This is something that I posted on Making Sense of Fluoride, but thought I'd re-post here; it deserves to be widely read. I've highlighted some of the main points made by the authors as they address issues frequently raised by those opposed to community water fluoridation.
The Science-Based Medicine blog is an excellent resource and well-worth adding to your regular reading list. A few days ago Clay Jones (a paediatric hospitalist) & Grant Ritchey (DDS) posted an article entitled "Preventing Tooth Decay in Kids: Fluoride and the Role of Non-Dentist Health Care Providers". It's reasonably long but contains a number of key points.
The first is that "there are a number of stumbling blocks that prevent children from receiving appropriate dental care" – including distance from/accessibility to a provider, not to mention the costs involved.
Secondly, that the majority of people will be affected by caries: " [r]oughly 90% of us will have some degree of tooth decay during our lifetime"; that this prevalence increases over time, and that – sadly but unsurprisingly – it is most marked in poorer sectors of society. Interestingly they also characterise caries as infectious – because the bacteria involved can be & are spread from mouth to mouth. (Consequently they advise against 'spit-cleaning' a child's dummy, which sounds just about as insanitary as popping it straight back in from a sojourn on the floor.) And there's also a genetic component, which means that "[t]ooth decay truly is a complex, multifaceted process that clearly isn’t as simple as forgetting to floss every day or even the socioeconomic status."
There's a description of the effect of fluoride on tooth enamel, which says quite explicitly that "when exposed to fluoride either systemically during tooth development or topically via toothpaste, fluoridated water, or professional application, becomes strengthened." Jones & Ritchey agree that dental and skeletal fluorosis are problems when ingesting higher levels of fluoride, but add a caveat that bears repeating: "It must be emphasized that skeletal and severe fluorosis of the teeth do not occur as a result of any sort of community water fluoridation, or because of fluoride in toothpastes or professional fluoride treatments [my emphasis]. They occur in areas with naturally occurring fluoride levels far in excess of what is safe, and are rare in the United States. In these areas, a defluoridation process must be undertaken to return the water concentration of fluoride to safe and optimal levels."
And they have some strong words to say on the so-called 'fluoride controversy'.
As I said, it's a long-ish piece but well worth reading in its entirety.
For those interested in reading more on this issue, my colleague Ken Perrot has written extensively on fluoridation over at Open Parachute: here, for example.