A Look Back at…”Healthy” Smoothies & Your Teeth

Updated from the original post for July 11, 2013

Drink Your Fruit & Veggies?

smoothiesThink you can just drink your fruit and veggies in a delicious fruit smoothie? Research from the BDJ might make you think twice – at least if you care about your teeth.

Researchers found that smoothies can, in fact, be quite damaging to enamel – the hardest tissue in the body, protecting the softer tissues within. But a number of things contribute to erosion, including dry mouth, medications, bruxing (habitual grinding and clenching) and sugars and acids like those you find in the typical smoothie.

Damaged enamel means sensitive teeth and a heightened risk of cavities.

While certain fruits proved to be more damaging than others, the BDJ study found that “some fruit smoothies have the potential to bring about dental erosion if consumed irresponsibly.” To lower the risk, the authors suggest eating while enjoying your smoothie (which, you may argue, may defeat the purpose of having a smoothie, but we urge you: read on).

The trouble with smoothies – as with fruit juices – is their reputation of being “healthy.” There are those who, instead of eating fresh fruit and veg, drink lots of such beverages for a nutritional boost – or, more worrisome, give them to kids instead of whole produce. The drinks’ sweetness makes them especially appealing. Like other animals, we’re evolutionally partial to sweets since they’re associated with high energy foods. (Cats, in fact, may be the only animals that grew out of the sweet tooth.)

Although the sugar in smoothies can be a problem – and there can be a lot of sugar (see this and this, for instance), as as much or more than in most sodas – the BDJ study was concerned more with acidity. Food and drink with a pH value lower than the critical pH of tooth enamel (5.5) are erosive. Most smoothies have a pH value around 2 or 3. Most sodas do, too.

This PSA from the Wisconsin Dental Association pounds the point home:

What about using a straw? Some say it helps get the beverage past the teeth while getting nutrients into the consumer, but that skirts a related issue. As Dean Kathryn Harley of the Faculty of Dentistry at the Royal College of Surgeons has suggested, if kids are constantly exposed to sweet foods like juice, candy and desserts, they may increasingly reject lesser sweet foods such as whole fruits and vegetables.

Remember that the easiest way to get your fruit and veggie intake up is by eating them, not drinking them. To get kids to eat vegetables, try serving them alongside foods you know they enjoy, or serve fresh vegetables as a snack. In her excellent post on “11 Proven Ways to Get Kids to Eat More Vegetables,” blogger Darya Rose suggests using the one bite rule: require your child to try one bite of an unfamiliar food before rejecting it altogether – along with 10 other great ideas.

None of this is to say that you have to cut out smoothies or juices completely. If you like them, enjoy them once in a while. But here’s an added plus of opting for more whole fruit and veg over smoothies and juice: Not only do you avoid the sugars and acids, the more complete nutritional intake can help remineralize your teeth, keeping them strong and healthy. Foods rich in nutrients such as calcium, antioxidants, Vitamin D and phosphorous are especially beneficial.

Image by Ken Hawkins

At Risk for Prediabetes or Diabetes?

pricked finger

Not sure if you’re at risk of developing type 2 diabetes?  The American Diabetes Association (ADA) wants to help you with its “Alert Day,” slated for March 28.

The ADA has a free, quick, and anonymous risk test available you can use to find if you’re at risk for type 2 diabetes. If you are, their site can help you learn how to decrease your risk. Certainly there are many outlets, that offer good information, tips to help you maintain a healthy weight, make better food choices, incorporate exercise and ways to maintain motivation. To reclaim and maintain your health you’ll need to identify what works best for you. Could be a supportive friend who will take a daily walk with you or a one day a week dinner party with friends interested in healthy cooking–let it be unique to you.

Whether you take a holistic approach or a more traditional one, we believe Alert Day serves a critical function in bringing a much needed awareness to the diabetes epidemic. The CDC estimates that 29 million Americans have diabetes yet only 21 million have been diagnosed. That means that 8.1 million remain undiagnosed.

If you’re concerned that one of them could be you

  1. Schedule a dental exam and hygiene visit.
    The latest science indicates that dentists can play a vital role in diagnosing diabetes. If you have gum disease, science now indicates it could mean you already have diabetes or that it’s immanent.

  2. See another health care provider.
    A health care provider can evaluate and monitor your level of risk. They can also support you in developing a lifestyle that may improve your disease profile. This is critical because diabetes is a disease of chronic inflammation. As such, it affects the entire body. Systematically, it has been linked other diseases of chronic inflammation, such as

    • Cardiovascular disease.
    • Obesity.
    • Stroke.
    • Some cancers.
    • Periodontal disease.
  3. Do your research and make necessary changes.
    There is good information out there. Through the years, we’ve put together our own library on health and wellness. Much of it is geared toward eating better, exercising more, and improving diseases of chronic inflammation. Since the health of your mouth is vital to your overall health, we’ve made it easy to search our blog by topic anytime. Here’s a sampling of entries that can help you learn more about the systematic nature of diabetes. Check them out, because whether it’s  March 28th’s Alert Day, or any other day, we think it makes for some pretty good reading:

    Image by Alisha Vargas

Replace a Tooth by Mimicking Your Body’s Nature

Dr. Masoud Attar & Dr. Hamid Shafie

Dr. Attar with dental implant expert Dr. Hamid Shafie at a recent seminar in San Francisco

As we say on our home page, perfection is our passion – which is perhaps the biggest reason why Dr. Attar consistently pursues additional training and education. You can’t achieve perfection without being a perpetual student.

In fact, there’s a quote well-known in dental circles, by a fellow named G.V. Black, who’s considered the father of operative dentistry: “The professional man has no right other than to be a continuous student.”

One of the most recent seminars Dr. Attar attended was in San Francisco and focused on replacing missing teeth with zirconia (ceramic) implants.

As a biological office, we constantly strive to use the most compatible materials for our patients. We know many of you have worked hard to eliminate metals from your mouth. We also believe when you’re looking for a way to replace your missing tooth, you shouldn’t have to compromise. While many offices place conventional metal alloy implants (usually titanium), we use only ceramic for the dental implants we place.

Here are 6 reasons why:

  1. Biocompatibility

    While any material placed in the body has the potential to react, zirconia appears to be very biocompatible for most patients. The firm bond that establishes itself between the bone and the ceramic implant is believed to be bio-inert. This means your body doesn’t react with an inflammatory response as it would with a foreign body.

    In contrast, research shows titanium-based implants both corrode and degrade, generating metallic debris. This debris may have harmful biological effects over time, including the development of renal hepatic injury and renal lesions.

    Additionally, an increasing number of individuals with titanium implants, dental or orthopedic, present with allergies, sensitivities and other skin and immune reactions that necessitate removing the implant from the body. These reactions happen over time with continued exposure to the metal. An allergy or reaction to a dental implant may cause pain, inflammation, infection, bone loss and implant removal. Material testing for implant materials should be considered, especially metals.

  2. Maintenance

    dental implant illustrationRegardless of the type of implant material you select, much attention should be giving to keeping the gum tissue around it clean. Like teeth, implants can fail if bacteria accumulate along the gum. To complicate the matter, tissue doesn’t attach to an implant in the same way it attaches to your natural teeth.

    But research indicates the lack of electric conductivity in ceramic implants makes it harder for bacteria to stick. This makes it easier to maintain healthy tissue with proper cleaning technique. And unlike a bridge, which can be hard to floss effectively, an implant, for all practical purposes, is like a tooth. You can, and should, floss like you do with your natural teeth.

  3. Meridian flow

    Because they’re biologically inert, zirconia implants may offer the best option for maintaining meridian flow from tooth to organ, and organ to tooth. This is especially important to those who employ the principles of acupuncture and pay particular attention to their body’s meridian flow and blockage.

    Not familiar with this concept? You can learn more about it here.

  4. Esthetics

    In contrast to titanium implants’ grey color, ceramic implants are white. This may not seem like a big deal because, let’s face it, they’re implanted in the gums. But in patients with gum tissue recession or thin gums, the grey cast of titanium can become visible. Ceramic implants, on the other hand, retain a natural look with no grey shadow or show through.

  5. Biomimicry in Design

    Ceramic implants have been optimally designed to mimic your natural tooth. Like your tooth, ceramic implants are a one-piece design. There’s no abutment connected with a fixation screw as you commonly see in titanium implant designs.

  6. Functionality

    When you’re looking at replacing a tooth, you want it to be successful. You don’t want to have to revisit this tooth again. To succeed, it must hold up with how you use your mouth, especially the forces of chewing. By creating the diameter and length to that of natural teeth, ceramic implants are foundationally tempered to withstand chewing force.

Any way you look at it – functionally, aesthetically, holistically – when opting for implants, ceramic is clearly the best option for mimicking your natural teeth.

The Impact of Drinking Sugar

You may have seen this image making the rounds on social media lately – a powerful reminder of soda’s impact on your health:

impact of soda

But one thing it neglects to mention happens within the first 30 seconds of drinking pop: It damages the enamel covering your teeth. Enamel. The hardest tissue in the human body. The one tissue your body has no way of making more of.

Zoom into a Tooth by Weird_Weird_Science

As enamel is worn away and the more delicate dentin is exposed, the teeth become sensitive and more vulnerable to decay. Research has shown that among heavy soda drinkers, the damage can be as severe as that wreaked by meth and crack.

Of course, soda is merely among the worst offenders. All similarly sugary and acidic drinks are the issue: fruit juice and juice-based drinks, sports drinks, energy drinks, sweetened teas, flavored waters. So even as soda consumption has finally started to go down, enamel erosion continues to be a big problem.

According to research published earlier this year, nearly 80% of adults show some sign of it. Most cases are mild, but 15% had signs of moderate to severe erosion. As we noted before, this is one reason why tooth decay is eventually an issue for virtually all adults.

Along with sugary and acidic snacks, sweetened beverages are a terror for teeth – a fact most recently confirmed in a study published right at the start of this month. This meta-analysis of past studies found that the more sugary, acidic products you consume, the more erosion. They also found that milk and yogurt “had a protective effect.”

And that only makes sense. For one, dairy has also been shown to have a neutral or alkalinizing effect in the mouth. Cheese, especially, may help prevent cavities, according to research published in General Dentistry. It also provides something those other products inherently lack: the nutritional building blocks for remineralizing teeth and bone, keeping them strong and resilient.

There’s a choice that, consciously or not, each of us makes repeatedly each day: Do we give our body what it needs to do its job or do we confound it by throwing up roadblocks to optimal health? Do we support the body’s self-regulating, self-healing capacities or undermine them?

Give your body the nutrition it needs, it knows what to do.

Guest Post: Trace Minerals for Your Teeth

Our thanks to the office of Dr. Bill Glaros for letting us share the following post from their blog:

teethThe enamel coating that protects your teeth is 96% mineral – the highest mineral content in any human tissue. That makes it the strongest tissue in your body. But like any other tissue, you need to care for it – at least if you want it to stay healthy and whole.

One of enamel’s fiercest enemies is, of course, the sugary, acidic Standard American Diet. Not only does it thwart your body’s efforts to remineralize your teeth, it actually demineralizes them, as well.

A nutrient-rich diet, on the other hand, supports healthy, ongoing remineralization.

And it’s not just about calcium, although that indeed is a critical mineral for keeping teeth strong and sturdy. It’s not just about vitamin D or K or phosphorous. What we really need is a mixed mineral and vitamin cocktail in our diet, as many nutrients require the presence of others to work effectively.

There are many minerals that play a supporting role. They’re called “trace minerals,” as, normally, we only need tiny amounts of things like iron, chromium and zinc. But if one of those miniscule pieces of the puzzle is missing, the remineralization process can be set back.

Like all essential nutrients, minerals are best supplied through plants – which absorb them from the soil – or through the meat, milk, cheese, butter and eggs of animals that feed on those plants. Excellent whole food sources of minerals include dark, leafy greens and other vegetables, nuts, and seeds, whole grains, legumes and meat. (Whole food matters, as the more our food is processed, the more nutrients it loses.) Foods that deplete minerals include coffee, soda, sugar and alcohol.

Many herbs and spices contain minerals, too, and one in particular stands out as an excellent source of many of the nutrients critical to enamel integrity: stinging nettle.

stinging nettleThe herb Urtica dioica, commonly known as nettle, is probably one of the most useful plants available to mankind. Though it’s prickly nature makes it hard to harvest (a sting from a nettle plant can cause swelling and itching like a bug bite), it’s rich in protein, fiber, vitamins and, most importantly, minerals.

Humans have been braving nettle’s sting for centuries. With its spinachy-cucumbery flavor, it is found in many delectable recipes all over the world and was once prized by the Native Americans as a nutrient source in the spring when other food sources were scarce.

Medicinally, nettles have been used throughout history to treat allergies, kidney and urinary tract disorders, digestive disorders, musculoskeletal issues, skin irritation, hemorrhage, flu, arthritis and gout. In the old days, it was common practice to flog oneself with nettle branches to relieve joint pain!

Thankfully nowadays we have time tested recipes like Nettle Soup, Nettle Pesto and delicious teas, as well as products like capsules and tinctures.

And how much of a mineral-laden punch do you get? Check out this chart provided our friends at skipthepie.org:


Look at all those glorious minerals! Lots of calcium, a bunch of manganese, a dash of phosphorus and potassium, a little bit of protein, also a great source of Vitamins A, and K… Nettle equals nutrient heaven for your teeth and bones!

Learn more about cooking with stinging nettle:

Images: SuperFantastic & zen Sutherland

Helping Your Child Not Fear the Dentist

As we near the middle of National Children’s Dental Health Month, think back to your first dental appointment. Was it scary? Uncomfortable?

dentist and young patientThat’s the case for many children, but the dentist doesn’t have to become the Boogeyman.

Yes, there’s plenty in a dental office that can seem weird and scary to a child at first. There are strange tools and smells and sounds. There are unfamiliar people wearing gloves and masks, poking about in your mouth. Most frightening?:

The sight, sensation, and fear of pain from the needle and dental drill have been frequently shown to be the most fear-evoking stimuli for dentally anxious children. Whereas children sometimes present with fears of specific treatments, other children report a more general anxiety associated with the dental setting ⁄treatment.

Unfortunately, some kids fear the dentist because they experience dental pain before their first visit. ever visiting a dentist. According to a study published last year in Caries Research,

the lower the family income at birth and the higher the severity of dental caries, the higher the prevalence of dental fear. Children who never visited the dentist and those who frequently experienced dental pain were positively associated with higher dental fear prevalence.

Perhaps it’s no surprise that kids with dental anxiety were also found to visit the dentist less, setting up a vicious cycle. Untreated dental problems generally don’t get better on their own, only worse. Those who most need treatment go without – until it becomes an emergency situation.

There is evidence that parents who consistently fail to take their children to the dentist report that their children’s dental anxiety is one of the influencing factors for their avoidance behaviour. Interestingly, research has found that there may be long-term oral health implications resulting from children’s dental anxiety, as dentally anxious children are more likely to be symptomatic, rather than proactive, users of dental services in adulthood.

Starting visits early can stop this cycle. A child’s first visit should occur around age one or when their first tooth erupts. Some parents assume that there’s not much dental care that can be provided at such a young age, but early visits are a great benefit. For one, they can help familiarize the child with the dental office environment and how dental visits work: that they can be pleasant and not painful, nurturing and not scary. Early visits can help establish a pattern of regular dental care and a lifetime of healthy habits.

More, the dentist will be able to chart the child’s orofacial development and catch any emerging problems with alignment or function sooner rather than later – when they tend to be easier and less costly to fix.

Parents magazine offers an excellent set of tips for helping your child overcome fear of the dentist. Among the most important things you can do:

  • Set a good example by demonstrating good hygiene habits and going to the dentist routinely yourself.
  • Encourage your child to practice good hygiene habits. By the time your child is 2 or 3, they can learn how to brush their own teeth. Before then, use a small, soft-bristled brush to gently clean their teeth for them. Regularly floss their teeth, as well, until they are old enough to do so correctly on their own (by the age of 6).
  • Take your child to their first dental visit when they’re about a year old or their first tooth has erupted. After that, bring them in for regular exams and cleanings according to the schedule your dentist recommends.
  • Finally, find a dentist who enjoys working with children and will help your child feel comfortable. A plain, sterile office may be just fine for adults, but such a setting can make some children anxious. Think kid-friendly, and select a dental practice that offers a play area and has a very friendly, smiley staff.

Happy National Children’s Dental Health Month!

Image: Mikael Wiman

Yesterday’s Fluoride Vote in Dallas

Despite a valiant grassroots effort to get the city to change its fluoridated course,

Dallas Morning News screenshot

Only [Sheffie] Kadane and Adam Medrano voted against the $1,060,800 contract with Mosaic Crop Nutrition to fluoridate Dallas’ water supply for the next three years.

Kadane tried to kill the deal. He insisted that “you ingest that fluid, you take it into your belly, you eliminate it,” so clearly fluoride in the water supply does nothing. “Unless you spread it on,” he insisted, “it’s not helping in any way shape or form.” Said Kadane, “Dental hygiene is the way to prevent cavities … it’s not by using flouride.”

Not to mention things like diet, exercise, sufficient rest and sleep, and all else that goes with making a healthful mouth, body and life.

Unfortunately, addressing those kinds of issues as a matter of public health is much more difficult, expensive and time-consuming than just adding fluoride to the water supply.

That aside, Kadane made an important point that often gets lost in the sometimes outrageous rhetoric thrown around this issue: Even if you accept that any topical benefit is worth the risks of regular ingestion, fluoridation is no “substitute for dental care”.

After all, even though more than 2/3 of the population have fluoridated water, youth tooth decay in this country continues to be described as an “epidemic.”

But though fluoridation remains Dallas policy for the time being, the fight for a fluoride-free future will, no doubt, continue.


Mouth Guards: Protecting Your Teeth (& Maybe Even Your Brain)

Sure, legendary Cowboy running back Tony Dorsett will get his share of the NFL’s settlement with former players over concussion-related brain injuries, but what he – and other players – lost remains invaluable.

My brain is priceless. There isn’t enough money that they can give me to make me want to look the other way.

Last year, Dorsett was diagnosed with signs of chronic traumatic encephalopathy – a progressive degenerative disease that only be definitively diagnosed after death. Symptoms include negative changes in mood, cognition and behavior. There’s no treatment known to reverse the damage. Early death is common.

Of course, most of us don’t play sports anywhere near the level of pros, nor with the intensity. Still, there are risks, and equipment for playing safely is a must – especially when it comes to contact sports. In fact, one seemingly minor choice can make a difference.

custom & standard mouth guardsA mouth guard.

According to the Academy of General Dentistry, mouth guards prevent more than 200,000 injuries every year – including mouth cuts, jaw injuries and tooth damage. When properly fitted, the can also provide some protection from concussion. Although their main purpose is to protect the teeth, there is research that suggests they may also “help absorb shock, stabilize the head and neck, and limit movement caused by a direct hit to the jaw.”

The key is that they are properly fitted – as demonstrated by a study published earlier this year in General Dentistry. Researchers observed 412 high school football players, some of whom were given custom mouth guards, while others received standard, over-the-counter (OTC) devices. Those with the OTC guards turned out to be more than twice as likely to suffer mild concussions.

It makes sense that a device designed specifically to fit your teeth and bite would be more effective. It fits snugly and more comfortably than any one-size-fits-all unit ever could. They can even be designed to facilitate better breathing. Yes, they can cost more, but they also tend to be more durable.

An in-between option is an OTC “boil and bite” mouth guard. Boiling it softens the plastic so you can bite into it and thereby customize it to your bite. They have their drawbacks, though:

Available in limited sizes, these mouthguards often lack proper extensions and repeatedly do not cover all the posterior teeth. Dental mouth arch length studies have shown that most boil and bite mouthguards do not cover all posterior teeth in a majority of high school and collegiate athletes. Athletes also cut and alter these bulky and ill fitting boil and bite mouthguards due to their poor fit, poor retention, and gagging effects. This in turn further reduces the protective properties of these mouthguards. When the athlete cuts the posterior borders or bites through the mouthguard during forming, the athlete increases their chance of injury, especially concussion, from a blow to the chin. Some of these injuries, such as concussion, can cause life long effects.

Additionally, these units tend to be bulky, making it harder to breathe, talk and drink normally.

That said, they’re better than nothing, but considering what’s at stake, investing in a custom mouth guard is the wisest option.

Image by MartialArtsNomad.com

Dentin Defense: How Your Teeth Keep Themselves Healthy & Whole (Guest Post)

Originally posted on the blog of Dr. Bill Glaros
Used with permission

Believe it or don’t, but the idea that sugar causes cavities? Not exactly true.

So why are dentists so down on the stuff? Because it’s the favorite food of the pathogenic microbes that cause tooth decay and gum disease, and as they say, what goes in must come out. In this case, what comes out is so acidic, it can wreck the strongest tissue in your body, tooth enamel – which also happens to be the only tissue your body can’t make more of. Once it’s gone, it’s gone.

tubulesFortunately, your teeth have a way of protecting themselves – courtesy of the flow of fluid inside the three miles of microscopic tubules of the layer of dentin that tooth enamel protects.

The fluid within those dentinal tubules is mostly cytoplasm that’s passed through the membranes of odontoblasts: special cells that form part of the inner pulp of a tooth and create new dentin around it. Under normal, healthy conditions, this dentinal fluid flows in an outward direction, from the pulp, through the dentin, toward and through the enamel. (Though it looks solid, enamel is actually porous.)

As Dr. Ralph Steinman demonstrated at Loma Linda University more than four decades ago, this has a few important implications when it comes to dental health:

  • Since dentin has no direct blood source, the outward flow draws nutrients from blood vessels in the pulp into the dentin, keeping it healthy.
  • The outward flow repels acids and microbes, keeping them from penetrating the tooth.
  • The fluid, being alkaline, helps neutralize acids generated by the microbes.

So if teeth are protected, why do they become vulnerable to decay? Because sometimes, the flow can actually reverse course or otherwise be disrupted. When dentinal fluid flows inward, toward the pulp, it draws acids and pathogens into the tooth, as well.

Factors that can reverse or disrupt the flow include high intake of sugars and simple carbs, inactivity, chronic stress, pharmaceutical drug use and malnutrition (not getting enough vitamins, minerals and other necessary micronutrients).

Suffice it to say, healthful eating and an active, balanced lifestyle are among the best things you can do to make sure your teeth can take care of themselves as they were designed to do. (The others, of course, are regular flossing and brushing.)

Nutritionally, you want to be sure to get plenty of calcium, phosphorous and vitamin D, all of which help remineralize your teeth, keeping them strong and solid. Also, a healthy intake of antioxidants may reduce inflammation, which subsequent research has shown capable of interfering with good hypothalamus function – the gland Dr. Steinman and his colleague Dr. John Leonora found to control the parotid (main salivary) gland that, in turn, guides the flow of dentinal fluid. (Of course, inflammation is also the common denominator of gum disease, heart disease, diabetes and other chronic illnesses.)

It all comes down to care of the body and care of the teeth. As Dr. Ken Southward wrote not long ago in General Dentistry,

The tooth is designed to withstand the harsh oral environment, provided it is properly nourished. A high-sucrose diet affects the tooth from the outside by enabling oral bacteria to produce acid and from the inside by reducing the dentinal fluid flow and the body’s ability to control the inflammatory process in the dentin…. Minimizing sucrose as well as increasing fruit and vegetable intake and nutritional supplementation are modifiable lifestyle decisions with significant measurable benefits.

Eat less sugar and more produce – again?!? Is that the advice for everything?!?

Just about…which is a very good sign of just how important those food choices are.

For a clear and solid summary of Steinman’s and Leonora’s research, see this article.

Image via healingteethnaturally.com

56% of Dentists Say “No” to Fluoridation

The official pro-fluoridation position is unambiguous:

The American Dental Association unreservedly endorses the fluoridation of community water supplies as safe, effective and necessary in preventing tooth decay. This support has been the Association’s position since policy was first adopted in 1950.

fluoride_comic_cropConsidering itself to be the voice of dentists as a whole, however, the organization might want to start rethinking their position.

Recently, The Wealthy Dentist – a marketing website for dental practices – conducted a survey that included a very simple question: Do you support water fluoridation?

Overall, 70% said no. Counting only responses from dentists, a clear majority still said no – 56%, to be exact.

Here’s what some of those dentists had to say when asked if they “see fluoride as a wonder drug or deadly chemical” (all emphases in the original):

  • Fluoride belongs in toothpaste, not water. That way, those who want it can have it. Besides, fluoride is only effective topically, not systemically.”
  • Fluoride should not be added to the water supply as its effects on individuals cannot be monitored and the dose cannot be controlled. Treatments may be indicated in the dental office and people can choose to use fluoride toothpaste and rinses as well.”
  • “I think the classification of it as a toxic waste is pretty self explanatory.”

Yet, as the Fluoride Action Network notes,

Despite this, many in the public health community continue to advocate for fluoridating water supplies. Unlike their predecessors, today’s advocates insist that fluoridated water provides an effective source of topical fluoride by increasing the fluoride content in both saliva and plaque. Even if true, however, recent studies show that there is virtually no practical difference in tooth decay rates between fluoridated and non-fluoridated areas. Accordingly, if fluoridated water does have a topical effect on teeth, it appears sufficiently miniscule that use of topical fluoride products can readily replace it.

It certainly doesn’t seem enough to justify the real, documented health risks of ingesting fluoride, from fluorosis to developmental problems to cancer.

There is also growing concern that we are getting too much of the stuff, which has lead the Department of Health and Human Services, among others, to recommend that EPA lower the levels allowed in water. Those who want fluoride are welcome to it and can easily get it through toothpastes and rinses. (Indeed, in some stores, it’s impossible to find toothpaste that does not contain fluoride – even “natural” products such as some varieties of Tom’s of Maine.)

Besides, there is a better way.

“The commendable goal of prevention,” says the International Academy of Biological Dentistry and Medicine,

should be advanced by effective routes, not by fluoride. When the public water supply is fluoridated, fluoride is taken into the body systemically when people drink water. Fluoride taken systemically has little to no effect in decreasing tooth decay.

As health professionals, we favor effective national and community efforts for cavity prevention; for example, a campaign for children to reduce sugar intake would have demonstrable effects on cavity reduction.

Fluoride just isn’t necessary for good dental health – but other things are. Proper nutrition and hygiene, for instance, are vital.Teeth need minerals such as calcium, magnesium and phosphorus ; vitamins such as D and K. They need to be cleaned regularly and well, not just with brushing but flossing, too. (Brushing alone cleans only about 60% of your total tooth surface.) They need to be spared added sugars and refined carbs, which serve mainly to feed the bacteria that form biofilm (plaque) and acidify the oral cavity.

Not only are such steps are more effective than fluoride, they have the bonus of contributing to whole body health, as well.