Dr. John Johnson, a Lubbock pediatric dentist, sees cases of fluorosis all the time. Dr. Elizabeth Dannenberg, another Lubbock dentist, sees it too: splotchy, discolored teeth. In rare, severe cases, they even become brittle and chalky.
The cause is too much fluoride, and it comes from drinking water.
“There’s a lot of fluorosis in West Texas,” Dannenberg said.
But she clarified those cases aren’t typically in Lubbock.
Johnson and Dannenberg agree; most cases of fluorosis aren’t found in kids who drink only Lubbock tap water. It’s primarily found in kids who frequently drink water from the surrounding area.
Lubbock’s drinking water contained an average of about 0.77 milligrams per liter in 2010. That’s right on target, said Aubrey Spear, the city’s director of water resources.
Last month the U.S. Department of Health and Human Services and the U.S. Environmental Protection Agency lowered the recommended levels of fluoride for the first time in 50 years to 0.7 milligrams per liter of water. Before the new recommendation was made in January, the accepted level of fluoride was 0.7 to 1.2 milligrams per liter of water. Too much fluoride can cause fluorosis, or defects in tooth enamel, in children under the age of 8.
“I see it all the time,” Johnson said. He suggests his young patients who live in or visit those areas avoid drinking the water and stay away from any additional fluoride.
Fluoride occurs naturally in the soil throughout the South Plains. Consequently, well water and ground water often contain more fluoride.
It’s not the case for all towns in the region. The fluoride levels must be analyzed on a case-by-case basis. Water quality reports from the past two years show that Muleshoe’s water contained 0.4 milligrams of fluoride per liter of water, Floydada’s had 2.56 milligrams per liter, Littlefield had 2.04 and Plainview had 1.81.
But some fluoride is healthy. It all depends on how it’s consumed. Topical fluoride, the kind dentists apply in fluoride treatments, helps teeth grow strong. The fluoride in toothpaste is also beneficial, unless it’s swallowed, according to the American Academy of Pediatric Dentistry.
Johnson tells parents no fluoride in toothpaste until children prove they can spit it out, typically around age 3 or 4. He recommends they buy toddler or training toothpaste until then.
It’s when fluoride is ingested that problems occur. A little fluoride is good. Cities that don’t have naturally occurring fluoride add it to water. But too much can have negative effects. In most cases, fluorosis is mild and primarily cosmetic, Dannenberg said.
But in more severe cases it can lead to tooth decay, and even bone problems.
Fluorosis primarily affects children under the age of 8, whose teeth are still developing.
“While they’re developing, we don’t want to see the fluoride,” Johnson said.
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