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What’s in Your Water?

Written by Annie Duong

Image by rawpixel from Pixabay

Maintaining your dental health has never been easier than it is today, especially with the development of more efficient and advanced dental technology. What’s one of the most efficient and convenient ways to fight oral bacteria? Look no further than your kitchen faucet.

The introduction of fluoride in public water facilities and mass-produced food items was a groundbreaking public health initiative in Grand Rapids, Michigan in 1945 [1]. Public fluoridation has immensely helped many urban cities and has been a model for similar initiatives globally, such as pasteurizing dairy and administering vaccines. It has been proven to have an immense benefit for the reduction of many oral diseases and infections at a low-cost with a high accessibility. Although the direct fluoridation of drinking water is the main way fluoride’s elements are distributed, manufactured food and drinks processed by fluoridated water are another way to increase fluoride intake in the body.

The formation of dental caries is generally straightforward: plaque on the tooth’s surface is made up of bacteria, often mutans streptococci or lactobacilli, produced by acidic byproducts. The calcium phosphate mineral in the enamel is then dissolved in a process called demineralization [2]. Every time the bacteria metabolizes carbohydrates that enter the mouth, they produce organic acids that dissociate and create hydrogen cations which dissolves minerals in the teeth and releases the calcium and phosphate ions out of the tooth. This quickly lowers the pH in the solution and continues to diffuse the acids in the tooth enamel or dentin. If this process continues, the tooth develops a cavity. As such, fluoride is beneficial precisely because it effectively inhibits the bacteria’s metabolic processes. Fluoride travels through the bacterial cells in the form of hydrofluoric acid, which inhibits an enzyme called enolase that is crucial to metabolize sources of glucose or energy. The fluoride also inhibits demineralization enhancing remineralization as the calcium and phosphate is restored by components in human saliva and neutralizing the acids. The minerals are essentially replaced and reverse the mineral diffusion gradients [2].

Fluoridation is ultimately safe and effective. In the first few decades after fluoridation was introduced, evaluations in New York, Ontario, and Illinois have found that tooth decay in children decreased by seventy percent in contrast to communities without fluoridation, and more than sixfold as many schoolchildren were without caries in fluoridated public systems [1]. Ultimately, this system has prevented much infection and needless pain while improving the quality of life in many urban and city areas. It is important for the public to recognize the value of public health initiatives in order maintain the best care for all in the most efficient way.

References:
[1] Horowitz, Herschel S. “The Effectiveness of Community Water Fluoridation in the United States.” J Public Health Dent. 1996;56(5 Spec No):253-8.
[2] Featherstone, John D.B. “The Science and Practice of Caries Prevention.” Jada Continuing Education. 2000; 131: 887 – 899.

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