I have been a practicing dentist for over a quarter of a century. While I am all for fluoride and cavity prevention, I disagree with the Star-Ledger editorial board that water fluoridation is the right public policy for New Jersey. Yes, statistically, fluoridated water will reduce dental caries in some children. Yes, it is the cheapest way to administer fluoride. But it is not the best treatment, and our patients deserve the best.

Fluoride works best systemically in the developing tooth bud. Once the tooth erupts and the enamel is formed, systemic fluoride (fluoride in water) has very little effect. This means that once the second molars erupt (at approximately 12 to 13 years of age) fluoride in water will have no real effect. Therefore, the large segment of the population older than 13 will be subject to fluoride without getting any benefit.

Putting fluoride in the water is like doing an uncontrolled experiment. One part per million is the recommended amount of fluoride in the water. A child over the age of three should receive one milligram of fluoride per day for optimal fluoride protection. Do the math: the child would have to consume a liter (a little more than a quart) of tap water per day. In this age of canned soda, boxed fruit juices and bottled water, who is going to ensure their child drinks that much tap water?

Moreover, kids are already getting some fluoride. If a processed beverage is produced in a community with fluoridated water, that product may contain fluoride. (If present regulations do not require manufacturers to list products’ fluoride content, they should.)

Too much fluoride can lead to fluorosis, a condition of white spots and mottling of the enamel on the teeth. Over the years, I have consulted many patients on this condition. Uncontrolled fluoride ingestion could lead to many more kids with fluorosis.

For those who believe that government-controlled fluoridated water will be a panacea, be careful what you wish for. And don’t forget to floss.

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