The use of fluoride varnish treatment (FVT) to minimise the development of dental caries has increased, having been widely used for four decades in Europe, Canada and other parts of the World. National Health Service (NHS) dentists in England carried out almost 850,000 FVTs on young people in 2010-11.
Into the mouths of the very young…
FVT is a flammable, yellow resin containing 5% concentrated sodium fluoride. It is thinly brushed onto tooth surfaces in the same way that nail varnish is applied. It is harmful if swallowed, it may cause sensitisation on contact with skin, it releases carbon monoxide as it decomposes, and very toxic gas on contact with acid (saliva can be acidic, especially in the presence of acidic foods!). All effort should be made to avoid inhaling the vapour during application, and if food is consumed within 24 hours, there may be nausea and sickness as a result of ingestion of the un-dried varnish. No toxicity data were available for one product we looked at. Nevertheless, such treatments are marketed for children, and, disconcertingly, are now available in child-friendly strawberry, spearmint, melon, and bubble gum flavours!
Cochrane reviews highlight insufficient data
A 2002 Cochrane review concluded that there was suggestion of a caries inhibiting effect, but it added there were insufficient data on potential side effects and adverse events of FVTs. It called for studies of higher quality, with full safety assessment. A 2008 review also called for better quality research.
There are no definitive trials for the use of FVTs in primary care, which means that their use in the US is ‘off-label’, and not Food and Drug Administration (FDA) approved.
Frequency of treatments— the more the merrier?
On both sides of the Atlantic, children may receive FVTs from their dentist or nursery/school— or both types of care provider. It’s even possible for children receive two treatments on the same day! Despite the gaping holes in safety data, it is un-reassuring that Scottish authorities have deemed such double dosing on the same day, or even four doses a year as safe! Provided that they don’t take their fluoride tablets the day before, the same day, and the day after, they are encouraged not to stop the additional fluoride treatment, nor their fluoride toothpaste!
It seems that those advocating FVTs fail to consider total fluoride intake. Using the UK National Diet and Nutrition Survey, Mansfield calculated that in a quarter of the UK population, fluoride consumption from all sources exceeds the safe intake defined by the Committee on the Medical Aspects of Food Policy (CoMA) (regardless of water fluoride concentration). Between age 6 months and six years the safe intake of fluoride is considered by CoMA to be 0.12 mg F/kg/day, and in younger infants 0.22 mg F/kg/day. How many children are receiving toxic doses, we wonder?
Tooth decay: fluoride deficiency, or dietary imbalances?
In a strange topsy-turvy turnaround of logic, we are also being told that, due to the presence of mere background levels of natural fluoride, bottled water is now the baddie when it comes to children’s drinks! Funny that. We thought it was high acidic, high sugar and high phosphorous containing colas, sodas and fruit drinks and juice, many being both high in sugar as well as highly acidic.
So much for prevention strategies, to which health authorities seem so keen to pay lip service. Why is it okay for children to be regularly exposed to corrosive, dentally-challenging liquids, along with the serious imbalances of the Western diet, while simultaneously being exposed to toxic doses of fluoride?!
Call to Action
If your dentist or dental hygienist recommends fluoride treatments such as varnishing, ask them about the evidence for this, and quiz them about total fluoride exposure from all sources, as revealed in Peter Mansfield’s research.
Be aware of all the sources of fluoride to which you or your children are exposed, and reduce it as much as possible. If your children are using a fluoride toothpaste, ensure that none is swallowed and that the child rises his or her mouth thoroughly with unfluoridated water; this should involve 3 rinses. Be aware that most mineral water contains traces of naturally occurring fluoride, but that some has fluoride deliberately added. Check the information provided on the bottle and remember that naturally-occurring fluoride is very different to its toxic synthetic counterparts.
Contact your elected representatives and let them know that you are concerned about vulnerable people and animals being exposed to toxic doses of fluoride, the first obvious symptom of which is fluorosis on teeth enamel. Draw their attention to the growing list of members of the scientific, academic and professional communities, and others promoting sound public health policy worldwide who have signed the 2003 petition to all governments practicing, and all organisations supporting, water fluoridation.
Enjoy a balanced diet, avoiding sugary snacks, fruit juices, squashes or sodas in between meals. Clean teeth thoroughly, no sooner than one hour after the end of a meal. If you use fluoride toothpaste, ensure that children do not swallow the paste and that they rinse well.
Ensure that your diet includes sources of vitamin K2, vitamin A (retinol), and vitamin D3— you can make this by spending safe amounts of time in the sun— there is mounting evidence that this combination of nutrients works particularly well to utilise dietary calcium and to keep teeth and bones in great shape!