Teething trouble for kids using fluoride
by Emma Burns, The Max, (Glasgow) Daily Record, May 24th,
SMILES WORSE: FEARS ARE GROWING THAT WE
COULD DO MORE
LOOK at the picture on
the right and you see a pretty girl with a lovely smile. What you can't see
is the agony behind it.
Carena Smith's teeth have been horribly damaged by fluoride - the
substance that was meant to protect them.
When her adult teeth came through they were mottled, lacking in enamel
and were soon stained brown by food and drink.
ALL SMILES NOW: Dawn with her children
Carena and David
Carena Smith had to have lengthy dental
treatment after her front teeth were ruined by
the stuff that was supposed to make them strong
Carena hated them so much that she begged her parents, Dawn, 42, and
Mark, 41, to let her have them removed.
They were horrified. Dawn had been giving Carena and her brother David 16
fluoride supplements to ensure they had strong teeth.
Carena, 14, was persuaded to try a less
drastic but expensive and lengthy dental treatment. She can smile happily
again after having veneers stuck over her two front teeth, the worst
But it was a complicated procedure that took three attempts.
Dawn, of Linlithgow, feels guilty that it was her own dedication in
giving Carena the recommended dose of fluoride drops, tablets and
mouthwashes that led to her teeth being spoiled.
But it was all recommended by the authorities and she is shocked that the
debate about putting fluoride into Scotland's water has been reopened.
Last summer, Health Minister Susan Deacon wrote to the chairmen of all
the health boards asking for ideas on how they might consult the public on
Since last autumn, the NHS Centre for Reviews and Dissemination at the
University of York has been carrying out an in-depth study of the evidence
for and against fluoridation of public water supplies.
Its report has been completed and is due to be published next month. If
it comes out in favour of fluoride, the pressure will be on to introduce it
in Scotland for the first time since since 1982, when a 17-month legal
hearing ended with judge Lord Jauncey supporting battling Scots granny
Catherine McColl's attempt to have it banned.
Alastair MacLean, secretary of the British Dental Association in
Scotland, is 100 per cent pro-fluoridation and expects the York academics to
come out in favour.
He said: "It would be extraordinarily strange if they didn't."
He believes the benefits to teeth outweigh any disadvantages and points
out that around the Moray Firth, where fluoride occurs naturally in the
water, 87 per cent of five-year-olds have perfect milk teeth compared with
32 per cent in other areas.
At 12, 76 per cent of the children with fluoridated water had perfect
adult teeth compared with 46 per cent from other areas.
He said: "The positively-charged fluoride ion becomes incorporated into
the enamel of the teeth, making it harder.
"When the surface of the tooth is attacked by sugar - which happens
several times a day-the fluoride makes the area much much tougher."
He says the benefits are not just for children - they last throughout
life. This is because fluoride gives a big boost to the body's natural
ability to repair teeth every time they are attacked by sugar in food or
He added: "People don't develop tooth decay later on. They have a much
lower level for the rest of their lives.
"Older people are less likely to develop decay on the roots of their
teeth exposed by receding gums, which is extremely difficult to treat."
Compared with those advantages, Alastair MacLean believes the downside of
fluoride is negligible.
He said: "Dental fluorosis is a comparatively minor problem which is
unusual in areas where the amount of fluoride in the water is set at one
part per million.
"In its most common form, it is small white stains on the teeth. I
personally would rather have small white spots on my front teeth than big
decayed holes m my back ones."
Surveys of 26,011 12-year-olds and 14-year-olds in Scotland over the last
10 years have found that 10 per cent of them have marks on their teeth which
may be fluorosis - probably caused by eating toothpaste. But only three per
cent of them are aware of it.
Professor Len Stephen, of Glasgow Dental Hospital, is another staunch
supporter of fluoridation and claims it is children from poorer families who
will benefit most if is introduced to the water supply. He said: "Children
from social classes one and two have dramatically less tooth decay. Their
parents make them brush their teeth and don't let them eat sugary snacks all
"Parents from social classes four and five either don't know the advice
or ignore it.
"Their children would benefit twice as much from fluoride in the water.
"I believe it is wrong that a minority who shout loudest are stopping
something of benefit to the majority."
But there are downsides with fluoride.
In parts of India and Africa, where fluoride occurs naturally at 10 parts
per million -10 times as much as is permitted in this country - and where,
because of the heat, high quantities of water are drunk daily, around 10 per
cent of the population can be seen on X-rays to have skeletal fluorosis,
according to Professor Stephen.
Fluoride builds up in their bones, making them thicker but more brittle.
The worst affected can develop holes in their bones, making them more
vulnerable no osteoporosis and fractures. Anti-fluoride campaigners claim
that as well as skeletal fluorosis, an excess of fluoride can cause gut
problems, depression of the immune system, bone cancers particularly among
boys and men, lower IQ in children and even Down's Syndrome.
Margaret Cooper, who runs the National Register of Children with Dental
Fluorosis, said: "If fluoride is introduced to the water supply, people with
kidney problems and certain cancers who cannot tolerate fluoride, will have
to buy all their water in bottles, even for cooking and brushing their
They will effectively be barred from using tap water, in the name of
reducing the number of filings in teeth. I find that outrageous and
It is particularly questionable as there are studies which show that
teeth are no better in fluoridated towns than ones without fluoride.
One report, by the late Dr John Colquhoun, former Principal Dental
Officer of Auckland, New Zealand, stated: "Surveys showed that there is
little or no differences in tooth decay rates between fluoridated and
non-fluoridated places throughout America.
"From other lands - Australia, Britain, Canada, Sri Lanka, Greece, Malta,
Spain, Hungary and India - a similar situation has heart revealed - either
little or no relation between water fluoride and tooth decay, or a positive
one (more fluoride, more decay)."
He argued that the real reason why our dental health has improved over
the past 50 years is nothing to do with fluoride in the water or in the
He believed it is because we eat a much healthier diet with more fruit,
vegetables and cheese, and brush our teeth more.
Dr Sheila Gibson, research physician at the Glasgow Homeopathic Hospital,
who is an the advisory panel to the York review, said: "Fluoride is a very
powerful poison one of the most toxic substances found in the Earth's crust.
"It has an adverse effect on the brain, the nervous system, the immune
system, the pancreas, the stomach and kidneys.
"It can be particularly detrimental for older people with kidney failure
who cannot excrete as much of it as a healthy person would, leading to it
building up rapidly in their bones.
"Adding fluoride to the water supply is medicating people without their
consent, with no knowledge of their medical condition. It is highly
dangerous and profoundly unethical."
Around 27 substances, including carbon, acids and manganese, are already
added to the water in Strathclyde.
With both sides so adamant that they are in the right and the other side
is totally mistaken, it is hard to tell where the truth lies and hopefully,
the York review should clarify things.
But it is certainly acknowledged by both sides that too much fluoride in
children under seven can cause dental fluorosis.
Professor Stephen says the real danger lies in children eating fluoride
toothpaste. He maintains that it is better to give them tablets or drops
which you can measure, and no toothpaste or the merest smear of it on their
brush, than risk them swallowing a daily overdose.
He recommends 0.25mg from when the first teeth come through until eight
months, 0.5mg from eight to 16 months, 0.75mg from 16 to 24 months, lmg
until six years, and 2mg thereafter.
He said: "It is higher than other people recommend but you don't get
fluorosis with that dose, if you control the dentrifrice."
Fluoride works by interfering with the crystalline structure of enamel as
it is forming on the teeth still buried in the gums. It replaces a molecule
which has a similar structure. In moderation, that makes the teeth harder.
But if too much fluoride gets into the enamel while the teeth are still
forming, it can develop fine pores, leading to the mottled look.
Where there are lots of pores, the entire surface of the teeth can be
stained by food and drink, making the teeth look dirty and diseased.
That is what happened to Carena and David Smith. Mum Dawn, a former
primary school teacher, was scrupulous in following the advice she was given
by her local dentist and health centre.
They told her to give fluoride drops to Carena from three months and to
start David, then two, now 16, on fluoride tablets.
She said: "I did it exactly as prescribed. I never questioned it. My
dentist said I must give fluoride daily because otherwise the effect would
"Other mothers may not have bothered or may have forgotten. I did as I
was advised because I believed it was the right thing to do.
"And I supervised them every day as they brushed their teeth twice a day
with children's fluoride toothpaste."
David's adult teeth showed some signs of mottling. But the real shock
came with Carena's front teeth.
They were brown, mottled and seemed to have very little enamel.
Dawn said: "She was very upset about her teeth looking like that.
"Children at school kept asking why her teeth were dirty and we had a few
tears over it. For a while she wanted them taken out and to have false
teeth. She thought anything was better than those brown teeth."
At first, however Carena was prescribed more fluoride, in a mouthwash.
It was only two years later, when she was nine, that she was diagnosed as
Eventually, when she was 11, she was treated by having part-porcelain
veneers fixed to her two front teeth. And one molar was removed because the
fluoride had led to it being malformed.
Dawn is angry and distressed that she unwittingly gave her daughter daily
doses of something that was doing her harm.
She is worried about the long-term expense for Carena of having
replacement veneers, particularly once she is an adult and no longer
qualifies for free NHS treatment.
And she hates the thought of Carena being exposed to more fluoride.
Dawn said: "I worry about the long-term effects. The only thing I can do
is to try and make sure she doesn't ingest any more fluoride in any way.
"We have fluoride-free toothpaste and she doesn't drink tea - fluoride is
found naturally in tea.
"But I worry about reconstituted fruit juice. What if the water in that
"I'm 100 per cent against having fluoride introduced into our water and
not just from my own point of view. How could people avoid it if they need
"No government should put something that has known risks into the water."
MORE DAMAGE THAN GOOD BY TRYING TO GET
HEALTHY MOLARS ON TAP
[Top left] SORRY SIGHT: Careen's front teeth ended up badly
stained by food and drink
COVER-UP JOB: After having porcelain veneers fitted over her existing
teeth, Carena [immediate left] now has a lovely smile again