Posted on 2/10/2019 by Dr. Seth Senestraro
|When it comes to better protecting your oral health, few advances have made a more significant difference than the widespread adoption of fluoride. Even though the use of fluoride in the public water system was a point of debate in Portland a few years back, the overwhelming majority of dentists and oral health professionals remain convinced of its ability to help strengthen tooth enamel and prevent decay.
However, over concerns of adding too many artificial chemicals and unnecessary compounds to their bodies, some people have simply elected to forego the use of products that contain fluoride or simply don’t fully appreciate the difference this compound can make to their oral health. But if you’re using a toothpaste that’s fluoride-free, brushing and flossing alone won’t be enough to keep your teeth and gums healthy, according to the results of a new study.
The fluoride found in toothpaste is what helps prevent tooth decay more than just simply the act of brushing, say researchers from the University of Washington.
What Makes a Healthy Tooth?
The role of fluoride on oral health actually touches on a debate that oral health professionals have had internally for years. The debate stems over the importance between a “clean tooth” and a “sound tooth” when trying to prevent cavities.
Those in the “clean tooth” camp say that brushing and flossing daily are the most important things a patient can do to protect their oral health. That’s because quality oral hygiene will remove the sticky biofilm known as plaque , the primary cause of tooth decay and gum disease , from the surface of their teeth before it can break down tooth enamel.
Conversely, those in the “sound tooth” camp believe that brushing and flossing play an important role, but one further supported by the use of fluoride. The reason? Well, fluoride helps to strengthen tooth enamel, thereby limiting the damage done by plaque. That way plaque has a harder time breaking down tooth enamel, making brushing and flossing even more effective at protecting our long-term oral health.
You can think of the difference between these two philosophies like this: Using an umbrella will help to keep you dry if it’s raining outside. But if you use the added protection of wearing a rain coat plus an umbrella, you’re certain to stay as dry as possible.
A Case for Fluoride
All of this brings us to the study conducted by the research team at UW who wanted to focus on the intensity of oral hygiene to see if that alone could make a difference in preventing cavities.
As part of their study, researchers examined a comprehensive range of studies published over a 57-year period between 1950 to 2017. The team found three randomized clinical trials, including one that involved over 740 teens and preteens, that were detailed enough to properly analyze the results. The follow-up period in the studies ranged from between 2 to 3 years.
Researchers then assigned each of the kids in the studies to one of two groups , an intense oral hygiene group and a usual oral hygiene groups. The intense group of kids in all three studies were kids who received supervision of their oral hygiene, including plaque removal, at school, but who brushed with toothpaste that did not include fluoride.
When comparing the two groups, researchers found no significant difference in the number of cavities that developed.
Let’s unpack that result.
Kids who had their oral hygiene monitored by adults to ensure they brushed and flossed corrected as least twice a day developed the same number of cavities as the group of kids who brushed and flossed less frequently but used fluoride. So in other words, the kids in the intense oral hygiene group had to work twice as hard to reach the same level of cavity prevention as the kids who used fluoride.
There you have it, the case for fluoride. If you have any questions about the best ways of brushing or whether to include fluoride as part of your oral hygiene routine, make sure to ask Dr. Senestraro during your next appointment.