Should Fluoride Be Added to Drinking Water in Order to Tackle Dental Health Inequalities?

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Fluoride is in your drinking water, toothpaste, mouth rinses and other oral-care products, but what is this little element you may ask?

It is actually the thirteenth most available element on the earth's crust, and is naturally found in water, soil, foods and a variety of minerals including fluorapatite and fluorite.

So what is so special about fluoride?

Fluoride is said to protect the teeth in a number of ways:

  • If the teeth are damaged by acid, fluoride gathers in these demineralised areas and strengthens the enamel. This process is called remineralisation.

  • However, fluoride also works by preventing the demineralisation which is caused by acid. It is the bacteria in the mouth which combines with sugars that produces the acid causing the erosion of tooth enamel. This happens by lowering the solubility of tooth structure in acid conditions.

  • There is some evidence fluoroapatite which is formed to replace some of the natural hydroxyapatite in enamel and Dentine slightly modifies the shape of teeth strengthening the normally weak fissures in the tooth surface.



Be aware. Fluoride is useful for preventing cavities and making teeth stronger, but it is much less effective if a cavity has already been formed.

Why is fluoride added to drinking water?

Around ten percent of the United Kingdom population receives fluoridated water. In 2003, the All Party Parliamentary Group on Primary Care and Public Health stated that fluoridation should be introduced as a means of tackling dental health inequalities. This is due to the success of fluoridation in places such as the United States of America whom stated that adding fluoride to tap-water should decrease the prevalence of tooth decay in the population. This was based on many studies which found that when fluoride was added to people's drinking water, tooth decay decreased. In addition no reputable studies have shown any detrimental effects of fluoride

Who requires fluoride?

The simple answer is everybody. Children have a need for fluoride in order to protect their permanent teeth whilst they are being formed. Adults need fluoride to protect their teeth from decay. The World Health Organisation considers fluoride an essential dietary nutrient.

However, there is a high-risk group of the population who are in more need of fluoride treatment. These are people:

  • With poor snacking habits

  • No (or very little) access to dental hygienist

  • Poor dental hygiene

  • Diets that are high in carbohydrates/ sugars

  • Bridges, crowns, braces and other restoration procedures

  • A history of cavities (tooth decay)



What happens if you intake too much fluoride?

Whilst fluoride in little amounts has positive effects, fluoride in large quantities can do you harm. For example, during childhood, if a child were to receive high concentrations of fluoride during tooth development it can result in tiny white specks or streaks in the enamel of the tooth. This is an example of a mild case of dental fluorosis.

In more serious cases the tooth may have more evident discolouration and brown markings which would make the enamel rough and difficult to clean.

What level of fluoride is safe?

The recommended level of fluoride in water is 1 part per million. Mild mottling starts at 2 parts per million the level of mottling increases withe increasing fluoride levels. Mottling does not happen on fully formed teeth, only forming teeth are affected. In parts of Africa levels of fluoride occur naturally at 90parts per million. In these areas the indigenous population suffer no other detrimental effects.

In conclusion.

Fluoride is a safe and effective way to protect teeth from what is the second most common disease in the world. Bad teeth can cause pain and infections from bad teeth can be life threatening. Loss of teeth affects the person life in many ways: health, diet and nutrition, self confidence, speech,are all affected to a great degree. Fluoride in water works with no need for any action on behalf of the person drinking it. Water filters will remove the fluoride for people who are against its inclusion as such fluoridation is a very positive thing an should be recommended. Fluoride is not available to protect the teeth of children in the Humberside area.
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