How harmful is fluoride in toothpaste

The misunderstanding about fluoride

by Jasmin Krsteski

Fluorine is dangerous, fluoride is important for our health. Two letters that make a big difference. This is confusing and some people find it difficult to trust the health benefits of fluoride. Reports of possible consequential damage stir up fears too much. Around 300,000 studies show that fluoride does not have a negative impact on health, but on the contrary can reduce our risk of tooth decay by 40 percent. We explain why fluoride is important and how and in what amounts it should be used.


What is the difference between fluorine and fluoride?

Fluorine is a halogen and is indeed very harmful: even the smallest quantities of the gas in the air can corrode our eyes and lungs. It is so dangerous because it is very reactive, i.e. it reacts very easily with other substances. For precisely this reason, however, it does not occur in nature in its pure form at all. Naturally, we only find it in bound form, such as in the connection with sodium as sodium fluoride in our toothpaste. This salt has very different properties than fluorine gas. But is it completely harmless? Anyone looking up the Internet will quickly come across reports claiming that fluoride damages the brain and is responsible for all kinds of diseases.

Is Fluoride Harmful?

“All things are poison, and nothing is without poison; it is the dose alone that makes sure that a thing is not poison. ”This famous sentence by Paracelsus also applies here. It is the same with sodium fluoride as with sodium chloride, our table salt: this also has little to do with the chlorine in swimming pool water and we willingly use it to add salt to our food. In very high doses, like sodium chloride, sodium fluoride would cause symptoms such as nausea and vomiting. Prof. Dr. Dietmar Oesterreich, Vice President of the German Dental Association, gives the all clear: "You would have to give a small child a whole tube of toothpaste to induce vomiting." When brushing your teeth, you only take a very small amount of toothpaste, most of which you spit out . According to the German Dental Association, fluoride is one of the most thoroughly examined active ingredients and is even ten times less “toxic” than table salt.

How does tooth decay develop?

Bacteria live in our natural plaque. If we ingest sugar, these bacteria also ingest it, metabolize it and produce acids. They damage our teeth because they remove minerals from our tooth enamel and thus promote the development of tooth decay. Fluoride can counteract this process, as Mai Thi Ngyuen-Kim explains in her book "Komisch, alles chemisch". The chemist and moderator of "Quarks & Co" does away with the prejudice that fluoride is harmful to health. Our tooth enamel consists largely of hydroxyapatite, which is very sensitive to acids. If we now brush our teeth with toothpaste containing fluoride, the fluoride penetrates the tooth enamel and throws out hydroxide ions. And that's a good thing: “Because this exchange creates a wafer-thin layer of a firmer, more stable mineral called fluorapatite, which acids can no longer harm,” writes Ngyuen-Kim. “By the way, shark teeth consist of almost 100 percent fluoroapatite. That's why shark teeth are particularly firm and shark bites are particularly painful. ”Fluoride also promotes remineralization of the tooth.

The study situation

"The study situation is clear: from more than 600 international studies, it emerges that fluoride is one of the main factors why tooth decay has decreased in the last decades", says dentist Dietmar Oesterreich. He is aware of the skepticism many people have about the ingredient and views it with concern. “Fluoride is very effective and very easy to use. If many people would forego it, tooth decay could become a serious disease again. ”He is particularly critical when parents decide for their children not to use fluoride. "Basically, you should brush twice a day with age-appropriate toothpaste containing fluoride," advises Oesterreich. Age-appropriate means: "Toothpaste for adults should contain 1,000 to 1,500 ppm of fluoride, and toothpaste for children up to 6 years of age should contain 1,000 ppm." Some countries, such as the USA, fluoridate drinking water in order to ensure an adequate supply for the population. Germany decided against this measure. The Federal Institute for Risk Assessment, however, recommends the use of fluoride-containing table salt. In the pharmacy or drugstore there are also fluoride gels and fluoridated mouthwashes to buy that should be applied once a week. "I would always talk to the dentist about whether this is necessary," says Oesterreich. This can be the case if there is an increased risk of tooth decay. So-called “white spots”, white spots on the teeth, are among other things a sign of decalcification. Then an additional fluoride application makes sense. However, discoloration on the teeth can also be a sign of fluorosis. This occurs when too much fluoride has been used. "However, this is very rare and a purely aesthetic problem," says the expert.

Tablets for toddlers

Many children receive fluoride tablets in the first few years of life, mostly in connection with vitamin D prophylaxis. Experts are also discussing whether this is necessary. "Fluoride works topically, so it is best to do it directly on the tooth surface," explains Oesterreich. For fluoride tablets to work properly, they would have to be sucked. “With a 0-2 year old child, this recommendation will hardly be implementable. The important vitamin D prophylaxis can, however, also take place without the combination with fluoride. "It is important to brush with fluoride-containing children's toothpaste at the beginning of the eruption of the first tooth." The Federal Institute for Risk Assessment recommends using only one form of fluoride prophylaxis in children from this point on, i.e. either fluoride-containing toothpaste or tablets.

What does a toothpaste contain?

Fluoride: Most toothpastes contain sodium fluoride to prevent tooth decay. In a few instead amine fluoride or a combination of both. However, there is also toothpaste that does not contain fluoride. The German Dental Association expressly recommends using fluoride-containing creams. Stiftung Warentest basically rates all toothpastes without fluoride as "poor". "Sodium fluoride is the most tried and tested form of the fluoride compound," says dentist Dietmar Oesterreich.

Grinding wheel: They ensure that coverings are rubbed off when cleaning. Depending on the toothpaste, the cleaning bodies differ in consistency and size. Most calcium-free silica is used, which cannot interact with fluoride. Special whitening toothpastes, which are supposed to make teeth whiter, can be very abrasive and under certain circumstances attack the tooth enamel. The higher the so-called RDA value, the more abrasives the paste contains.

Surfactants: They ensure that the toothpaste foams up nicely when you brush and thus reaches hidden places. So they ensure that you can clean more thoroughly - and have more fun doing it.

Aromas and flavors: Menthol or peppermint oil make you feel fresh after brushing your teeth.

Other ingredients: For periodontitis or pain-sensitive teeth, some toothpastes contain, for example, triclosan or pyrophosphate. In addition, it usually contains preservatives and humectants. Special toothpastes also contain vitamin B12 as an addition. They are suitable for vegans who are often deficient in vitamin B12. The vitamin is well absorbed through the oral mucosa.


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