It is well established, through decades of research and practice, that fluoride safely strengthens teeth against the development of dental caries (decay) (Iheozor‐Ejiofor et al., 2015). Fluoride exposure has been primarily facilitated through municipal water supplies and fluoridated toothpastes and rinses.
In communities, like Powell, where water is not fluoridated, the need for fluoridated toothpastes, rinses, and varnishes is heightened. This need is exacerbated for our clients because they live in long-term care centers, environments that are known to have higher than average rates of dental caries (Haumschild and Haumschild, 2009). For these reasons, we use in our clinical care and prescribe to our patients, prescription strength fluoride varnishes and toothpastes.
Historically, and currently, some groups and individuals have voiced concerns related to the safety of fluoride exposure. Two persistent concerns are a hypothesized weakening of bone in older populations and fluorosis.
In the mid to late 20th century, researchers reported highly conflicting evidence between fluoridated municipal water supplies and hip fracture incidence. An amalgamation of this research indicated no protective effect of fluoridated public water in reducing hip fractures while also failing to establish a firm link between fluoride and an increased risk of hip fractures (Jacobsen et al., 1992). More recent data indicate no significant link between fluoride exposure and hip fractures (Public Health England, 2014).
Fluorosis is a “cosmetic” side effect, meaning it doesn’t negatively impact one’s health, and is exclusively seen in children and adolescents (Moore et al., 2021). Indications of fluorosis are white or brown spots on teeth. As older populations are not known to develop fluorosis, we do not view this as sufficient reason to avoid fluoridated products in our care, especially in light of the demonstrable benefits in reducing caries incidence.
These findings give us confidence that fluoridated products are safe when used in appropriate modes and amounts.
For further reading, we recommend the American Dental Associations articles on fluoridated water and supplements.