Strong, healthy teeth are more than just the makings of a beautiful, confident smile—good oral health is a key component to good overall health. This might explain why adding fluoride to tap water is considered by the Centers for Disease Control and Prevention to be one of the greatest public health achievements of the 20th century.
Fluoride is a naturally occurring mineral found in food that strengthens teeth and reduces risk of decay and cavities by 25 percent, according to the Cleveland Clinic. In fact, fluoride is a “powerhouse for oral health,” in the words of Dr. Scott Finlay of Annapolis Smiles. “It strengthens tooth enamel, making it more resistant to decay caused by acids produced by bacteria. Additionally, fluoride can reverse early stages of tooth decay by re-mineralizing weakened enamel. It also helps reduce harmful bacterial activity in the mouth, creating an environment less conducive to cavities. For both children and adults, fluoride serves as an essential defense against tooth decay.”
Why fluoridate water?
The movement to fluoridate tap water really gained momentum in 1962 with a U.S. Public Health Service recommendation following decades of research. But even before this recommendation from a public agency, many municipalities had been adding fluoride to tap water and seeing a sharp decrease in the number of children with cavities.
The concept: When small amounts of fluoride are added to public water, anyone who consumes that water from the tap throughout the day gets exposure to fluoride, which coats the teeth and strengthens them. Most water contains natural amounts of fluoride, but not in levels high enough to prevent tooth decay.
Over the decades that followed the U.S. Public Health Service recommendation, more state and local governments chose to implement water fluoridation into their public water supply based on the agency’s guidance. Since then, oral health across populations have drastically improved. In a 2015 statement, Dr. Vivek H. Murthy, then the U.S. Public Health Service Surgeon General, noted that it wasn’t uncommon for young teenagers to have lost one or more of their adult teeth to tooth decay prior to the 1960s, and half of Americans age 65 or older had lost all their natural teeth, which had to be replaced with dentures.
“Patients who regularly use fluoride, whether through water or other sources, typically experience fewer cavities and less severe decay,” Finlay says. “Their teeth are generally more resilient against the acids that cause decay. In contrast, individuals without regular fluoride exposure are more likely to develop cavities and may face more frequent dental treatments. Over time, the difference can significantly impact both oral health and dental expenses.”
Protecting those pearly whites
Although most of us would agree we want a vibrant smile with strong teeth, the benefits of good oral health go far beyond aesthetics. Harmful bacteria breeding in the mouth can cause inflammation and instigate problems all over the body. Studies have found correlation between gum disease and heart disease, likely because oral bacteria can enter the bloodstream and worsen the buildup of plaque that causes heart attacks and strokes. Oral bacteria entering the bloodstream can also cause an infection of the heart lining known as endocarditis.
Despite these benefits, the process of public water fluoridation has been the subject of criticism from people who call it “mass medication” (though it’s worth noting that fluoride is a natural mineral, not a type of medicine). Fluoride, like many other minerals, can be harmful in excessive amounts—hence why we’re not supposed to swallow toothpaste—but extensive research on the part of the CDC and the World Health Organization have found water fluoridation to be both safe and effective.
Why water is such a winner
Are there other sources of fluoride that can benefit teeth? Of course. Many brands of toothpaste and mouthwash have fluoride, as do foods like fish, shellfish, spinach, and potatoes. The American Dental Association considers fluoridated tap water to be better than these other sources because it provides consistent, low-level exposure on an ongoing basis—pretty much every time you take a sip of tap water.
Finlay agrees with this. “To benefit fully from fluoride in tap water, regular consumption is essential. The small amounts in water work cumulatively to strengthen teeth over time,” he says. “While fluoride toothpaste does provide some protection, it doesn’t replicate the consistent exposure from drinking fluoridated water.”
So, if you’re looking for strong, beautiful teeth that will last you a lifetime, brushing and flossing are important—but drinking tap water throughout the day could be the unsung hero of your oral health routine.
Other Sources of Fluoride
Fluoridated water is not the only source of fluoride. If you’re looking to increase your consumption of fluoride, you can look for fluoridated toothpaste or mouthwash, or you could include more of the following foods in your diet:
- Black tea
- Shellfish, especially shrimp and crab
- Spinach
- Okra
- Chard
- Potatoes
- Grapes and raisins
- Oats
Tips for Strong Teeth
Fluoride isn’t your only safeguard against tooth decay. Remember to practice good tooth care by:
- Brushing your teeth twice a day with a soft-bristle toothbrush—and don’t forget to floss
- Watching your consumption of sugary and acidic foods, which can break down tooth enamel.
- Not smoking or chewing tobacco, which will not only discolor your teeth but also cause gum disease.
- Getting plenty of calcium, which is important for strengthening your teeth the same way it strengthens your bones.
- Visiting your dentist every six months for a cleaning and checkup.
