Warning: Don’t Swallow the Toothpaste…Even Though it Tastes Like Candy
In Brief
Fluoride is not essential for human growth and development, and it has been identified as one of 12 industrial chemicals known to cause developmental neurotoxicity in humans. Concerns have been raised about potential associations between fluoride and health risks such
as cancer, bone fractures, musculoskeletal effects, reproductive and
developmental effects, neurotoxicity and neurobehavioral effects, and
effects on other organ systems.
advertisement - learn more
To complicate matters, concerns have
also been raised about children’s use of toothpaste, much of which
contains fluoride. Earlier this year, the Centers for Disease Control and Prevention (CDC) and pediatricians both warned about children using too much toothpaste, resulting in ingestion of fluoride.
Risks of Fluoride to Children
Specific health risks to children from
fluoride have been recognized and include bone cancer (osteosarcoma), IQ
loss, attention-deficit/hyperactivity disorder (ADHD), and many other
adverse outcomes. Exposure to excess fluoride in children is also known
to result in dental fluorosis, which has been identified as a first sign
of fluoride toxicity.
According to data from the Centers for Disease Control and Prevention (CDC) released in 2010, 41% of children aged 12-15 exhibit fluorosis to some degree.
Dental fluorosis can range from very
mild to severe and is a condition in which the teeth enamel becomes
irreversibly damaged and the teeth become permanently discolored,
displaying a white or brown mottling pattern and forming brittle teeth
that break and stain easily. According to data from the Centers for Disease Control and Prevention (CDC) released in 2010, 41% of children aged 12-15 exhibit fluorosis to some degree.
However, a new analysis of the most
recently available government data found that 65% of American children
now have some degree of dental fluorosis. This data and more
information are included in a March 2019 report published in the Journal of Dental Research – Clinical & Transactional Research.
Additionally, in extreme cases, fluoride
toxicity from dental products can be fatal. For example, in 1974 a
three-year old Brooklyn boy died due to a fluoride overdose from dental
gel. A reporter for the New York Times wrote of the incident:
“According to a Nassau County toxicologist, Dr. Jesse Bidanset, William
ingested 45 cubic centimeters of 2 percent stannous fluoride solution,
triple an amount sufficient to have been fatal.”
advertisement - learn more
Background on Fluoride in Toothpaste and Required Labeling
Fluoride was not widely used for
any dental purposes prior to the mid-1940’s. In 1945, it was first used
for artificial water fluoridation in spite of warnings about its
potential hazards. Meanwhile, fluoridated toothpastes were
introduced and their increase in the market occurred in the late 1960s
and early 1970s. By the 1980s, the majority of commercially available
toothpastes in industrialized countries contained fluoride. Other
fluoridated dental products were likewise promoted for commercial use in
recent decades.
Fluoride added to toothpaste can be in the form of sodium fluoride (NaF), sodium monofluorophosphate (Na2FPO3), stannous fluoride (tin fluoride, SnF2), or a variety of amines. Toothpaste used at home generally contains between 850 to 1,500 ppm fluoride, while prophy paste used in the office during a dental cleaning generally contains 4,000 to 20,000 ppm fluoride.
Brushing with fluoridated toothpaste has been reported to raise
fluoride concentration in saliva by 100 to 1,000 times, with effects
lasting one to two hours.
The U.S. FDA requires specific wording for the labeling of
“anticaries drug products” sold over-the-counter, such as toothpaste
and mouthwash, including strict warnings for children. The labeling is
designated by the form of the product, as well as by the fluoride
concentration. Warnings also are divided by age groups (i.e. two years
and older, under six, 12 years and older, etc.). Some warnings apply to
all products, (with suggestions for bold copy and fill in the blanks)
such as the following:
- For all fluoride dentifrice (gel, paste, and powder) products. “Keep out of reach of children under 6 years of age. [highlighted in bold type] If more than used for brushing is accidentally swallowed, get medical help or contact a Poison Control Center right away.”
- For all fluoride rinse and preventive treatment gel products. “Keep out of reach of children. [highlighted in bold type] If more than used for “(select appropriate word: “brushing” or “rinsing”) ” is accidentally swallowed, get medical help or contact a Poison Control Center right away.”
Dangers to Children from Toothpaste
A research article published in 2014 raised
significant concerns about this labeling. The authors established that
over 90% of the products they evaluated listed the FDA warning for use
only by children over the age of two on the back of the tube of
toothpaste and in small font.
Similar circumstances were reported about warnings from the American Dental Association (ADA). The researchers documented that
all of the toothpastes with approval or acceptance by the ADA placed
the ADA warning (that children should use a pea-sized amount of
toothpaste and be supervised by an adult to minimize swallowing) on the
back of the tube in small font.
Misleading marketing strategies are regularly used in selling children’s toothpaste as if it is a food product, while warnings regarding overconsumption among youth are minimized.
Marketing strategies were further
identified as promoting toothpaste as if it were a food product, with
the researchers acknowledging this tactic could dangerously result in
children swallowing the product. More specifically, the researchers stated:
Aggressive marketing strategies targeting children were identified: every toothpaste in this sample displayed at least 1 children’s animated character, 50% had at least 1 picture of a food item, 92.3% stated they were flavored and 26.9% depicted a full swirl of toothpaste, directly contradicting dentist recommendations for young children…Misleading marketing strategies are regularly used in selling children’s toothpaste as if it is a food product, while warnings regarding overconsumption among youth are minimized.
Indeed, research suggests that
toothpaste significantly contributes to daily fluoride intake in
children, partly due to swallowing toothpaste. Some research has even
suggested that, due to swallowing, toothpaste can account for greater
amounts of fluoride intake in children than water. In light of the
significant fluoride exposures in children from toothpaste and other
sources, researchers at the University of Illinois at Chicago explained that their findings raised “questions about the continued need for fluoridation in the U.S. municipal water supply.”
Other Dental Products Also Contain Fluoride
Mouth rinses (and mouthwash) can also
contribute to overall fluoride exposures. Fluoridated dental floss is
yet another product that contributes to overall fluoride exposures.
Fluoride gels and foams can also be used at the dentist office and
sometimes even at home. Many consumers use these products in combination
on a regular basis, and thus, these multiple routes of fluoride
exposure are even more relevant when estimating overall intakes.
In addition to these over-the-counter
dental products, some of the materials used at the dental office can
result in even higher fluoride exposure levels. Dental
“restorative” materials, which are used to fill cavities, are used on
children, and consideration of the fluoride levels in these materials is
crucial. Many of the options for filling materials contain fluoride,
including all glass ionomer cements, all resin-modified glass ionomer cements, all giomers, all polyacid-modified composites (compomers), certain types of composites, and certain types of dental mercury amalgams. Fluoride-containing
glass ionomer cements, resin-modified glass ionomer cements, and
polyacid-modified composite resin (compomer) cements are also used in
orthodontic band cements.
Silver diamine fluoride is now another
fluoride dentifrice. This is a relatively new dental procedure that was
FDA approved in 2014 for treating tooth sensitivity, but not dental
caries. Concerns have been raised about risks of silver diamine
fluoride, which can permanently stain teeth black.
Reduce Fluoride Exposures for Your Children
Since fluoride is being added to all of these products,
as well as the majority of American community water supplies and other
consumer items, parents are tasked with the responsibility of overseeing
their children’s fluoride intakes. Given the current levels of
exposure, parents should reduce and work toward eliminating avoidable
sources of fluoride, including water fluoridation, fluoride-containing
dental materials, and other fluoridated products, as means to promote
their children’s health and safety.
For more information, learn the Fluoride Facts from the International Academy of Oral Medicine and Toxicology (IAOMT). To read more specifically about fluoride and dental products, including references to scientific research, visit https://files.iaomt.org/wp-content/uploads/IAOMT-Comprehensive-Review-on-Fluoride-in-Dental-Products.pdf.
Author Bios
These writers co-authored the 2017 “International
Academy of Oral Medicine and Toxicology (IAOMT) Position Paper against
Fluoride Use in Water, Dental Materials, and Other Products for Dental and Medical Practitioners, Dental and Medical Students,Consumers, and Policy Makers.”
Amanda Just, MS: Ms. Just is the Program Director of the International Academy of Oral Medicine and Toxicology (IAOMT).
She is also a freelance writer and dental consumer who has shared her
writings about the impact of toxic dental materials with the United
Nations Environment Programme, the U.S. Department of State, the U.S.
Food and Drug Administration (FDA), and various NGOs.
Griffin Cole, DDS, NMD: Dr. Cole is a Past President of the International Academy of Oral Medicine and Toxicology (IAOMT)
and has been featured on numerous radio and television programs
including World News Tonight with Diane Sawyer. He has been published in
four several national peer-reviewed publications about restorative and
cosmetic dentistry, and in 2013, he became the first dentist to be
published in a peer-reviewed journal for his case study treatment of
Bisphosphonate-Related Osteonecrosis of the Jaw utilizing ozone therapy
for successful treatment of this disease. He lectures to health
professionals on practice management and biological dentistry and is a
clinical instructor at the American College of Integrative Medicine and
Dentistry in New Jersey.
The End of Censorship! CETV App Now Available!
CETV is our platform beyond censorship! Access our news broadcasts, exclusive interviews and original shows We're celebrating our iOS and Android app release with a 50% OFF SALE!
SUBSCRIBE NOW!
No comments:
Post a Comment