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Wednesday, March 2, 2011


Want to keep your teeth: Follow the surprisong tips:

Break a sweat: Excercise may lower the risk of gum dfisease, says Samuel Low, DDs, former president of the American Acasemy of Periodontology.
Power up: Use a high quality electric toothbrush wiuth a small head , says New York periodontisr, Greg Diamond, DDS : "The're optimized to remove plaque."
Go beyond Floss
If your gums recede (as even healthy gums can), interproximal brushes, which look like pipe cleaners, may worlk better than floss, which can miss plaque on a root.
Wait to bush
It takes 30 minutes for saliuva to newutralize the acids in foods. "Brushing righ after eating can brush the enamel away" Diamond warns.
Watch your gums
Insist that your dentist examine your gums with a probe. If the gum pocket surrounding a tooth is deeper than 3mm, you migh have gum disease, which, if untreated, can lead to the loss of the tooth.
Get off hte bottle
Many bottled waters lack fluoride. Consider adding a filter to your tap instead.
Wet your whistle
Teeth depend on saliva to remove microbes. if your mouth is dry, a prescription rinse, tablet, or chewing gum can help.

Tuesday, February 15, 2011

Raise Your Fluoride IQ

Changes to fluoride levels in drinking water are stirring questions among the public. Dental hygienists can be the first to provide patients with fluoride facts and guidance.

The debate over drinking water fluoridation was reawakened last month when the federal Environmental Protection Agency (EPA) revised the recommended levels for fluoride in community drinking water for the first time in nearly 50 years. The EPA’s action touched off a vigorous exchange in the media between camps that support or oppose fluoridation. As this exchange filters out to patients, many will seek the counsel of dental hygienists.

Regardless of practice setting, oral health care professionals should be prepared to address patients’ concerns with evidence-based knowledge, as well as an awareness of how both positions are supported. This month’s Sunstar E-Brief examines the facts behind the EPA’s move, and offers insight into what drives arguments on both sides.


The revision to recommended fluoride levels was spurred by two important statistics about fluorosis (or spotting of teeth). Both figures appear in a National Center for Health Statistics (NCHS) data brief dated November 2010.1 The first shows that in a survey conducted from 1999 to 2004 dental fluorosis was present among 41% of adolescents ages 12 years to 15 years. In stark contrast, a survey conducted from 1986 to 1987 reveals that fluorosis in this same age group was 23%.

In short, the prevalence of fluorosis among adolescents rose 18% between 1986 and 2004. The same report also shows that children and teens are not the only groups affected by fluorosis.


The United States Department of Health and Human Services (HHS) and EPA play different roles in carrying out water policy: HHS oversees the national water fluoridation plan, while the EPA is responsible for setting the legal, enforceable standard for parts of that plan—including fluoride levels for drinking water. The new level of fluoride HHS recommends is 0.7 milligrams per liter. The legal, enforceable standard for the maximum amount of fluoride allowed in drinking water is set by the EPA, and currently stands at 4.0 mg/L.

The HHS move to reduce the recommended level to 0.7 mg/L aims to maintain its benefits in preventing tooth decay and minimize risk of fluorosis.

The EPA has been collecting data since 1996 through a series of Six Year Reviews the agency is required to perform under the Safe Drinking Water Act. The reviews evaluate information, including data gathered by the National Research Council (NRC), that suggest whether a change in water regulations is warranted. After the first Six Year Review in 2003, the NRC submitted data about fluoride exposure to the EPA and recommended the agency update its fluoride risk assessment2. In 2010, after completion of the second Six Year Review, the EPA again received new data. Both the EPA and HHS are monitoring the effects of the new drinking water standards to determine if additional measures should be taken in the future.

Since fluoridation levels for public drinking water were set in 1962 the availability of fluoride through sources other than drinking water has increased. Some of those sources include dental products such as toothpaste, mouth rinses and varnishes as well as professionally-applied fluoride treatment. Fluoride is also present in tea, gelatin and most seafood as well as food prepared in fluoridated water.


Though debate over fluoridation was renewed by the joint EPA/HHS announcement, it is not the first time calls have been made to rethink the practice of fluoridating drinking water. Rallies against use of fluoride reach back decades. Many critics argue it is not enough to reduce fluoridation levels, but that fluoridating public drinking water should be done away with entirely.

Some of the prevailing dissent among opponents is crystallized by the National Health Federation ( Describing itself as a “health freedom organization,” the group emphasizes the toxic potential of fluoride by pointing out the Food and Drug Administration regulates systemic fluoride as a prescription drug. The organization also says that toothpaste labeling that includes instructions to contact a poison control center “if more than a pea size amount [of fluoride] is swallowed” points to fluoride’s potential toxicity.


The American Dental Association (ADA) remains a staunch supporter of fluoridation, as reflected in a letter from the association to Prevention magazine that states, “Every day the media seems to pick up on a new ‘study’ that can scare the public.”3 The letter maintains that substantial scientific research exists to support fluoridation, and offers the ADA’s assurance that the benefits of community water fluoridation are well established. The ADA also notes its solidarity with the Centers for Disease Control and American Academy of Pediatrics in recognizing the benefits of water fluoridation in the prevention of dental decay.3

In a separate letter to the National Academy of Sciences’ Toxicological Risk of Fluoride in Drinking Water Project, the ADA seeks to dispel what it describes as misinformation provided by individuals connected to a number of EPA employees “who oppose community water fluoridation.”4 The letter notes that despite many attempts to establish a link between cancer and water fluoridation, all such attempts have “ultimately been rejected by the scientific community.”

The American Association of Public Health Dentistry (AAPHD) is lockstep with the ADA. One week after HHS announced it would lower the recommended level of fluoride to 0.7 mg/L, the AAPHD issued a statement lauding the revision. It also confirmed the AAPHD’s commitment to educate the public about the benefits of community water fluoridation.5

With strong opinion swirling around the government’s fluoridation policies, this is an ideal time for dental hygienists to locate and interpret dental literature that will strengthen their clinical knowledge. Patient awareness has been raised, and clinicians who understand both sides of the issue will be better able to deliver the educational component of dental hygiene care for which all in the profession are trained.