On September 19, CNN released an article stating the fluoride exposure in utero is linked to lower IQ in children. I urge you to be ready to answer questions regarding fluoride. My fear is patients will read the article title and take the limited study out of context. Let’s review the study and equip you with the facts to be better prepared.
The study can be found here. This study shows many limitations, including the sample time, lack of information about iodine in salt, which could modify associations between fluoride and cognition, and the lack of data on fluoride content in water given that determination of fluoride content.(1) Therefore, the study has no way of knowing how much fluoride the women were exposed to via natural fluoride in their water source. Determining the source of the water is important because natural fluoride in the water source has up to 1.38 mg/L, which is double of that of the United States.(1) Furthermore, we have no idea which women drank from the water source vs. the bottled water.
The initial study is aimed to “estimate the association of prenatal exposure to fluoride with offspring neurocognitive development.”(1) The researchers report that additional studies are needed to confirm the link. Most consumers will see the title of the CNN article and assume all sources of fluoride are dangerous. We understand the benefits of fluoride in correct amounts. It is our role to educate on the importance of the therapeutic benefits of fluoride.
As dental professionals, it is important to remember that multiple factors contribute to tooth decay. Therefore, if the patient decides not to accept the fluoride recommendations, we can reinforce the importance of biofilm disruption, provide products that will help balance the pH of the mouth, and recommend diet changes to reduce the patients’ risk of tooth decay. It is important to value the patient’s personal views, while providing respectful, yet strong education to support ingredients shown to prevent decay.
As a public health hygienist, I have personally witnessed a link between decreased rates of decay in communities with access to fluoride, and I recommend fluoride to my patients.
It is essential that as oral health professionals, we understand the limitations of one study. Putting our own beliefs on any ingredient aside, the fact is that patients can feel misled by their oral health provider because of the media portrays one study. Without trust, the patient will devalue the education and services we offer or recommend.