Editor's note: With Robert F. Kennedy Jr.'s nomination as the head of the U.S. Department of Health and Human Services, it is possible that the rumblings from November of fluoride being removed from public water systems, could come true. Using that as a potential backdrop, we asked five dentists for their opinions on the move and how it could impact dentistry. Here's what they said.
Over the last century, communities throughout North America and the rest of the world have embraced water fluoridation. Grand Rapids, MI, was the first city to add fluoride to its public water supply in the 1940s, and countless other cities have followed its lead ever since. This practice has single-handedly helped millions of people worldwide avoid tooth decay.
But could it be ending soon? Over the years, studies have suggested potential links between the fluoridation of public water supplies and everything from developmental damage in children to cancer. Recently, this has led to landmark rulings in the U.S. regarding the U.S. Environmental Protection Agency's (EPA) water fluoridation regulations, and it could result in cities phasing out the process of fluoridating water in the not-too-distant future.
Some people within the medical community have celebrated this move. They have criticized agencies like the EPA for not doing enough to monitor fluoride levels in drinking water and warn the general public about their possible dangers.
However, not everyone is convinced this is the right step. Dr. José Valdés of Pure Smile Makeover Center is among those who are skeptical. Although Dr. Valdés' practice is in Mexico, where fluoride is added to table salt instead of public drinking water, he routinely treats dental patients from the U.S. and other countries. He fears the elimination of water fluoridation could lead to a spike in the demand for restorative dental procedures.
Dr. José Valdés.
"People will have to work even harder to prevent tooth decay and other basic dental problems if water fluoridation ends," Valdés said. "Unfortunately, this could lead to a greater need for restorative services, such as cavity fillings, and have a detrimental impact on how people feel about their smiles."
Valdés hopes communities will reconsider their stances on water fluoridation and either keep the practice around for now or, even better, develop a new solution to help people deal with tooth decay. In the meantime, he's preparing to provide more of his patients with the restorative services they will likely need if water fluoridation goes away. He's also gearing up to show them how cosmetic services like teeth whitening and veneers can help if tooth decay affects them.
"Mainstream dental practices must adapt to the changing world and ensure we provide patients with the services they need most," Valdés said. "Whether that means offering restorative services that stop tooth decay from causing cavities or extending fluoride-free teeth whitening treatments that enable people to make their smiles shine, we must continue to deliver options that leave them feeling great about their teeth and gums. I will also continue to encourage my patients to use fluoride toothpaste, which strengthens enamel and can reverse early decay. The level of fluoride in toothpaste is safe as long as it's not ingested."
"This is an opportunity to strengthen our relationships with patients and showcase our ongoing commitment to their oral health," he said.
We also asked four other dentists for their thoughts on the potential end of fluoridation and how it could impact dentistry. Here's what they had to say.
Dr. Arlene A. Asante is a dentist and motivational speaker. She attended Howard University College of Dentistry in Washington D.C. After completing dental school, Asante attended an advanced education in general dentistry program in Bangor, ME, and later worked as an associate dentist. She is licensed in Maryland and Washington DC.
"The end of water fluoridation could significantly impact the economics of mainstream dental practices. Without fluoridated water, tooth decay is likely to become more prevalent, leading to greater demand for restorative treatments such as fillings, crowns, and root canals. While the practice may benefit financially, patients may face higher overall dental costs. Dental practices may see an increase in revenue from these procedures, as a surge of untreated caries drive patients to seek dental care," Asante said.
Dr. Tyler Hales.
Dr. Tyler Hales is a celebrity cosmetic dentist and founder of Hales Aesthetic, located in Orange County, CA. Hales graduated from the University of Southern California School of Dentistry, where he discovered his passion for cosmetic dentistry and now dedicates his time exclusively to creating confident smiles with porcelain veneers.
"Fluoridated water is a main factor that helps prevent cavities. Most people do not get enough fluoride to supplement healthy teeth. By ending water fluoridation, the dental industry will see an uptick in dental cavities and can lead to potential tooth loss and other health issues," Hales said.
"I truly believe that oral health is one of the most important factors for overall health. When oral health decreases, it will eventually lead to tooth loss, which leads to functional and masticatory issues. When people are unable to eat, they will not get the nutrients they need and overall health will decline. This all begins with the foundation of which habits are best for the teeth and oral health overall. Without fluoridated water, people will need to find ways to replace it such as xylitol in gums or mints, brushing their teeth more consistently or getting cleanings as often as every three months instead of six months," Hales added.
Dr. Kenny Brown is an oral and maxillofacial surgeon and the co-founder and chief executive officer of Feno, an oral health technology company aiming to bridge the gap between oral health and overall health.
"The end of water fluoridation could lead to an increase in dental decay, driving demand for restorative treatments and preventive measures like fluoride varnishes and sealants," he said.
"While some have concerns about fluoride, its removal will require individuals to be more diligent with their oral hygiene routines to maintain oral health. Cosmetic dentistry may also see growth as patients seek solutions for issues like discoloration and enamel damage caused by untreated caries. Practices that focus on education, prevention, and innovative care will be well-positioned to adapt to these changes," Brown said.
Dr. Chelsea Perry earned her Bachelor of Science in biology from Indiana University, achieving dean's list honors and joining the Phi Eta Sigma National Honor Society and the National Society of Collegiate Scholars. Perry graduated from the Tufts University School of Dental Medicine in Boston at the top of her class with a Doctorate of Dental Medicine. Perry is also a member of the American Academy of Dental Sleep Medicine.
"The end of water fluoridation could lead to an increase in tooth decay and related dental issues, potentially driving higher demand for general and restorative dental services," Perry said.
"However, for cosmetic dentistry, the impact might be less direct, as these services are often elective and sought by individuals prioritizing aesthetics over necessity. Over time, if oral health declines broadly, cosmetic practices might see a shift in focus toward more restorative work. Overall, dental practices could experience increased revenue from treatments," Perry said.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
