Want to Beat Tooth Decay? Address the Cause

There are plenty of reasons to say no to fluoridation, but what about fluoride applied directly to the teeth?

If the idea is to prevent decay, a new study in the Journal of Dental Research suggests that, at best, it may minimize damage but not prevent it all together.

fluoride varnish For this study, researchers followed 1248 young, caries-free children over the course of three years. (“Caries” is the clinical term for tooth decay.) Half the kids got a “preventive package” of fluoride varnish, fluoride toothpaste, toothbrush, and standard dental education every 6 months. The other group got education only.

By the end of the study, 39% of the kids in the control group had developed caries. So had 34% of those who got fluoride.

The mean number of cavities was 9.6 in the control group…and 7.2 in the fluoride group.

The “success” of fluoride here is clearly underwhelming.

The trial had high retention and compliance rates but failed to demonstrate that it did keep children caries free. There is evidence from the trial that once children develop caries, the intervention does slow down its progression. [emphasis added]

So what if, instead of trying to mitigate damage we were to actually prevent it by addressing its cause?

That cause is, of course, the overconsumption of sugars. In the rush to fluoridate, this tends to be forgotten. As another paper in the JDR put it,

The importance of sugars as a cause of caries is underemphasized and not prominent in preventive strategies. This is despite overwhelming evidence of its unique role in causing a worldwide caries epidemic. Why this neglect? One reason is that researchers mistakenly consider caries to be a multifactorial disease; they also concentrate mainly on mitigating factors, particularly fluoride. However, this is to misunderstand that the only cause of caries is dietary sugars. These provide a substrate for cariogenic oral bacteria to flourish and to generate enamel-demineralizing acids. Modifying factors such as fluoride and dental hygiene would not be needed if we tackled the single cause—sugars. [emphasis added]

Other research suggests that caries can be prevented by limiting sugar intake to less than 3% of your total daily calories. (For a 2000-calorie per day diet, that’s just 60 calories or about 15.5 grams of sugar a day; for a 1500-calorie diet, a mere 45 calories or about 11.5 grams. To put that in perspective, there are 39 grams of sugar in a 12-ounce can of Coca-Cola and 47 grams in a bag of Skittles.)

At the same time, increasing intake of nutrient-dense whole foods further supports your teeth’s natural ability to remineralize, protecting them from the oral pathogens (“bad bugs”) that cause decay. Toothpastes containing theobromine may also be helpful as a part of a good, overall home hygiene plan.

Bottom line? Decay and cavities are not inevitable. But preventing them isn’t up to fluoride. It’s up to you.

Image via healthcare-news

Fluoride in Your Tea

5001227590_1a883e0927_zThough we’ve blogged before on the benefits of green tea for healthy gums and its ability to relieve oral pain, we’ve not looked at the relationship between tea – green or otherwise – and fluoride

A recent entry on the Nourished Kitchen blog, a traditional foods blog, posed the question: Should you be worried about fluoride in your kombucha? If you have never even thought to ask the question, you’re not alone. Most of us don’t know where to look for fluoride.

In answering the question, the blog’s creator Jenny McGruther cites the Big Book of Kombucha:

Kombucha is made from weak tea, rather than strong, so there will be less fluoride in kombucha than a strong tea of the same volume.

On the surface, this answer might seem plausible. But it’s an incomplete answer. The reality is, since we don’t often consider what foods and beverages may contain fluoride; since many of us live with fluoridated municipal water supplies; since many of us use products like toothpaste and mouthwash that contain fluoride, we have no real way of knowing what our daily intake is.

The truth is, ingesting a known toxin daily at unknown levels can be problematic.

Though McGruther says she doesn’t “worry about relatively small amounts of fluoride in the modest amounts of kombucha my family drinks,” this might err on the side of simplicity.

If you’re wondering about fluoride in tea products, one of the best sources for scientifically based information is the Fluoride Action Network.

Five informative links to assist  your decision making:

  1. How fluoride ends up in a tea plant?
  1. Which tea contains high levels of fluoride?
  1. What kind of health issues a heavy tea drinker might expect?
  1. How much fluoride is in newer tea commodities, such as: packed teas, bottled tea, canned tea, and instant tea powders?
  1. How to minimize your exposure to fluoride in tea, and other products?

That said, it’s important to remember that drinking tea does have many benefits, some which may offset potential fluoride exposure. A well-researched approach can provide information that allows for balanced decision making.

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A Look Back at…Keeping Your Teeth Naturally Healthy

Originally posted June 4, 2015

The Caries Crisis

tooth models showing cariesAccording to the latest CDC statistics, almost all adults have experienced dental caries – 91% to be exact.

“It is not what people are doing wrong,” Dr. Bruce Dye, who led the survey, told Today. “It is maybe what we can do better.”

Well, that’s a way of putting it – and a positive one at that. Yet tooth decay doesn’t happen just because it happens. Some “wrong” things are playing a role – or, at the very least, are doing little to help.

Consider fluoride, which the Today write-up mentions as one intervention that “greatly reduces rates of tooth decay.” Consider that nearly 70% of Americans receive fluoridated water. Consider that in some stores, it is near impossible to find non-fluoridated toothpastes. Fluoride is everywhere.

Then consider again: 91% of American adults have experienced tooth decay. More than a quarter have untreated tooth decay.

The upside to that startling statistic is that it may be partly explained by the fact that more of us are keeping more of our natural teeth for a longer time. In fact, the rate of edentulism – having no teeth – has dropped almost 40% over the past 50 years.

But the ideal, of course, is not just to keep all your teeth but to keep them in their naturally healthy condition.

A major help is ditching soft drinks and fruit juices – the two biggest culprits when it comes to enamel erosion, which leaves the teeth more vulnerable to decay. Even better is when that’s part of a move to a simpler, more wholesome diet.

It’s interesting to note that our distant ancestors typically had far less oral disease than we do. For instance, people living during the Middle Ages did have problems like worn down or broken teeth, but as recently discussed in a column on Slate:

Contrary to the depiction of medieval peasants with blackened and rotting teeth, the average person in the Middle Ages had teeth that were in very good condition. This is substantially due to one factor—the rarity of sugar in the diet. Most medieval people simply could not afford sugar, and those who could used it sparingly, usually as a seasoning or minor ingredient and almost never as a condiment or the basis of a dish. This means that most people used natural sugars, such as those in fruits and honey; even then, they ate this kind of sugar sparingly. Taken with a diet high in calcium via dairy, high in vegetables and cereals, and low in foods that cause decay, the average medieval person ate the way most modern dentists would recommend for good teeth.

Not surprisingly, tooth decay was actually much less prevalent in the Middle Ages than it became in later centuries, when mass imports of sugar from the tropics made it a staple rather than a rarity. Surveys of archaeological data from the medieval period show that an average of only 20 percent of teeth show any sign of decay, as opposed to up to 90 percent in some early 20th-century populations.

This is totally in line with what Dr. Weston Price found through his observations of indigenous populations. He found that who ate traditional diets consumed at least four times the minerals and water-soluble vitamins than those who ate industrial diets, and had good orofacial development and good oral health. Once they transitioned to a Western, industrial diet with its white flour and refined sugar, crowded, crooked teeth, caries and other problems soon appeared.

Better food: A better way than fluoride to support good oral health.

Image by Xauxa

Theobromine Toothpaste May Encourage Tooth Remineralization

toothpaste in tubeOkay, so you don’t really neeeeed toothpaste.

Yes, you read that right. In fact, in many cases, you’re better off without it – especially if your only “option” is the average toothpaste you find in your average big box or drug store.

In our opinion, that option’s no option, due to the potentially toxic ingredients conventional toothpastes typically contain.

Take sodium fluoride, for instance – a drug under the jurisdiction of the FDA. It’s the ingredient that merits the poison warning you see on every box.

Whether from hygiene products, “supplements,” or fluoridated water, too much fluoride during the first eight years, while teeth are still developing, can cause dental fluorosis. In severe cases, the teeth turn brown, with rough and pitted surfaces. It’s a clear sign of too much fluoride.

If only the concerns were “just cosmetic,” right? But fluoride has also been linked with many chronic conditions. These include arthritis, neurological issues, cancer, cardiovascular disease, pineal gland problems, thyroid disease, kidney disease, and endocrine disruption – to list but a few.

And for all this, it may not even prevent decay. (It certainly doesn’t address the cause.)

Other problem ingredients include sodium lauryl sulfate, triclosan, titanium dioxide, and FD&C blue dye 1 and 2.

So if that’s what’s available, then ditching the toothpaste is a good thing. You don’t neeeeed it. After all, the main reason we use it is just to provide a little grit to help remove plaque more easily – and for the pleasant taste and clean feeling it leaves.

And for that reason, most of us probably don’t want to do without.

Fortunately, there are great nontoxic alternatives available. One of our favorites, as we’ve mentioned before, is Theodent. It’s an option you can feel good about.

cocoa Theodent’s active ingredient is theobromine, a natural compound derived from cocoa beans. Research suggests that this alkaloid may encourage tooth remineralization by restoring minerals to the tooth’s structure – all without relying on fluoride.

Even more promising research has published of late, further supporting theobromine as a safe and effective alternative to fluoride.

One study serendipitously found that theobromine causes the formation of large hydroxylapatite (HAP) crystals. Hydroxylapatite is the main mineral in tooth enamel. While small crystals were seen to increase demineralization during acid exposure, large crystals did not and were associated with less decay. Because of this – and its safety – the authors consider theobromine “a better ingredient than fluoride.”

We believe that theobromine can be used as an ingredient of dentifrices and even if swallowed accidentally, there are no adverse effects.

A second study pitted Theodent classic – in both fluoride-free and fluoridated forms – against Colgate Regular (containing fluoride) and a prescription remineralizing paste. The goal was to compare their effectiveness at decreasing tooth sensitivity. Theodent did so more quickly than the others. Colgate fared the worst. Clearly, the theobromine made a difference.

If you want to decrease sensitivity, prevent decay, freshen your breath, and avoid a whole host of toxins, Theodent is definitely worth a try. Even though you don’t really neeeed it, we think you’ll waaaant it.

Images by Adam Minter & Carsten ten Brink

Fluoride, Fluoride, Fluoride…

 
children's toothpasteWe all want the best for our kids, and like everything in life, there are different opinions on how to get there.

Maybe you go out of your way to read labels in your attempt to give your family the best quality products you can. But there’s one label you might have missed: the one on your family’s toothpaste.

warning on children's toothpasteBuying that bright, candy-esque packaged toothpaste because it might encourage brushing is naturally based on the best of intentions for the child.

But if it’s fluoridated, you’ll notice a poison control warning.

 

Seek first to understand, then to be understood.
– Dr. Stephen Covey

The Fluoridated Party Line

In January, a Norwegian study on oral health messages was published in the International Journal of Dental Hygiene. The aim was to investigate recommendations given to the general public by dentists, dental hygienists, dental nurses, and public health nurses on preventing caries (tooth decay).

More than 800 health professionals answered the authors’ questionnaire.

  • 59-71% judged oral hygiene education to be the most important part of preventing caries.
  • 84-98% recommended that all children use fluoride toothpaste.
  • Half recommended fluoride lozenges for 50% or more of children.

The message is clear: Fluoride, fluoride, fluoride. But does that make it right? Accurate? Effective?

It’s Too Much Sugar, NOT too little Fluoride

Frankly, it’s distressing to realize that diet seems not to have been mentioned at all – or not by enough to merit highlighting.

In terms of prevention, fluoride is, at best, a stop-gap measure – an attempt to minimize damage rather than keep it from happening in the first place. It’s a point that was made nicely in a paper published last year in the Journal of Dental Research.

The importance of sugars as a cause of caries is underemphasized and not prominent in preventive strategies. This is despite overwhelming evidence of its unique role in causing a worldwide caries epidemic. Why this neglect? One reason is that researchers mistakenly consider caries to be a multifactorial disease; they also concentrate mainly on mitigating factors, particularly fluoride. However, this is to misunderstand that the only cause of caries is dietary sugars. These provide a substrate for cariogenic oral bacteria to flourish and to generate enamel-demineralizing acids. Modifying factors such as fluoride and dental hygiene would not be needed if we tackled the single cause—sugars. [emphasis added]

Instead, preventive self-care for children gets reduced to a “how-to” message for parents: fluoridate. This is concerning.

Education as a Foundation of Health

When it comes to families with young children, the emphasis on fluoride is a culturally ingrained message that supersedes parental control. As a parent, you can regulate the cookie jar, but, how do you regulate, much less know, the quantity of fluoride your child ingests from toothpaste? Fluoridated water? Juices? Soft drinks? Processed meat? Other sources?

You can’t.

If you’ve ever left a dental office feeling shamed because you didn’t embrace fluoride for your kids, you should know there are alternatives. In biological dentistry, generally speaking, oral health care isn’t so much a “message” as it is a holistic philosophy.

Rather than just throwing fluoride recommendations at you, we seek to understand the desires and goals you have for your family’s dental care. Once we understand, we work to identify individual habits that may influence health outcomes and emphasize education regarding diet and effective cleaning techniques rather than fluoride.

We believe this approach not only empowers you and your family to achieve your health goals, but employs the truest sense of “self-care for children” in the prevention of tooth decay.

A New Paste that “Heals Cavities”: Too Good to Be True?

pasteConsidering this post been shared more than 37,000 times on Facebook, you, too, may have heard about an “amazing” new dental paste from Japan that purports to “heal” cavities without drilling. Some folks hail it as a “miracle.”

Buzzwords like “new,” “amazing” and “miracle” hook us in. Who wouldn’t want to stop dental decay with a quick fix? But we should be careful that the desire for an alternative to the dental drill not disable our critical thinking when we hear claims that a product can heal cavities, remineralize decayed teeth, grow tooth enamel, allow teeth to self-repair.

For instance, read more closely and you’ll find that this new paste doesn’t promote true self-repair. It’s a synthetic enamel, and there are some important caveats to consider:

  • The paste must be applied by dentist because of its “chemicals.”
  • The paste works best on “microcaries.”
  • The treated tooth will become “whiter” than the natural tooth structure around it.

Dig a little deeper, and you also find that this product contains sodium fluoride in an acidic solution and 35% hydrogen peroxide. The acid dissolves the tooth on which it is applied so the fluoride can bond to the tooth.

If you’re a regular reader of this blog, you know the concern over systemic effects of fluoride. As for the peroxide? Here’s some of what the material safety data sheet has to say:

Very hazardous in case of skin contact (irritant), of eye contact (irritant). Hazardous in case of skin contact (corrosive, permeator), of eye contact (corrosive), of ingestion, . Slightly hazardous in case of inhalation (lung sensitizer). Non-corrosive for lungs. Liquid or spray mist may produce tissue damage particularly on mucous membranes of eyes, mouth and respiratory tract. Skin contact may produce burns. Inhalation of the spray mist may produce severe irritation of respiratory tract, characterized by coughing, choking, or shortness of breath. Prolonged exposure may result in skin burns and ulcerations. Over-exposure by inhalation may cause respiratory irritation. Inflammation of the eye is characterized by redness, watering, and itching. Skin inflammation is characterized by itching, scaling, reddening, or, occasionally, blistering.

The deeper you look, the less wonderful the product sounds. It’s not even available yet and is in clinical trials in Japan only. More testing, says the dentist who developed the paste, is needed to prove its safety. At this time, there are no plans to run trials in the EU or US.

Besides, the truth is, when it comes to microcaries, effective home care – especially flossing with proper technique – can be enough to spur natural remineralization. More extensive decay, however, is a different issue…

Image via Dr. Kazue Yamagishi

Research Group Finds Evidence for Fluoridation Wanting

It was a little shocking and very gratifying to see the headline in such a major media outlet at the start of this week:

Newsweek headline on fluoridation review

The review in question is the latest from the Cochrane Collaboration, which Newsweek described as “the gold standard of scientific rigor in assessing effectiveness of public health policies.” Cochrane’s Oral Health Group analyzed the data in 155 studies on fluoridation, caries (tooth decay) and fluorosis.

Overall, they found very little good quality evidence supporting the practice today.

At best, they found some evidence that fluoridation reduces cavities in children – but with some important caveats. As described in the plain language summary of the review,

Although these results indicate that water fluoridation is effective at reducing levels of tooth decay in children’s baby and permanent teeth, the applicability of the results to current lifestyles is unclear because the majority of the studies were conducted before fluoride toothpastes and the other preventative measures were widely used in many communities around the world.

Most of the research – 97% – was also deemed at high risk of bias.

Does fluoridation benefit adults? Evidence was found wanting. Would caries rates jump if fluoridation were stopped? Again, evidence was found wanting. In the end, wrote the authors,

There is very little contemporary evidence, meeting the review’s inclusion criteria, that has evaluated the effectiveness of water fluoridation for the prevention of caries.

The available data come predominantly from studies conducted prior to 1975, and indicate that water fluoridation is effective at reducing caries levels in both deciduous and permanent dentition in children. Our confidence in the size of the effect estimates is limited by the observational nature of the study designs, the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles. [emphasis added]

Despite all this, fluoride remains the only medication added to public water. It’s considered good “prevention.” Yet there are more effective and far less toxic things we can do to prevent caries, starting with good hygiene and healthful, nutrient-dense diets.

For every medication – every health intervention – carries some degree of risk, and when it comes to fluoride, the more we learn about its risks, the more they exceed any theoretical benefit. While the current review didn’t consider the systemic effects of swallowing fluoride, it did consider fluorosis – the mottling of tooth enamel due to excess fluoride exposure.

The researchers calculated that, in areas with a fluoride level of 0.7 ppm in the water, approximately 12% of the people evaluated had fluorosis that could cause concern about their appearance. This increases to 40% when considering fluorosis of any level .

It’s interesting to note that the level mentioned – 0.7 ppm – is the recently revised recommendation of the US Department of Health and Human Services. One of the reasons they lowered the level was concern about too much fluoride in the modern environment. Some of it may be naturally occurring. Most is manufactured – typically byproduct of the phosphate fertilizer industry. It’s available in toothpastes and rinses. You can even find fluoridated floss! Conventional dentistry has its fluoride treatments and supplements, as well.

And then there’s the stuff in water.

Documented health risks from chronic fluoride exposure include thyroid problems and cognitive delays, as well as cardiovascular disease, diabetes and other conditions.

No evidence of benefit, yet good evidence of risk? It’s time to finally and for good “Get the F Out of Texas” and end this practice. We deserve clean, pure water.

The Caries Crisis

tooth models showing cariesAccording to the latest CDC statistics, almost all adults have experienced dental caries – 91% to be exact.

“It is not what people are doing wrong,” Dr. Bruce Dye, who led the survey, told Today. “It is maybe what we can do better.”

Well, that’s a way of putting it – and a positive one at that. Yet tooth decay doesn’t happen just because it happens. Some “wrong” things are playing a role – or, at the very least, are doing little to help.

Consider fluoride, which the Today write-up mentions as one intervention that “greatly reduces rates of tooth decay.” Consider that nearly 70% of Americans receive fluoridated water. Consider that in some stores, it is near impossible to find non-fluoridated toothpastes. Fluoride is everywhere.

Then consider again: 91% of American adults have experienced tooth decay. More than a quarter have untreated tooth decay.

The upside to that startling statistic is that it may be partly explained by the fact that more of us are keeping more of our natural teeth for a longer time. In fact, the rate of edentulism – having no teeth – has dropped almost 40% over the past 50 years.

But the ideal, of course, is not just to keep all your teeth but to keep them in their naturally healthy condition.

A major help is ditching soft drinks and fruit juices – the two biggest culprits when it comes to enamel erosion, which leaves the teeth more vulnerable to decay. Even better is when that’s part of a move to a simpler, more wholesome diet.

It’s interesting to note that our distant ancestors typically had far less oral disease than we do. For instance, people living during the Middle Ages did have problems like worn down or broken teeth, but as recently discussed in a column on Slate:

Contrary to the depiction of medieval peasants with blackened and rotting teeth, the average person in the Middle Ages had teeth that were in very good condition. This is substantially due to one factor—the rarity of sugar in the diet. Most medieval people simply could not afford sugar, and those who could used it sparingly, usually as a seasoning or minor ingredient and almost never as a condiment or the basis of a dish. This means that most people used natural sugars, such as those in fruits and honey; even then, they ate this kind of sugar sparingly. Taken with a diet high in calcium via dairy, high in vegetables and cereals, and low in foods that cause decay, the average medieval person ate the way most modern dentists would recommend for good teeth.

Not surprisingly, tooth decay was actually much less prevalent in the Middle Ages than it became in later centuries, when mass imports of sugar from the tropics made it a staple rather than a rarity. Surveys of archaeological data from the medieval period show that an average of only 20 percent of teeth show any sign of decay, as opposed to up to 90 percent in some early 20th-century populations.

This is totally in line with what Dr. Weston Price found through his observations of indigenous populations. He found that who ate traditional diets consumed at least four times the minerals and water-soluble vitamins than those who ate industrial diets, and had good orofacial development and good oral health. Once they transitioned to a Western, industrial diet with its white flour and refined sugar, crowded, crooked teeth, caries and other problems soon appeared.

Better food: A better way than fluoride to support good oral health.

Image by Xauxa

Activists Fighting to “Get the F Out of Texas”

fluoride free logoNext Wednesday, activists will gather outside Dallas City Hall in protest of the city council’s decision to keep on fluoridating city water. “On March 25,” declares Fluoride Action North Texas in a press release on the event,

our large and diverse group will stand together to voice; we are outraged the council ignored the science that shows fluoridation is not safe and effective for everyone. We are livid the Council did not take advantage of the many opportunities at their disposal to have open debates or conversation with the experts about fluoridation. We are appalled at the blatant disregard for the voice of the people and the Council’s lack of informing the public. This group of thirteen voted to continue a program that the risks far outweigh the supposed benefits. We assert The Dallas City Council’s action of purchasing the Hydrofluorosilicic Acid to be added to the Dallas Water Supply as a willful disregard for the health of the public. This action cannot go unchallenged.

Of course, Dallas isn’t the only city in Texas where concerned citizens are making a difference. Down in Austin, activists believe this is the year in which change may finally be possible. After all, their city council is almost entirely new, and their new mayor “has expressed a willingness to take a fresh and impartial look at fluoridation.” What’s more,

Even the staunchest local supporters of fluoride—after years of labelling us fringe, weird, tin foil hat and the like, have been slowly forced to acknowledge the fact and adapt their tactics accordingly. Key to the sea change was likely a survey conducted by KEYE-TV in mid-2012 in which roughly half (49%) of those polled called fluoridation as a waste of money… Since it’s now impossible to insult fluoride opponents without insulting about half of Austin’s population, the politically-motivated pushers of fluoridation have backed off a bit and directed their scientifically-bankrupt ire elsewhere.

One of their actions has been to secure airtime for an excellent PSA to “Get the F Out of Austin”:

Since the study mentioned in the PSA was done, others have continued to confirm that fluoride is not something we should be ingesting so much of. (Even conventional dentists and public health advocates have noted that we’re all getting far too much fluoride.) A study published earlier this year in the journal Environmental Health, for instance, found that ADHD rates are higher in states where a larger proportion of people get fluoridated drinking water. Obviously, more study is needed to determine if there’s a causal link. Yet in light of past research – such as last year’s neurotoxins study in Lancet Neurology – the new data does suggest continued caution.

Another recent study – this, in the Journal of Epidemiology and Community Health – showed a link between excess fluoride consumption and underactive thyroid. Simply, fluoride blocks your thyroid’s natural ability to produce iodine. Hypothyroidism, in turn, can cause other problems, such as depression, weight gain, fatigue and muscle pain.

Fluoridated water has proven to be no panacea. The risks it has been shown to carry far outweigh any modest benefits it may confer. As Paul Connett has said, “It is time to get dentistry out of the public water supply and back into the dental office.”

To voice your concern about fluoride to the Austin City Council, visit Fluoride Free Austin’s “Take Action” page.

To make a donation to help Fluoride Free Austin keep their PSA on the air, visit their project page at Indiegogo.

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.