Toothpaste: to be taken with a pinch of salt

Updated: Sep 30

After many years of going to the same dentist, today was the first that they discovered that I don’t use a fluoride toothpaste and haven’t done so since being a student in Dundee. (As an architecture student I admired the pink colour and art nouveau packaging of Euthymol toothpaste, I also had a pink pencil that I used on all my design presentations and I had just discoved the brilliant album Pink Flag by Wire so felt that it fitted in with the way I saw my self and wanted to be seen) (There are worse reasons for deciding on a brand)

Not a big deal I thought but they were genuinely surprised, proceeding to recommend that I did, or that at least I used a mousse to remineralise my teeth.

This prompted me to review the relevance my original reasons, and to consider whether my original anti-fluoride stance should be updated.

Reviewing detailed studies now available, it is clear that misinformation and prejudice (against anything that was imposed by the 'state') was a substantial part of the original decision, based on a belief formed by reading an ill-informed newspaper article that fluoride, like mercury accumulated in the body and was somehow linked with cancer. In the absence of any other data, I felt, on balance, that it was better not expose myself to the additional risk. And having made the decision, I stuck with it.

So, after a few hours of unstructured research after my dental appointment I found the following:

1.The body needs to ingest 3 mg of fluoride/day for its benefits to be felt i.e. a considerable reduction in caries and enhanced bone growth (although this becomes less relevant as an adult )

2.A check on fluoride levels in Bristol confirms that no fluoride is added and that the naturally occurring level of fluoride in water in Bristol is in the region of 0.3mg/l i.e. 10% of RDA

3.A check on the amount of fluoride ingested by brushing teeth shows that 0.1mg are ingested each time i.e. 0.2 mg/day: at 6.6%RDA this well below the recommended 3mg/day suggested.

So if fluoride in water and using fluoride toothpaste facilitates just 16.6% of RDA I asked myself where does the remainder of the RDA occur and I found was that fluoride occurs naturally in many of the things we eat and drink and that these far outweigh the levels found by using a fluoride toothpaste or drinking fluoridated water e.g.

In black tea fluoride levels are found between 1.5-6 mg per litre whereas green tea and fresh coffee have levels of 1.3-1.5 per litre. So, just three cups of tea or coffee alone gives 50% of the RDA.

A glass of red wine, it seems offers the equivalent fluoride level of 1 litre of water (0.3mg) equating to 10% RDA/Glass.

In addition, certain foods contain naturally occurring fluorides such as strawberries which offer 0.04 /100g, spinach which offers 0.07mg/100g, grapes and avocados which offer 0.07mg/100g.

Seafood is high in natural fluorides offering 2.4mg/kg. i.e 15% RDA /portion and oatmeal offers 0.07mg/100g.

So just on a reasonably balanced modern diet of 2-3 cups of tea /coffee, water, oatmeal, fish, fruit and vegetables along with a glass of wine the RDA for fluoride is easily achieved.

This was not my diet as a student in Dundee (sausage, chips and beans from the student union was the staple diet for many of us on grants) so perhaps my concern about being over-fluoridated were misplaced, so why the insistence by dentists that fluoride toothpaste Is better for us than a non-fluoridated toothpaste?.

Perhaps they too are labouring under misinformation and prejudice. Perhaps they should stop assuming that we are all consumers of the lowest possible denominator diet, perhaps they should consider us as individuals and ask us the appropriate questions to formulate a bespoke, person-centred health solution and not hand out misinformed platitudes but I can see that its hard to do that when all they really get to see of you is your open mouth and evidence of last night’s Vindaloo.

Hugo Haring : Lithograph 1985

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