Bottled water is an increasingly popular beverage in the United States. While drinking bottled water helps to increase hydration, according to the American Dental Association it may also be increasing rates of tooth decay because it lacks fluoride that is necessary for protecting teeth.
Fluoride is a natural mineral that occurs in water, rocks and soil. Fluoride is especially important for the protection of teeth from tooth decay. It is absorbed into the tooth enamel, and remineralizes the teeth against decay caused by acid erosion. Acid erosion occurs when bacteria begin to break down food particles left behind in the mouth that were not removed by brushing or flossing.
Fluoride has added to most municipal water systems for the last seventy years as a passive way to protect the teeth of the general public, an action heralded by the Centers for Disease control as one of the top 10 health achievements of the 20th century. Additionally, fluoride is a popular additive to toothpastes and mouth rinses. In fact, 95 percent of toothpastes on the market have had fluoride added to them. When fluoridated water is used in combination with fluoridated toothpastes, patients experience increased protection against tooth decay.
“When patients replace tap water for bottled water, they are limiting their exposure to fluoride,” said Dr. Stefania Caracioni, D.D.S, L.V.I.F.
Caracioni, a Topeka, Kansas, dentist provides her patients with dental fluoride treatments as a way to prevent tooth decay.
“While these twice a year treatments can help fortify the teeth and protect them against decay, it is not the same as regularly exposing the teeth to fluoride through drinking tap water,” Caracioni said.
Regular fluoride treatments from the dentist in combination with treated tap water and fluoride added toothpastes create a significant protection against bacteria causing tooth decay. The American Dental Association agrees with Caracioni. The ADA suggests that patients make the switch back to tap water.
“If patients do not like the taste of tap water, water filtration systems may help,” said Caracioni.
She also understands the convenience factor of bottled water for patients on the go.
“Fill up a reusable bottle of tap water and carry that with you,” she said.
There are some bottled water options that have fluoride added back to them, and Caracioni suggests seeking those out if patients can’t break their bottled water habit.
According to the Bottled Water Market, Americans consumed 11.7 billion gallons of bottled water in 2015. This is a 7.6 percent increase in consumption over 2014, and translates to 36.3 per person. Many of these consumers are children, who are at risk of tooth decay in their developing teeth.
“Fluoride is critical for the protection of a child’s teeth,” said Caracioni.
Fluoride not only protects the baby teeth that they have, but it also protects the adult teeth that are still below the gum line. It has been shown to decrease tooth decay in children who are regularly exposed to it via public drinking water by almost 30 percent, according to the Centers for Disease Control and Prevention Task Force on Community Preventative Services.
If patients are concerned that they are not getting enough fluoride to protect their teeth, there are dietary supplements available to add fluoride back to their diets.
“Some patients do not have access to fluoridated water, or they may not regularly visit their dentist for fluoride treatments,” said Caracioni. “Dietary supplements for fluoride are an excellent way for patients to get this tooth saving mineral.”
Acid erosion caused by bacteria is not the only type of acid erosion that fluoride can protect against. Diets high in acid and sugar also erode tooth enamel. Fluoride strengthens the teeth against damage from food and beverages, too. Some patients also have acid erosion because they are taking certain medications, or have chronic dry mouth.
Patients concerned about whether or not they are getting enough fluoride should discuss options for additional dental fluoride treatments and supplements with their dental provider.