Kari Wordsworth

Kari Wordsworth

“Gluten-free!” “Fat-free!” “BPA free!” “Fluoride-free!”

In a world where there are so many options, it can be confusing to know which is best.

I understand how toothpaste labeled “fluoride-free” can sound like you are choosing a product that may be a healthier option — but it is not. The truth is that the American Dental Association (ADA) only recommends toothpaste that contains fluoride for everyone over the age of 2. Furthermore, the ADA also backs community water fluoridation as one of the best public health measures to fight against cavities.

From time to time, towns and communities across the country wage battles to remove fluoride from water supplies. Unfortunately, these forums often deal with misinformation about the safety and effectiveness of fluoridation. As a third-year dental student, I want to clear up some common misconceptions about fluoride.

What is fluoride?

Fluoride is a naturally occurring mineral that helps prevent cavities and can even stop the process of a cavity further forming.

OK but how does fluoride make our teeth stronger?

Fluoride can help reverse damage from bacterial acid attacks and prevent more from occurring by making the outer layer of your tooth, the enamel, stronger. Fluoride increases remineralization of early growing cavities, stopping them from getting worse and it also fights cavity formation by fighting the same bacteria that cause cavities.

Isn’t fluoride toxic?

Like so many things, if consumed in large amounts, fluoride can be toxic. However, you would need to consume an impossible amount of fluoridated water, in the region of 120 gallons, in one sitting, for it to be considered toxic.

But I’ve heard fluoride causes cancer. Is that true?


To date, no reputable studies linking fluoride to cancer in humans exist. In fact, numerous scientific studies that examine community water fluoridation support fluoride as a safe practice.

Doesn’t too much fluoride lead to white spots on teeth?

Fluorosis is not a disease; it is a cosmetic issue. Fluorosis presents as fine white spots on the teeth that likely only your dentist will notice. In a recent study among persons aged 6-49, only 2 percent had moderate fluorosis, and less than 1 percent had severe fluorosis.

The Environmental Protection Agency (EPA) has taken steps to ensure that fluoride is applied at a very specific concentration to reduce the risk of fluorosis while also providing effective protection against cavity formation.

Isn’t fluoride only beneficial if used topically — why have it in our water supply?

As dental providers, we advocate for both topical application of fluoride (often in the form of a varnish), as well as support community water fluoridation supervised by the EPA. Both topical and systemic intake of fluoride help fight cavities, just in different ways.

In summary, fluoride is nothing to fear, despite what you might hear from a variety of sources. Fluoride is widely viewed by dental professionals as the greatest public health intervention free to the public and easily accessible to the general population.

It is crucial that we understand its many benefits while also debunking any misinformation surrounding fluoride as it is essential to our oral health and general well-being.

And one last thing: Throw your charcoal toothpaste away. It is too abrasive for your teeth!

Kari Wordsworth is a member of the ECU School of Dental Medicine’s Class of 2023 and a J. Bradley Wilson Schweitzer Fellow. She is from Huntersville, N.C.

Contact Bobby Burns at baburns@reflector.com and 329.9572.