Should You Buy Fluoride-Free Toothpaste?

The number of options when you purchase a toothpaste product can be quite overwhelming. Should you stay away from a whitening toothpaste or are they safe? Should you choose to control tartar first or focus on the fluoride content? Perhaps both would be better?

There are so many questions, and it has become even more confusing for the consumers. You may have heard about the claims against fluoridated toothpaste. Some people and entities, particularly the media, talk about the dangers of using fluoride. These hazards are indeed alarming, especially if you are a parent. You may not want your child to get near such a thing – most importantly, put it in their mouth.

However, is there truth behind all these claims? Should you fear fluoride and go for fluoride-free toothpaste instead? This blog will try to answer all these questions. This way, you will know what to do, whether to make the switch or stick with your current toothpaste that contains fluoride.

toothpaste on a toothbrush

What Is Fluoride?

We have all heard about vitamins and minerals, and they are all mostly positive. Many minerals occur naturally, and they can have a positive effect on the body. For instance, calcium usually has a good reputation for keeping the bones strong.

Meanwhile, another naturally-occurring mineral known as iron is essential in transporting oxygen to the cells. Zinc is also a mineral that keeps the immune system strong. There is another mineral that is also quite common, known as fluoride, which can also protect the body.

Fluoride, just like the other minerals mentioned above, occurs naturally. It is found in different water sources, which include the ocean because it is present in the rocks and soil. Some foods also contain fluoride. It actually comes from fluorine, which is a natural element that is commonly found all over the Earth.

When most people think about fluoride though, one product comes to mind: toothpaste. This mineral is added to toothpaste because of the proven benefits it gives to the teeth. Fluoride has always played a huge role in preventing tooth decay. Its capacity to reduce cavities is not the only reason why it exists in toothpaste. For decades, it has been confirmed that this mineral can help improve people’s overall health.

Fluoride has many uses. Aside from being a present mineral in several toothpaste products, it is also in cement, tooth fillings, varnishes, gels, floss, and fluoride supplements. Aside from dental products, fluoride is also an ingredient in perfluorinated drugs, food, drinks with water that contains fluoride, pesticides, and waterproof items.

Why Does Fluoride Exist in Toothpaste?

Fluoride is useful for children who are beginning to grow teeth. During this time, enamel begins to develop, which is crucial. Enamel should be hard, so it can resist decay and cavities. Fluoride can help children achieve stronger enamel.

Once teeth have emerged, the mineral can keep the enamel strong. Children and even adults who love eating sugary foods will need the protection of fluoride. The bacteria from sugar will produce acid that can lead to tooth decay. In this case, the teeth must get the re-mineralising effect of fluoride. If the enamel becomes worn or weakened, fluoride will help rebuild it through consistent brushing with fluoridated toothpaste.

Fluoride is not only present in toothpaste, but also mouthwash and tap water. Therefore, when you brush and rinse your teeth, you can already get the benefits of fluoride.

Other reasons why fluoride is in toothpaste and water include:

  • Decreases tooth decay from 20 to 40 per cent
  • Keeps teeth cavity-free
  • Affordable
  • Naturally-occurring
  • Safe
  • Effective

According to the American Dental Association, fluoride in drinking water is similar to adding vitamin D to milk and calcium to orange juice.

In 2015, a review discovered that fluoride in water reduced the number of children with decayed teeth by 35%. Since the introduction of fluoride in water, there was a 15% reduction in children with decayed baby teeth. Those with no decay in the permanent teeth increased in numbers by 14%.

The Campaign against Fluoride

There is no doubt that fluoride is beneficial for the teeth, especially in preventing cavities and tooth decay. However, some parents have raised their concerns about this mineral. Stories have circulated about how fluoride can result in certain issues, including dental fluorosis. Another is known as skeletal fluorosis, which can affect the joints and bones, leading to their damage.

Dental fluorosis is a real concern. However, it requires heavy amounts of fluoride for it to happen. This condition usually affects kids whose teeth are still in the development process. A certified sign that your child has dental fluorosis is when you see tiny white specks on the teeth. Most of the time though, these streaks are hardly noticeable.

Another sign is rough pitted tooth enamel. Sometimes, it is accompanied by dark brown stains. Although these symptoms may sound scary, particularly for parents, dental fluorosis does not have any direct effect on the health of the teeth. However, the discolouration can worsen overtime when it is not dealt with.

Aside from dental fluorosis, skeletal fluorosis is also a huge concern when it comes to excessive fluoride exposure. It is a bone disease whose symptoms include unbearable pain. Skeletal fluorosis is when the bones harden over time, causing them to become less elastic. Because of the reduced flexibility, the risk of fractures increases.

If it is not treated, this bone disease can continue to cause bone thickening. Tissues will accumulate over the bone, which can eventually lead to joint mobility issues. Fluoride is often associated with bone and joint diseases. If too much is consumed, there may be an increased risk of osteoarthritis, temporomandibular joint disorder (TMJ), and even bone cancer.

The great debate between non-fluoride and fluoride toothpaste has been going on for years. The biggest concern is with excessive fluoride exposure. Apart from the two forms of fluorosis mentioned above, too much fluoride in the bodily system can cause other problems, including:

  • Thyroid dysfunctionSome cases have shown that too much fluoride can impair the parathyroid gland. When it is damaged, it can lead to hyperparathyroidism where parathyroid hormone secretion becomes uncontrolled. This same health problem can also weaken the body when it comes to absorbing calcium.It is why one review described fluoride as a mineral that has an unquenchable thirst for calcium. The bone structures will be affected. When subjected to a blood test, it will show that the blood has high concentrations of the mineral. Since calcium remains in the blood without going to the bones, it can increase fracture risk as well.
  • Skin problemsAccording to the International Association of Oral Medicine and Toxicology (IAOMT), fluoride contributes to the development of acne and other skin issues. It should be noted, however, that IAOMT is one of the organisations that campaigns against adding fluoride to toothpaste and water.
  • Cardiovascular problemsToo much fluoride can also lead to arteriosclerosis, arterial calcification, and myocardial damage. The IAOMT experts believe that the mineral can also contribute to high blood pressure, heart failure, and cardiac insufficiency among other cardiovascular problems.
  • Reproductive problemsSome studies support that fluoride can lower fertility. It can also encourage early puberty in girls.
  • Poor cognitionA 2017 report showed that exposing an unborn child to fluoride could induce neurological problems when growing up. In this study, almost 300 women participated. During their pregnancy, they consumed fluoride, including using the mineral when brushing their teeth. Later on, they were tested for fluoride levels, including their children who were from six to 12 years old. The kids were tested twice – once at the age of four and another when they were around six to 12. Those with higher levels of the mineral were said to have lower IQ test scores.

It should also be noted that fluoride was listed as a neurotoxin in 2014, together with other industrial chemicals, such as lead and arsenic. It is even believed that fluoride can lead to attention deficit hyperactivity disorder (ADHD).

Fluoride poisoning is another problem to watch out for. High-level exposure to the mineral can cause a variety of health concerns, including abdominal pain. Other symptoms include excessive saliva, nausea, muscle spasms, and vomiting. In some cases, the patient can have seizures.

patient and orthodontist

Should You Be Worried?

A common cause for concern regarding fluoride is that it is present in water. When you drink tap water every day, will it result in fluoride poisoning? The answer is no. It will not happen to anyone who drinks tap water with fluoride. However, there is one probability. It would take for the drinking water to be contaminated first. It can often be due to an explosion or an industrial fire.

Excessive exposure to fluoride does not happen a lot, no matter where you live. Most of the time, it occurs because of public water fluoridation. If natural freshwater contains fluoride, it can be in high amounts, which is why you may not want to drink from this source. Bottled water that has not been tested yet can contain huge levels of the mineral as well.

According to the World Health Organisation (WHO), some places have drinking water that contains a high concentration of fluoride. These areas include South Asia, Africa, and the Eastern Mediterranean.

As we have mentioned previously, the IAOMT is against the use of fluoride, and its addition to drinking water. The claim is that fluoride is a neurotoxin that can be harmful in high doses. Other problems, such as teeth discolouration, bone issues, and even environmental concerns have been raised.

Parents, most specifically, are not happy about the addition of fluoride in water. After all, the body already has enough of the mineral. There are many other sources of fluoride as well, including food, beverages, and medication.

The debate has spread worldwide. In 2000, there were researchers from Germany who reported that the occurrence of tooth decay decreased after some cities stopped adding fluoride to the water. However, it was later discovered that the decline was due to better health products that people can now easily access.

The same researchers suggested that there may not be a need to eliminate the addition of more fluoride to water. However, it should be reduced to below 0.2 parts per million (PPM) or 0.2 milligrams for every litre of water. Currently, the amount is in 0.7 part per million. Just 0.3 ppm more and it will be in the amount that may lead to caries.

Is It Time to Stop Using Fluoridated Toothpaste?

Despite strong support from experts and pieces of evidence showing that fluoride is beneficial to oral health, some people are still not convinced. Consumers want to know if toothpaste with fluoride is much safer than those without. Fluoride-free is thought to be the natural and safer alternative to the products most of us have been using for years.

If you take a look at what online shoppers are saying, you will find that many are beginning to fear fluoride. Some even go as far as saying that bacteria-eliminating dental products have harmful ingredients, such as fluoride and triclosan. Whenever people brush their teeth, it means they are ingesting poison daily. No one wants to read and hear something like these statements, especially when children are involved.

The words “natural” and “safe” are two terms that are commonly used to describe fluoride-free toothpaste. However, dentists disagree. Fluoride has always been known as a natural mineral that occurs almost everywhere. It is also safe as an ingredient in toothpaste. For years, fluoride is considered the cavity fighter of nature. Some of its compounds have long been proven to prevent cavities.

father and daughter brushing teeth together

In reality, fluoride-free toothpaste is not bad, but more of a marketing scheme. These products do not help prevent tooth decay. However, they do have some benefits. After brushing, you will have a fresher mouth if you use “natural” toothpaste. Still, this effect is present when you use fluoridated toothpaste.

It is time to clear the misconception that brushing alone can prevent tooth decay. You can reduce the risk only if there is fluoride present. It is not a matter of cleaning your teeth, but it is actually about whether or not toothpaste is needed.

If you ask any dentist, you will learn that you do not truly need toothpaste to get rid of dental plaque. By simply brushing the teeth with toothbrush bristles, partnered with dental floss, can disrupt the build-up of plaque.

When we talk about plaque, it is the precursor of tooth decay and gum issues. Therefore, toothpaste is not a necessity, except if you need certain features, such as whitening agents. Nevertheless, even whitening can be achieved through abrasiveness. It will simply depend on the individual’s sensitivities. A fresher mouth can be achieved even with the mechanical action of brushing your teeth.

So what is the role of fluoride? After all, preventing tooth decay can be done with simply brushing, right? Fluoride is essential in toothpaste because it reduces demineralisation, which is known as the first stage leading to tooth decay. People who have mild demineralisation that has not progressed to a full-blown cavity can turn to fluoridated toothpaste for remineralisation. Fluoride is also vital in disrupting dental plaque.

Let us have a scenario. Two patients come to the dentist’s office. One of them uses the “natural” fluoride-free toothpaste while the other uses one with fluoride. Given that all things are equal, from the habits to the food and drink consumption, the dentist will immediately know the difference. One of them would have lower tooth decay potential – and it is certainly the one who uses fluoridated toothpaste.

The final question now is this: do you have to use fluoride toothpaste every day to get its benefits? Since there have been a few concerns about this mineral, wouldn’t it be nice to only brush with it once a week and use fluoride-free toothpaste for the rest of the week?

Unfortunately, you will not gain the benefits you want, particularly with tooth decay prevention, if you do not brush daily with fluoride toothpaste. As always, it is recommended that you brush at least twice a day with a pea-sized amount. It turns out this amount is not only for kids. Although there is no harm in using more, you do not need a lot to get the decay-fighting benefits of fluoride.

The Therapeutic Goods Administration (TGA) approves fluoride as an ingredient in toothpaste for preventing cavities. As long as it stays in the approved amount, there should not be any problem. Before you start using a product, make sure that you read its content. Even trusted brand names can be deceiving because many consumers tend to ignore product labels.

Nevertheless, the fluoride amount should be in the tube or the packaging itself. It may be difficult to locate, but it is usually indicated as PPM F. For bottled water, Australian manufacturers and producers are encouraged to have their products contain 0.6 to 1.1 mg per litre of fluoride. However, the fluoride content should be added in labelling.