Water, water everywhere, but is it safe to drink? – Michael Sultan Endocare

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  Posted by: Dental Design      9th July 2019

In the UK we are lucky enough to have a ready supply of water at our disposal. Unlike other countries where tap water is still unattainable or even unsafe to drink, in the UK we can go anywhere and fill a glass straight from the tap and enjoy.

However, how does water affect our oral health? Unlike other drinks that have widely discussed impacts on our mouths, water seems to rarely make the headlines, and this something that needs to be explored…

 

 

Fluoridation

Although much of Scotland and Wales remains without fluoride in their water, fluoridation schemes are fast becoming widespread in England.

Around 6 million British people have a significant amount of fluoride in their local water supply, and though this is only a small fraction of the population, it is a good sample size to see the effects that this element has on oral health.[i]In some areas fluoride is naturally occurring in water and its amount therefore fluctuates. In these cases, the water board of the area often artificially tops up levels to reach the desired amount.

But does fluoride actually make a difference? The answer is, simply, yes it does. Research has proven that fluoride in water can reduce decay by 40-60%.[ii]This is because fluoride effectively reacts with the calcium and phosphates in teeth and forms fluoroapatite – a highly resistant chemical that helps to ward off decay and keep teeth strong. Furthermore, fluoride tends to help control the pH levels of water, meaning that acid forming bacteria have to use a lot more energy to adapt to the neutral environment and therefore have less energy remaining to reproduce and cause damage to dentition.[iii]

Perhaps the biggest bone of contention about fluoride in water, however, is whether it is safe for consumption. Although it has been proven to significantly reduce decay, there are still groups of individuals who believe that fluoride can have negative impacts on health.

The main argument is that fluoride in water can quickly lead to fluorosis – a cosmetic issue that causes white spots, holes and other abnormalities on teeth due to too much fluoride exposure. Whilst this is namely a problem for young children and those who are developing their adult teeth, it has been found to cause psychological distress as these problems can impact the aesthetics of teeth.[iv]

Fluoride ‘toxicity’ is another aspect of fluoridation that individuals argue exists. Fluoride toxicity is when too much fluoride enters the body and begins to have negative effects such as the burning of soft tissues due to the chemical turning to fluoric acid in moist conditions, cellular poisoning, the inhibition of nerve function, hypocalcemia (electrolyte imbalance) that can interrupt heart function and the production of free radicals that inhibit the creation of antioxidants.[v]

These are all very serious effects, so it’s understandable that certain people think that fluoride in water may be a bad idea. However, it is worth remembering that these conditions are all only an effect of too much fluoride being ingested. In fact, research that examined incidences of fluoride toxicity found that the main culprit was people swallowing toothpaste after brushing their teeth rather than spitting it out.

But does this mean that we should ban toothpaste because it can be harmful if not used correctly? Of course not. By applying this logic to the fluoride argument people are effectively robbing whole communities of the chance to benefit from fluoride in their water. This is even after research that compiled 70 years of data has been published proving that water fluoridation is safe.[vi]

Does hard water make a difference?

Another aspect to consider with drinking water is whether it is hard or soft. In much the same way hard water affects washing machines and dishwashers by causing hard calcium deposits, these minerals too could have an effect on our general and oral health.

It has been argued in the past that hard water could be responsible for increased rates of cardiovascular disease, cancer, malformations of the central nervous system, Alzheimer’s disease, diabetes and all sorts of other conditions. However, one extensive study that gathered data relating to all of these conditions proved that drinking hard water, in many cases, actually provided some defence against these conditions, especially as it acted as a good supplement for calcium and magnesium, which some people would not otherwise consume enough of.[vii]

On the other hand, from a dental perspective there is some argument to be made that hard water can have a negative impact. Although the majority of minerals in water protect teeth, some professionals have argued that drinking too much hard water leads to much higher levels of calculus. If not removed, calculus can damage gums and cause periodontal disease.[viii]

What water is best?

In the end, it’s safe to come to the conclusion that tap water is completely safe for patients to drink and this should be encouraged, especially if there is water fluoridation in the area. Although there may be some minor drawbacks to using fluoridated water or routinely drinking hard water, these are merely cosmetic, can be solved at a patient’s request and can be completely kept in check with regular visits to the dentist. So, in the end, the benefits far outweigh the negatives.

 

 

 

 

For further information please call EndoCare on 020 7224 0999

Or visit www.endocare.co.uk

 

 

 

 

 

References

[i]The Telegraph. The Effects of Water Fluoridation. Link: https://www.telegraph.co.uk/news/science/science-news/11430233/The-extent-of-water-fluoridation-in-the-UK.html[Last accessed April 19].

[ii]The Oral Health foundation. Fluoride added to Water Supplies Confirmed as SAFE, According to Landmark Research. Link: https://www.dentalhealth.org/news/fluoride-added-to-water-supplies-confirmed-as-safe-according-to-landmark-research

[Last accessed April 19].

[iii]Aoun, A., Darwiche, F., Al Hayek, S., Doumit, J. The Fluoride Debate: The Pros and Cons of Fluoridation. Prev Nutr Food Sci. 2018 Sep; 23(3): 171–180.

[iv]Web MD. Fluorosis Overview. Link: https://www.webmd.com/children/fluorosis-symptoms-causes-treatments#1[Last accessed April 19].

[v]Aoun, A., Darwiche, F., Al Hayek, S., Doumit, J. The Fluoride Debate: The Pros and Cons of Fluoridation. Prev Nutr Food Sci. 2018 Sep; 23(3): 171–180.

[vi]The Oral Health foundation. Fluoride added to Water Supplies Confirmed as SAFE, According to Landmark Research. Link: https://www.dentalhealth.org/news/fluoride-added-to-water-supplies-confirmed-as-safe-according-to-landmark-research

[Last accessed April 19].

[vii]Sengupta, P. The Potential Health Impacts of Hard Water.Int J Prev Med. 2013 Aug; 4(8): 866–875.

[viii]Quora. Is hard Water Bad For Your Teeth?


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