The F-word

Fluoride. We love it, most patients don’t mind it, and some blame it for all the woes of the world.

When we’re at dental school we read the studies and learn all about how fluoride can prevent, remineralise and protect the dentition. Unfortunately, sometimes the misinformation spread by conspiracists and well-meaning Facebook mothers-groups is taken as gospel. I came out of dental school rearing to re-educate the masses on the benefits of fluoride. With the stats from the studies ready to go, I set out in regional practice looking to enlighten the (thankfully small) anti-fluoride community.

The first anti-fluoride patient caught me a bit off-guard. Her mouth was full of early carious lesions amongst failing composite resin restorations. We spoke about how fluoride could potentially solve her problems without the need for anaesthetics, drilling or filling – yet STILL she wanted to leave them, happy to return for a filling if she ended up needing one. This really bothered me, yet it happened over and over again. It seems rare for me to be able to change their school of thought around fluoride, but at the end of the day its their mouth and not ours.

When discussing fluoride, I like to use the following analogy:

Think of your teeth like a house, made of a wooden framework surrounded by bricks. The bricks can be knocked out of between the framework, or replaced and replenished at a later date, provided the framework is still in place. When we treat the teeth with fluoride, its replacing the lost bricks while also swapping some of the weaker bricks for stronger and more durable ones. The fluoride, allows us to have strong teeth resistant from breakdown, just like a strong brick house can weather a storm.

After explaining this to the patient, I like to let them know that I’m happy to treat them with or without fluoride. There are risks involved in most of our day to day decisions, and this is true regarding fluoride. Our job is to help the patient make an informed decision, which involves us sharing what we have learnt about the benefits and protection that fluoride treatments offer.

Final words

Don’t get bogged down on trying to convince all of your patients of all of your views. It was the done thing in the dental school clinics, but its not going to win over any patients in private practice. Share your knowledge, answer your patients questions, and treat them how they want to be treated within your ethical boundaries.