If there’s one thing human beings are really good at, it’s believing whatever it is they want to believe.
I was at Target yesterday buying some toothpaste, and I noticed a sudden proliferation of tubes that looked different in both the kids’ and adults’ sections. Burt’s Bees! Schmidt’s! Tom’s of Maine! A closer look showed that these were a new crop, at least in numbers like this:
Fluoride-free toothpaste!
If there’s one thing Target is good at, it’s quickly altering the products on shelves based on what people will buy. If you ever shop there, you know they’ll literally rip out an entire section without batting an eye. I shop there mostly because it’s a nice 10-minute walk from work, and I could probably write ten diaries on the regrettable state of many American things based on my visits, but I’m going to spare you that. (For now.)
The fact that these toothpastes have suddenly appeared in large quantities on their shelves, though, tells me that people want them and are buying them. They are A Thing now. Chalk another one up to the anti-science crowd!
Fluoride-free toothpaste?
To borrow an old comedian’s line, that’s like Christians against Christ! It’s like apple-free apple juice. Let’s zero in on the one ingredient that justifies the product’s existence and just take it out! There! Now it’s “healthy”! It’s “natural”! Can’t you tell by the trendy packaging?
Say what you want about fluoride, by the way, but don’t tell me it isn’t “natural”:
Fluorine is estimated to be the 13th most abundant element in the earth's crust and is widely dispersed in nature, almost entirely in the form of fluorides.
Can we get something out of the way? I’m sorry for having to put you through the motions on this:
Dental health experts worry that more people are using toothpaste that skips the most important ingredient — fluoride — and leaves them at a greater risk of cavities.
Most toothpastes already contain fluoride. While health authorities recognize fluoride as a cavity blocker, the internet is dotted with claims, often from "natural" toothpaste marketers and advocates for alternative medicine, that fluoride-free toothpaste also prevents cavities.
Dental authorities disagree.
"It's really important to debunk this idea that brushing your teeth stops decay. You need to have the fluoride," said Damien Walmsley, a scientific adviser to the British Dental Association and a dentistry professor at the University of Birmingham in England.
Also, the Sun will rise in the East tomorrow morning. Duh!
I have no idea where people got the notion that it’s OK, or even beneficial, to stop using fluoride on your teeth. But the language from the manufacturers sure has that anti-vaxxer feel to me:
Not every parent wants fluoride in their child’s toothpaste. So, we've carefully crafted this version of Fruit Fusion without Fluoride, leaving the choice up to you!
Hey, some people like their teeth to rot and fall out, others don’t! You get to pick! Yay!
Another nice line that implies that dentists are OK with this idea:
HOW TO USE
- Adults and children 2 years and older: brush teeth thoroughly after meals or at least twice a day or use as directed by a dentist.
You know what your dentist is actually going to direct, as long as his name is not Alex Jones?
Use fluoride!!
Why, in fact, let’s ask the American Dental Association what their official position is:
Use Toothpaste and Mouthrinse with Fluoride
Toothpaste with fluoride has been responsible for a significant drop in cavities since 1960. Look for one with the ADA Seal of Acceptance to make sure it contains fluoride.
Just like vaccinations have done with measles! Derrrrrrr!!
It’s hard to overstate just how many studies and reviews of studies keep finding this:
Conclusion: Personal oral hygiene in the absence of fluorides has failed to show a benefit in terms of reducing the incidence of dental caries [tooth decay].
And this:
We included 96 studies published between 1955 and 2014 in this updated review. [...]
This Cochrane Review supports the benefits of using fluoride toothpaste in preventing caries when compared to non‐fluoride toothpaste.
[...]
Only a minority of studies assessed adverse effects of toothpaste. When reported, effects such as soft tissue damage and tooth staining were minimal.
And no, I’m not pulling a William Barr summary on you; the whole report is right out there, so you can go and read all about 95% confidence intervals and concentration dependence if you really, really want to. But ninety-six studies. OOOOMG.
Now, it’s true, of course, that we don’t want to eat lots of toothpaste. We could end up with fluorosis if we do that:
Fluorosis is a cosmetic condition that affects the teeth. It's caused by overexposure to fluoride during the first eight years of life. This is the time when most permanent teeth are being formed. After the teeth come in, the teeth of those affected by fluorosis may appear mildly discolored.
That’s why little kids can use fluoride-free toothpaste with Thomas the Train and sparkly cartoon unicorns on it for a while, as they learn to brush and to not swallow their toothpaste. Fine. Awesome. My kids did that until they had 14 or 15 brain cells to rub together, too.
But older kids and adults not using fluoride? Holy John Birch Society. Look, it’s also bad to eat paper clips, but we do not therefore need packages of paper clips that are paper clip-free. There is a simple remedy, much simpler than banning them from your household: Don’t eat paper clips.
I’m stopping my the-Earth-is-round harangue there, because you don’t need me to keep harping on it, and I only decided to get off my butt and write this in the first place because I did learn some things.
I was under the impression that the main reason that fluoride kept you from getting tooth decay was that it killed the bacteria in your mouth. That’s not really it, though! It’s true that fluoride is not exactly good for bacterial health:
It has been shown on many occasions that fluoride can affect bacterial carbohydrate fermentation; however, are there other effects of fluoride on the bacteriology of dental plaque? Although very high levels of fluoride (0.16-0.3 mol/L) will kill bacteria, there is little evidence that fluoride causes dramatic changes in the number of species found in plaque or their relative concentrations.
Hmmm, so what does it do, exactly? It’s not a simple answer, even for dentists and oral health researchers:
[from 2013]
Karin Jacobs and colleagues explain that despite a half-century of scientific research, controversy still exists over exactly how fluoride compounds reduce the risk of tooth decay. That research established long ago that fluoride helps to harden the enamel coating that protects teeth from the acid produced by decay-causing bacteria. Newer studies already found that fluoride penetrates into and hardens a much thinner layer of enamel than previously believed, lending credence to other theories about how fluoride works.
The report describes new evidence that fluoride also works by impacting the adhesion force of bacteria that stick to the teeth and produce the acid that causes cavities. The experiments—performed on artificial teeth (hydroxyapatite pellets) to enable high-precision analysis techniques—revealed that fluoride reduces the ability of decay-causing bacteria to stick, so that also on teeth, it is easier to wash away the bacteria by saliva, brushing and other activity.
Huh. Interesting. So we are still figuring this out. That’s what science is for.
Meanwhile, we keep on with the time-honored Dance of the Gullible People And Companies Who Make Money Off Of Them:
Paul Jessen, a brand manager at Tom's of Maine, said its fluoride-free products don't promise to fight cavities. He said his company's customers generally understand this.
Yet customer comment on Amazon's website sometimes indicates otherwise, with many reviews insisting that the company's fluoride-free toothpaste does fight cavities. "If you brush regularly with or without fluoride, you reduce the risk of cavities," asserts one customer.
Paul, why would people even want to use toothpaste if it doesn’t fight …. oh, nevermind.