Fluoride Action Network

Tooth Much of a Good Thing?

Washington Post | June 27, 2000 | by Haleh Samiei

You think a wholesome act like Brushing teeth is free of Controversy? Wrong.

A Connecticut dental researcher is warning parents that exposing their children’s baby teeth to too much fluoride can lead to increased risk of enamel fluorosis once the permanent teeth erupt.

With enamel fluorosis, the natural ceramic cover of the teeth develops white lines, streaks, spots, plaques or brown stains. Severe cases can lead to the breakdown of enamel and the weakening of bone and tooth structure.

David Pendrys, an oral epidemiologist at the University of Connecticut Health Center, found that brushing habits or excessive fluoride supplementation in early childhood seemed related to the development of enamel fluorosis in 663 children aged 10 to 14. Results are published in the June issue of the Journal of the American Dental Association.

Pendrys acknowledges the benefits of fluoride in preventing tooth decay. And he is not concerned with the optimal amounts (one part per million, also reported as 1 milligram per liter) in municipal water supplies. His concern is the excess ingestion of fluoride before eruption of the permanent teeth, when the tooth enamel is forming–until about age 6 to 8, he says.

Pendrys says parents should make sure preschoolers use only a pea-sized amount of fluoride toothpaste. Avoid toothpastes with special flavors, he says, as they can encourage overuse. Parents should also encourage their child to spit out the toothpaste.

Another possible source of enamel fluorosis turned out to be powdered concentrate infant formula. When mixed with fluoridated water, levels of fluoride are a bit above optimal levels, says Pendrys. More studies are needed to verify whether this is an independent risk factor of fluorsis, he says. Until then, Pendrys recommends that people living in an optimally fluoridated area use ready-to-feed formula or mix the powdered concentrate with a bottled water with low fluoride content. (Unfortunately, bottlers are not required to disclose fluoride content on labels.)

Pendrys says concerned parents should talk with their physicians or dentists, who can advise on local fluoride content and whether fluoride supplements are needed. People who draw their drinking water from wells need to have their drinking water tested.