Q&A With Dr Emma
Hi Dr Emma,
I am emailing to ask about fluoride in toothpaste. I have an auto-immune thyroid disorder and my naturopath has recommended that I use toothpaste without fluoride in it as it is toxic and harmful to health.
I switched to a natural toothpaste (Miessence brand) and find it effective, however I am now concerned that the health of my teeth might suffer as a result.
I am 34 with no fillings currently and I am concerned about jeopardising my heath by using toothpaste with fluoride, or my teeth if I don't! I appreciate your advice and input.
Carrie from Churchlands, WA
Your naturopath is 100% correct in saying that fluoride is toxic. So is the chlorine added to our tap water to keep down the microbial count. So is Vitamin A in an inappropriate dose. There are definitely studies showing that populations with a high systemic fluoride exposure have altered thyroid hormone levels, but I am yet to see any evidence that brushing with a fluoride toothpaste causes the same effects, (unless you're swallowing all your toothpaste, which is a huge no-no!).
Where you live, the tap water is optimally fluoridated at 1ppm. So while you're getting a small systemic dose, it's in the order of 100x less than rodent studies, and at the very bottom end of human studies. If that concerns you, you can limit your systemic fluoride exposure by drinking water which has been through a reverse osmosis filter. For more information about systemic vs topical fluoride, have a look at another post of mine which I wrote in response to a question about fluoride tablets.
So where does toothpaste fit in? The point of fluoride toothpaste is that it's applied directly to your teeth, and then spat out down the sink. It's not meant to get into your system, just like you wouldn't eat pimple cream to improve your complexion. By using a non-fluoride toothpaste, you increase the risk of decay taking hold. Fluoride isn't the magical answer to preventing decay, there's a number of fronts you can attack to protect your teeth. It's certainly a good weapon to have in your arsenal though.
I have a lot of concerns about "natural" toothpastes. With a focus on providing a product free of synthetic chemicals, there tends to be a leaning towards ingredients which sound great but can cause long-term damage to teeth. A quick glance over ingredients shows things like bicarbonate of soda and sea salt. This sets off klaxons in the back of my brain screeching out "ABRASION!". Toothpaste is a product you use every day, on the same set of teeth you're planning to have when you're 95. It needs to be minimally abrasive to avoid the sensitivity and destruction of enamel caused by daily scrubbing. So while you're potentially avoiding chemical insult to your mouth from things some people are sensitive to, like sodium lauryl sulphate, instead you're wearing at your teeth physically. It's like using Jif to clean your French crystal wine glasses.
The short story is that there's insufficient evidence to show that fluoride toothpaste contributes to thyroid hormone disruption. There's a ton of evidence showing that fluoride toothpaste is effective in preventing dental decay. Every person is individual, so nothing is guaranteed, but the statistics show it's unlikely fluoride toothpaste is affecting your thyroid if you're not swallowing it, and that fluoride toothpaste is definitely helping to prevent your teeth from decaying.
Your best bet is to minimise how much fluoride you're swallowing, and take care of your teeth with a non-abrasive, fluoridated toothpaste.