited its use in the elderly.  There is no FDA approved drug for osteoporosis that increases bone formation.

Fluoride, calcium, and vitamin D with calcium was compared with vitamin D alone in the treatment of 85 women aged 65 years or older who had already experienced one or more backbone fractures from osteoporosis. The fluoride used was a long-acting form.

Women treated with fluoride saw a 68% reduction of new or repeat fractures compared with women who did not receive fluorider.

According to the results, the chance of fractures in other locations did not differ in the two groups of women, and estrogen use did not seem to influence the results.

Bone density increased in both treatment groups without measurable differences between the two.

Women treated with fluoride showed significant improvements in various measures of bone formation compared with women not treated with fluoride.

None of the ill effects previously associated with the use of higher doses of fluoride were seen in these patients.

``Our findings support the use of (long-acting) sodium fluoride with calcium and (vitamin D) in treating older ambulatory women with established osteoporosis,'' Rubin and colleagues conclude.

SOURCE: Archives of Internal Medicine 2001;161:2325-2333. (Reuters Health)

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New Fluoride Guidelines

Community water fluoridation is safe and effective in preventing dental caries in both children and adults. 

Dr. William Maas, director of CDC's Divisions of Oral Health stated that their study will "ensure that every family members gets fluoride in the right amount, in the right place and at the right time".

"Fluoride is needed throughout the lifespan to prevent and control tooth decay" said CDC director Dr. J. Koplan.  "Better directed use of fluoride can lead to considerable savings...without compromising the tremendous advances we've made in reducing tooth decay.

Our own Nebraskan State Dental Health Director, Dr. Kimberly K. McFarland, chair of the ADA Council on Access, Prevention and Interprofessional Relations said "The report confirms community water fluoridation is a safe, effective and inexpensive method of preventing tooth decay.  It benefits people in all age groups and of all socioeconomic levels, including those difficult to reach through other public health programs."

In average water fluoridation cost 72 cents per person per year, far less than the cost of a filling!

CDC recommends:


Frequent use of small amounts of fluoride for ALL ages


Parental monitoring of fluoride intake for children under the age of six


Fluoride concentration labeling on bottled water products


Education of professionals and public about this research.

For the more on this report: CDC Fluoride Report 

ADA News Sept. 2001, New Fluoride Guidelines pg 18.
* Centers for Disease Control and Prevention:

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              Fluoride and Your Health

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                        Source: Academy of General Dentistry

February 27, 2007

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