The “F” Word: Fluoride – A 70-Year Controversy

When I was in dental school, we were taught that fluoride was like a vitamin. They taught us how to prescribe this “supplement” – even to pregnant women.

That was then – science changes! Those of us who keep up with the research understand now that fluoride is not that wonderful game changer that would end cavities. The aim of science is not to open the door to infinite wisdom, but to set a limit to infinite error.

The Truth About Fluoride
I wrote my first article on fluoride over fifteen years ago. I never published it for fear of losing my license and having my dental peers blacklist me from the dental community. Today, the evidence and research-based science is overwhelming – the research-based evidence is in favor of the “no fluoride” understanding. The truth is that it is extremely easy to search for this information. The meta-analysis research is easily accessible to anyone; simply search the medical publication PubMed.com.

Unfortunately, many “scholars” are still standing by the 1950s idea that “fluoride is beneficial especially in low-income sectors,” or that “topical fluoride hardens tooth structure,” without considering that fluoride is everywhere: in our water, processed foods, and pharmaceuticals. Drugs used and prescribed every day worldwide contain some fluoride; for example, statins, antibiotics, antidiabetics, and inhaled anesthetics. Of concern is that, according to studies, approximately fifty percent of ingested fluoride is absorbed into the bones.

A thin strip of fluoride covering a child’s toothbrush contains 0.75–1.5 mg, which exceeds “recommended” amounts even by prescription. Even more worrisome is that fluoride is cumulative.

Would you give your child anything that had a black box warning from the FDA that says, “If more than a pea-sized amount is ingested, call POISON CONTROL”? This warning is on every fluoride toothpaste. Do you use a PEA-SIZED amount of toothpaste?!

As Dr. Mark Briener states in his article, “The Brain-Mouth Connection,” in Natural Nutmeg magazine, “How do you justify giving the same dose of any drug to an infant as to a two-hundred-pound man?” And according to the FDA, fluoride is considered a drug.

The Facts
The idea of fluoride in our water is not inherently bad; it makes it easier to strengthen teeth and prevent cavities, but at what cost? Studies now show that the rate of cavities is increasing despite the increase in education on cavity prevention, the increase in fluoride in our water supplies, and pharmaceuticals. I have been even more shocked to learn about the unexpected and worrisome side effects that fluoride is creating.

There is a vast amount of research supporting the idea that fluoride is not the healthy supplement it has been purported to be – I have over one hundred recent research studies (there are many more – I have only included those within the last ten years) showing undisputed evidence that this increase in fluoride has led to hip fractures, increase in thyroid deficiencies, and a decrease in IQ levels in children. These aren’t just stories – these are reputable medical journals and PubMed Research.

Some important and interesting facts include the following:

• The number of cavities worldwide, even after water fluoridation and fluoride treatments, has NOT decreased in relation to fluoride use. The WHO data since the 1970s states, “Although the prevalence of cavities has declined, the majority of worldwide communities that do not fluoridate, or those that never adopted fluoridation, have also experienced a reduction in cavities exceeding 75%.”
• Ninety-seven percent of Western Europe has rejected water fluoridation.
• The FDA has poison warnings on all fluoride toothpastes.
• The FDA states fluoride is a drug, not a nutrient.
• Fluoride is a known enzyme disruptor.
• Fluoride anti-cavity activity depends on the calcium and magnesium content in enamel.
• National Academy of Sciences: Fluoride decreases thyroid function.
• An increase in fluoride exposure contributes to hypothyroidism.
• Harvard meta-analysis: Children ingesting higher levels of fluoride tested had an average of seven fewer IQ points.
• Fluoride is NOT essential in growth and development.
• Fluoride is an unwanted by-product of aluminum, fertilizer, and iron ore manufacture.
• The amount of fluoride in water systems cannot be measured accurately; only an estimate can be made.
• To remove fluoride from water, a reverse osmosis system is required.

Biological Dentistry as a Solution
Biological dentists perform the same treatments conventional dentists do; for instance, we numb patients, restore teeth, take radiographs, and follow infection control standards. By maintaining optimal dental health holistically, a biological dentist aims to improve whole-body well-being and longevity. We use the least toxic approach in the world of dentistry and supplement it with all-natural and pure alternatives while maintaining the highest standards. This is biological dentistry.

Dentists have historically been taught that all aspects of dentistry are safe, and any toxicity is downplayed. We were even taught that fluoride is a vitamin! However, biological dentists believe that many conventional dental materials are toxic – mercury, fluoride, BPA, and Bis-GMA top the list.

I’m not in favor of banning anything. I still believe in patient autonomy. But I am also not in favor of mandating anything. Why force it on anyone? If someone wants a fluoride treatment, they can visit a dentist who supplies fluoride and even obtain a prescription for high-fluoride products.

We are all on the same side – we all want there to be fewer cavities in teeth and improved dental health. Unfortunately, research and experience indicate that fluoride is not the solution we had hoped it would be.

Thankfully, there is emerging evidence and research supporting new products like hydroxyapatite (the mineral teeth are made of). These products are as effective, if not more so, than fluoride at preventing tooth decay, without sacrificing our health.

So, let’s NOT use that “F” word anymore!

An Update
Beginning July 1, 2025, Florida will no longer add fluoride to our water supply! We are the second state (Utah was the first) in the nation. Finally!

The disconnect between established practice and emerging research demonstrates the tension between consensus and evidence. It is time for health professionals and all professional bodies to stop being entrenched in established dogmas. The reluctance to embrace new evidence leads to a dangerous status quo: practitioners remain unaware of, or unwilling to confront, the potential harms of their recommendations.

Dr. Josephine Perez, DMD, has been practicing dentistry for thirty years. She is a graduate of Tufts University School of Dentistry in Boston and interned at New Orleans Coast Guard/Navy Base. Her holistic approach to dentistry encompasses each person’s unique and entire (or whole—holistic) state of physical and emotional well-being. The ability to maintain health through preventive measures and treatments of oral disease is her priority. Dr. Perez focuses on the underlying condition rather than only treating the symptoms. She tests for biocompatibility to find pathways to reduce inflammation and apply biocompatible and biomimetic materials, supplements, and essential oils to restore and strengthen the oral cavity and, ultimately, the whole body. After decades of restoring and transforming smiles, Dr. Perez has integrated total wellness into her oral health enhancement practice – a revolutionary style of dentistry.