06/18/2025
I feel compelled to weigh in on this for my patients, because, in fairness, its difficult to know whom to believe and where to get good information. So let me help…
First, my professional opinion. The dental profession has many decades of evidence that when used topically and in appropriate doses, fluoride has a significant medical benefit to patients. It slows the growth of harmful bacteria. It repairs damage done to teeth by harmful bacteria. It makes teeth more resistant to future infection. I fully endorse the appropriate use of fluoride for all of my patients with the understanding that I live in an area where a large number of my patients benefit from ongoing public fluoridation.
Here is a link to the American Dental Association's info page on fluoride.
https://www.ada.org/.../community.../fluoride-in-water
If you want to do your own research, I recommend Google Scholar or using an AI-based search engine and ask for evidence that fluoride “at recommended doses” is harmful and what evidence exists to demonstrate that it is harmful “at recommended doses”.
Now, to address this attached article. I wish to express concern with the overall approach the FDA appears to be taking with regards to fluoride. As I comment, please do not take my comments beyond a response to this individual article.
In general, in medicine and regarding scientific “evidence”, usually clinicians such as myself make informed decisions by evaluating a robust body of scientific evidence which we use to educate and treat our patients. In this article, the FDA cites “evidence” they want to use as rationale to reverse current FDA approval for fluoride as a “systemic” “concentrated ingestible fluoride prescription”.
I applaud the FDA’s efforts to monitor the body of evidence available and, when new or growing evidence demonstrates that current approvals should be reconsidered, the courage to make those decisions in a way that is transparent to the public they serve. It is particularly important for the FDA to make clear, transparent statements, such as, “Based on the evidence presented in these five articles, we have decided to…” This will allow the entire world to review the five articles upon which their decision making is based. This strengthens public trust and enlists the entire world in monitoring the public health of our great nation.
However, I also point out that in general, dentistry has not been an advocate for systemic fluoride. Instead, our literature supports the topical application of fluoride through public fluoridation efforts and over-the-counter medications such as toothpaste as the most effective way to deliver appropriate “recommended” doses. This article cites the FDA’s desire to eliminate public fluoridation programs based on undisclosed “evidence” related to “systemic” ingestion of fluoride. Those are clearly not apples to apples. For that reason, I call into question the “evidence”-please provide specific studies so that we, as an educated citizenry, can evaluate for ourselves the adequacy of that evidence.
I fully applaud Commissioner Makary’s statement that, “[the] best way to prevent cavities in children is by avoiding excessive sugar intake and good dental hygiene, not by altering a child’s microbiome” and I believe most dentists would fully support this effort. However, I again point out that I as an individual dentist have always advocated in behalf of the topic application of fluoride and never in support of the systemic ingestion of fluoride. I further state that ingestion of fluoride through public fluoridation and systemic fluoride ingestion cannot be construed as equivalent unless proven to be so and the FDA has not released any reliable data that demonstrates this similarity.
Therefore, I urge my patients to continue to use their fluoridated toothpaste and to continue to consume the fluoridated water present in our community water sources. Finally, I also urge my patients to speak up and ask questions if you have concerns. I’m highly committed to helping you learn as much as you can about your health and how best to care for it.
The U.S. Food and Drug Administration (FDA) announced on May 13 that it aims to remove concentrated ingestible fluoride prescription drops and tablets for infants and toddlers from the market.
