Bottled water: Cause of cavity comeback?

Tooth decay is making a comeback, abetted by an unlikely culprit — bottled water.

"It's not the water that's causing the decay," said Jack Cottrell, DDS, president of the Canadian Dental Association (CDA) in MedPage Today. "It's the lack of fluoride." A natural mineral, fluoride is an established way to prevent tooth decay. Fluoride is absorbed easily into tooth enamel, especially in children's growing teeth, and once teeth are developed, fluoride makes the entire tooth structure more resistant to decay. The lack of fluoridation in bottled water was raised at the World Dental Congress in Montreal, as part of a general discussion about the sudden rise in tooth decay among children.

As more consumers sip bottled water, fewer of them ingest enough fluoride to prevent cavities. According to the American Dental Association, if bottled water is your main source of drinking water, you could be missing the decay-preventive benefits of fluoride.

Now celebrating its 60th year, community water fluoridation has become recognized as a key intervention:

• Most tooth decay can be prevented when fluoridation is combined with dental sealants and other fluoride products, such as toothpaste.
• The Centers for Disease Control and Prevention (CDC) ranks water fluoridation among the top 10 public health achievements of the 20th century. The American Dental Association and Delta Dental, among other industry leaders, actively support the use of fluoride to prevent and reduce the incidence of tooth decay.
• Tooth decay among children (4 to 17 years old) decreased an average of 29 percent after water fluoridation, according to studies conducted by the Task Force on Community Preventive Services, an independent group appointed by the CDC director.

How to get enough fluoride

If you or your children don't drink much fluoridated water, here are some ways you can add more fluoride to your diet:

• Commercially prepared foods and beverages that are fluoride-fortified. (Currently, 20 U.S. water-bottlers offer fluoridated products.)
• Fluoridated toothpaste and/or professionally-applied gels or varnishes. These products can help strengthen teeth by hardening the outer enamel surface.
• Dietary fluoride supplements (tablets, drops or lozenges). Supplements are available only by prescription and are intended for children ages six months to 16 years living in areas without fluoridated water in their community.

Last updated: May 2018