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What Is Fluoride?
If you’ve looked into getting a new toothpaste lately, you may have seen a lot of talk about fluoride. Half the town seems to say it’s a deadly chemical while dentists and oral health professionals advocate for its use. The truth is, there’s a tremendous amount of misinformation on fluoride, its dangers and its benefits. Below is a quick run-through of the basics you need to know about using fluoride to improve your oral health.
Basics Of Fluoride
For starters, fluoride is an entirely natural compound. The fluoride ion comes from the element fluorine, which is a naturally occurring element that can be found in the earth’s crust. As a result, our fresh water reservoirs such as lakes and rivers contain small amounts of fluoride naturally – anywhere from 0.1 to 4 parts per million. This is simply a result of water flowing on and around rocks that contain the element fluorine in them.
The main goal of infusing toothpaste and other dental care products with fluoride is to protect against tooth decay and cavities. According to the American Dental Association, fluoride is the only chemical proven to reduce tooth decay and help to prevent cavities. As such, it’s almost universally recommended by dentists and health professionals as part of a healthy oral care routine.
How Fluoride Works
Fluoride will help strengthen your teeth in one of two ways: ingestion and topical application. Ingestion is rather simple and can significantly improve teeth health in the developmental stages. As fluoride is ingested through a medium such as drinking water it is deposited throughout the entirety of the tooth, not just on the surface. This strengthens your teeth and makes them more resistant to acid erosion. Additionally, fluoride will become embedded in saliva, which can routinely bathe your teeth and apply fluoride topically.
Topical fluoride helps in a slightly different way. Tooth decay is a result of the activity from the bacteria in your mouth. The various germs and bacteria in your mouth will feed upon the sugar and starch that are present in foods that you eat. As they consume this sugar and starch they’ll excrete acid. This acid will alter the pH levels in your mouth. If the pH levels in your mouth drop below a certain threshold (specifically, 5.5 for enamel) the enamel on your teeth will start to wear away.
This is where topical fluoride (such as the kind you’d find in toothpaste) comes in. If fluoride is present when the enamel of your teeth is rebuilding, which happens continuously, it’ll slightly modify the remineralization process. Instead of your teeth rebuilding themselves with hydroxyapatite, they’ll instead rebuild with fluorapatite. The difference between these two materials (aside from their complicated names) is that fluorapatite is more resistant to the acid the bacteria in your mouth produce.
The crux of this is that your teeth are constantly being worn down and rebuilding themselves. Not using a fluoride based toothpaste for even a few days will cause your teeth to rebuild themselves with the less resistant hydroxyapatite. A constant and consistent presence of fluoride is necessary in order to keep your teeth continually strong.
Depending on who you talk to, the topic of water fluoridation can result in a pretty heated debate. At a high level, the idea of the government adding chemicals to our drinking water sounds a bit scary. As it turns out though, there’s a lot of science to back up the benefits of this.
As mentioned earlier, fluoride occurs in our drinking water naturally; however this natural amount of fluoride is not enough to help combat the effects of acid erosion of our teeth. As such, water fluoridation became an official policy in the United States in 1951 after numerous studies found it beneficial to preventing tooth decay.
The major concern around water fluoridation is the potential health effects it can have after repeated ingestion. As such, the CDC published an entire study around the effects of water fluoridation. The results were conclusive – water fluoridation is no danger whatsoever. Even at three to six times the standard amount there were no observable adverse health effects. Furthermore, the reports around removing fluoride from drinking water show a pretty severe increase in tooth decay.
Simply put, drinking tap water that includes fluoride is good for your oral health.
Dangers of Fluoride
Most of the major danger concerns with fluoride are pretty baseless. Of the six adverse health effects listed on Wikipedia’s page on fluoride toxicity, only fluorosis is “the only generally accepted adverse health effect” of fluoride.
What is fluorosis? It’s simply a cosmetic issue that presents itself when increased amounts of fluoride are ingested. Dental fluorosis is generally found in children’s teeth during tooth development. It can cause varying degrees of intrinsic tooth discoloration but is otherwise harmless. General treatments of fluorosis involve teeth bleaching, micro-abrasions, veneers and crowns.
A fluoride based toothpaste, along with mouthwash and flossing, is an important part of a healthy oral care routine. Most of the concerns around fluoride are based out of simple fear and not fact. Water fluoridation can significantly increase resistance to tooth decay and help to prevent cavities. The only concern around fluoride is its use with very young toddlers who may accidentally swallow toothpaste. For these cases, make sure to use a fluoride free toothpaste to help prevent cosmetic issues. Otherwise, fluoride is an extremely helpful way to keep your teeth healthy.
copy written by Jeffrey Williams
Acid Reflux, also known as Gerd (Gastro Esophageal Reflux Disease), is a condition in which the acid contents of the stomach back up into the esophagus, making its way into your mouth. The common symptoms include heartburn, nausea, a bitter taste in the mouth, and a chronic cough. Left untreated, acid reflux can cause serious damage to the esophagus and can lead to a precancerous condition.
What many people don't realize is that these acids can have a serious effect on your teeth. Enamel erosion, increased incidence of tooth decay, and recurrent decay around existing fillings and crowns are the 3 most common effects. It is up to your dentist to determine the source of the acid that has caused the damage. There are 4 common sources of tooth destroying acids:
1. the acid produced by the bacteria that live in the white sticky plaque that builds up on your teeth
2. the acids contained in citrus fruits and carbonated drinks
3. the acids that chronically bathe the teeth due to self-induced vomitting known as bulimia
4. the acids that chronically bathe the teeth due to acid reflux
The acids of the stomach are very powerful and can quickly and easily strip away the outer layer of enamel on the teeth. This is often seen on the inner surfaces of the teeth next to the tongue. This kind of erosion has a very particular look that your dentist can easily identify. When it is determined that the decay is due to stomach acids, the dental materials that will be used will be specifically chosen to be more acid resistant. The acid reflux or the bulemic condition will obviously have to be addressed as well.
The treatment for acid reflux include diet modifications, lifestyle changes, antacid medications and PPI (proton pump inhibitors) medications. If you suffer from any of the above symptoms, please consult your doctor and/or dentist.
Dr. Brian Kaplansky (Mississauga Dentist)
Dental Facts For Pregnant Women ( part two )
During pregnancy, the hormonal changes that your body is undergoing presents itself in many parts of the body including gum tissue. It is common for your gums to become very swollen and inflamed. Bleeding from the gums can easily happen because the inflamed gum tissue is very thin and fragile. This occurs in a majority of pregnant women and can be alarming in severe cases. If you didn’t follow my advice in my last blog, you may want to revisit it after learning about the possible consequences of poor oral hygiene during pregnancy.
The easiest way for bacteria to enter directly into your bloodstream is through the gum tissue. Your gums are typically very thin yet very vascular at the same time. There are many small blood vessels very close to the surface. This is especially the case when you are pregnant! That is why during pregnancy you are at greater risk of allowing bacteria to enter your bloodstream. This can be harmful to both yourself and to your baby.
This bacteria in the blood can affect you in three ways.
- The bacteria can cause a very serious infection in the blood known as septicemia that is potentially fatal for both mother and baby.
- The bacteria can lead to an increase in blood pressure which is detrimental to both mother and baby. Later in the pregnancy, it can lead to pre-eclampsia which affects 5-8 % of pregnant women. Pre-eclampsia and other blood pressure related disorders are leading causes of both maternal and infant death.
- Recent studies show that poor dental health can lead to the release of hormone-like substances called prostoglandins which can lead to premature labour. This, in turn, leads to low birth weight and a host of other undesirable effects of premature delivery.
Excellent oral hygiene is so important for the health of your teeth and gums, and is equally important for your overall well-being. This is especially true during pregnancy when your gums are particularly fragile and more likely to allow bacteria to penetrate into the bloodstream. There aren’t any reliable statistics to demonstrate how frequently this occurs, but prevention is always the key to good health!
Dr. Brian Kaplansky (Mississauga Dentist)
Dental Facts For Pregnant Women ( part one )
During pregnancy, the hormonal changes that your body is undergoing presents itself in many parts of the body including gum tissue. It is common for your gums to become very swollen and inflamed. Bleeding from the gums can easily happen because the inflamed gum tissue is very thin and fragile. This occurs in a majority of pregnant women and can be alarming in severe cases.
Mistakenly, many women will stop flossing and/or avoid the gums when brushing, because of the bleeding that results. In fact, you should be doing the exact opposite! When your gums are inflamed, they become more susceptible to plaque build up, which causes even more swelling and bleeding. The danger in allowing bacteria to accumulate under the gum tissue is that the bacteria can easily penetrate the thin and bleeding tissue and have direct access to your bloodstream . This can be dangerous to both you and your unborn baby.
There are 5 easy steps to follow that will decrease the likelihood of bacteria penetrating the bloodstream via your gum tissue:
- Floss your teeth daily but be sure to ask your hygienist how not to damage the gum tissue during flossing. Basically, the pressure of the dental floss should always be directed towards tooth structure, and not towards gum tissue. Expect lots of bleeding during the first week of flossing.
- Use a soft-bristled toothbrush and be sure to gently brush the area where the tooth meets the gum tissue. Don’t let bleeding stop you from thoroughly brushing.
- Rinse every morning with a solution of salt and water. Take a half teaspoonful of salt and mix it with half a cup of warm water and stir. Swish the solution vigorously one mouthful at a time until finished.
- Rinse every evening with Listerine to decrease the bacterial count in your mouth.
- Visit your hygienist or dentist every 3 months during pregnancy. The only precaution to be taken at the dental office is to not have any dental x-rays throughout your pregnancy.
In my next blog I will outline why you should take this article seriously and practice good oral hygiene. I will describe in more detail, the possible harmful effects to you and your unborn baby of bacteria entering your bloodstream through inflamed and bleeding gum tissue.
Dr. Brian Kaplansky (Mississauga Dentist)
Recent scientific studies have finally confirmed what we have suspected for many years; oral health directly impacts your overall well-being. When you are brushing and flossing your teeth, you are not only preventing tooth decay and gum disease, but you are also minimizing your risks in developing many of the degenerative diseases of the 21st century. Cardiovascular disease, diabetes, osteoporosis, cancer, chronic obstructive pulmonary disease (COPD), cerebrovascular incidents (stroke), pre-term births, and bacteremias (bacterial infection in the blood) have all been linked to the bacteria that lurks in the plaque found above and below the gum line in our mouths.
The presence of bacteria near the gum line causes inflammation which leaves the gum tissue swollen and prone to bleeding. The open wounds of the gum tissue are the entry points for the bacteria that reside in the area. These bacteria can now enter the bloodstream and settle in any of the tissues and organs of the body. The chronic inflammation of the gum tissue and the body’s response to that inflammation weakens the body’s immune system and increases one’s susceptibility to degenerative disease.
The British Medical Journal published a study in 2010 which concluded that “poor oral hygiene is associated with higher levels of risk of cardiovascular disease and low grade inflammation. The bacteria found in the plaque build up on blocked coronary arteries is the same bacteria found in subgingival and supragingival calculus.”
In 2010, The Journal of Dentistry published a review of the literature relating periodontal disease to cancer. Oral and esophageal cancers were the most consistent cancers in the studies that were related to periodontal disease. Gastric and pancreatic cancers had an association in most but not all of the studies.
The Journal of Clinical Periodontolgy in 2010 released a study proving that maternal periodontitis is associated with an increased risk of induced preterm birth due to pre-eclampsia.
What does all this mean? In very simple terms, we must understand that the mouth is the ideal environment in which bacteria can thrive. It is moist, dark, full of little nooks and crannies in which these bugs can multiply and grow, and is constantly being fed with the sugars necessary for their survival. It is this bacteria that manages to enter into our bloodstream through the walls of the gum tissue that they have weakened. Once in our bloodsteam, the bacteria and the inflammation that it causes, are the contributing factors to degenerative disease.
It is with this in mind that now, more than ever, dentists and hygienists in partnership with their patients, must do everything possible to maintain a plaque-free mouth to help minimize the risks in developing the above-mentioned life threatening diseases. Patient specific oral hygiene programs must be formulated and adhered to. This will often include the need for scaling every three months for at risk patients as well as the need for oral rinses, daily flossing, and irrigating devices.
Brushing and flossing will not only save your teeth; it may save your life!
Dr. Brian Kaplansky