By: General Dentist Donald Gundlach

Fluoride is one of the most discussed topics when it comes to the world of dentistry. You’ve probably heard a bit on both sides of the spectrum: one, that fluoride is not necessary, and the other, that fluoride is good for your oral health. 

Here’s the truth: when used correctly, fluoride does not pose a threat to overall health. Instead, it provides a benefit to oral health and aids in preventing cavities.

What Is Fluoride and Where Does It Come From? 

Fluoride is a natural mineral found in soil, water, and foods. It is both common and abundant in nature. Synthetic fluoride is produced to be used in drinking water and dental hygiene products such as toothpaste, mouthwashes, and various chemical products.

What Products Contain Fluoride?

Fluoride is found in dental products, such as toothpaste, mouthwashes, some floss, cement & fillings, gels, and varnishes. Many products are fortified with fluoride because of its ability to prevent tooth decay by about 20-40 percent, according to the American Dental Association, and reduces cavities in patients of all ages. As a result, the use of fluoride can save time and money due to costly procedures to restore teeth damaged by decay.  

Fluoride in Water

In many areas, water fluoridation is also used to help curb dental problems. In a study by Cochrane, when fluoride was added to their water supply, children experienced 35 percent fewer decayed, missing, or filled baby teeth and there was a 15 percent increase in children with no decay in their baby teeth.

How Does Fluoride Work?

Fluoride works to prevent tooth decay by…

• Changing the way enamel develops in children under the age of 7, making it more resistant to acid attack
• Creating an environment where better quality enamel is formed, assisting in resistance to acid attack
• Reducing the ability of bacteria in plaque to produce acid

All these benefits help protect and strengthen tooth enamel to prevent tooth decay and costly dental issues down the road.

Are There Risks Associated with The Use of Fluoride?

Like any substance you put into your body, moderation is key. While it’s proven that fluoride is beneficial in reducing tooth decay, there are side effects of ingesting too much fluoride. 

For most of us, we don’t have to worry about consuming too much fluoride because of regulations in the fluoridation of water and the safe amount used in dental hygiene products. The most common side effect of fluoride is temporary white spots or streaks on teeth with high fluoride exposure. This does not harm the teeth and is instead considered a cosmetic concern. These marks often disappear over time.

Small amounts of fluoride are unlikely to be dangerous and over 100 national and international health and other organizations recognize the benefits of adding a safe amount of fluoride to water and dental products.

Should I Use Fluoride?

The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have different standards of how much fluoride can be put into water to protect teeth in a safe manner, but we know that each regulation protects individuals from being harmed by too much fluoride. In the U.S., we take direction from the CDC, as international organizations such as the WHO have worldwide standards that are often not as strict as in the U.S.

Overall, the guaranteed benefits outweigh the potential risk, and we should consider fluoride our friend. 

If you’re concerned about fluoride treatment at the dentist, feel free to ask your dentist about ways to protect your teeth from decay. Using toothpastes, mouthwashes, and other dental hygiene products that contain fluoride is a great way to start.

For more information on the healthy use of fluoride, schedule an appointment below or call your local Dental Associates clinic.

Despite advances in dentistry, dental anxiety remains a problem for many. Research in the January 2013 British Dental Journal found that roughly 36 percent of the population experiences dental anxiety while 12% experience extreme dental fear. In efforts to mitigate anxiety, a new business concept — dental spas — is rapidly growing and creating a new face of dentistry.

Distinguishing fear, phobia and anxiety
While “dental fear,” “dental phobia,” and “dental anxiety” are often used interchangeably and aren’t necessarily isolated events, it is important to distinguish the terms. Fear is a reaction to a perceived threat, such as the high-pitched sound of drills at a dental office. Phobia — persistent and intense fear — in a dental setting is known as odontophobia, which can lead to “feelings of hypertension, terror, trepidation, and unease,” according to the March 2016 issue of Clinical, Cosmetic and Investigational Dentistry. Anxiety is the emotional reaction to an unknown danger and/or before the threatening stimuli is encountered. Dental anxiety is common enough across various societies to be considered a general public health concern.

Cycle of dental anxiety
Dental anxiety is not simply an emotion that negatively affects a patient’s dental office experience. Anxiety has long-term implications that, left unchecked, can lead to a vicious cycle of dental anxiety. Patients with dental anxiety delay dental care out of fear, which causes further deterioration of oral health.

Finish reading this article in the August issue of Contour magazine.

~Jane Lee, Houston ’23

By Dr. Lawrence Spindel DDS

Patients often come into the NYU School of Dentistry, where I teach with “emergency dental procedures”… They often have a particular symptom that is bothering them. The students often want to address the symptom immediately, but often they are required, in non emergency situations, to first do a comprehensive exam and treatment plan. 

It is not usual for these new patients at the school to initially express a resistance to taking a full set of radiographs and submitting to a full work up by that student. Quite often their student dentist will also want to immediately care for the tooth that’s bothering them, but although many patients come to our school to take care of the one problem that is bothering them, it’s very important that our student dentists understand the need for the performance of a complete patient assessment prior to performing the non emergency dental treatments.  Many problems that patients have are not terribly symptomatic, at least until that time when their conditions worsens and they are forced to seek “emergency care”. For this reason and others, most of our emergency treatments are palliative in nature and not definitive care.

Obviously, if a patient is experiencing an acute infection or a tooth that is causing significant pain, something should be done for them to alleviate their “acute” problem, but once they receive emergency treatment, it’s the dentist primary responsibility to evaluate their patient’s entire clinical situation.  As general dentist, we should always assess our patient’s overall condition and come up with a treatment plan, or multiple different plans that might be appropriate alternatives. This is principal that our students need to embrace, even when their patients maybe initially resistant.

A patient may say, “I am here to address this one tooth that’s bothering me and nothing else for now, but on the occasion that I’m in attendance, as the supervision, charge with the responsibility, for overseeing their student’s treatment, I engage the reluctant patient and explain that often dental problems are initially not overly bothersome but can be serious enough that they need to be addressed as well. Also, dental treatments can be expensive and patients should be aware of their overall problems before committing funds to treating just one tooth. Many patients actually have multiple problems that may influence the types of treatment that will ultimately be chosen. Teeth that have infections and/or large carious lesions may need multiple costly procedures to remedy and if multiple teeth are similarly involved, a patient needs to become aware of the extent of their problems, before deciding on expensive treatments to save just one tooth. After all patients have multiple choices to make, and options when they’re deciding which teeth should be saved and which should be extracted.

Once I explain this to patients, most tend to relax, especially after I point out that no one can force them to have any particular proposed treatment.  Still it is our duty to perform a comprehensive examination to determine the extent of their problems,  so that they can make an informed decision, concerning their subsequent treatment. Since no one can “force” them to have treatment, the “worst”case scenario is that our school may not provide the particular treatment they desire, (because in our opinion, it’s not in their best interest and we try to “do no harm” to our patients), but they’ll still be free to seek a second or third opinion elsewhere.