Fake news is increasingly present – and the health sector has also been greatly impacted by them. Recently, researchers from the University of São Paulo (USP) identified more than 300 false publications in the field of Dentistry. They are news that change the context of facts with true arguments, but totally altered, including through allegations of religious background.
Faced with the concern of health authorities and the negative risks to oral health, the Regional Council of Dentistry of São Paulo (CROSP) positions itself on a new theme of notes released through a movement (originating in the United States), which is placed contrary to the use of fluoride in water and in dental products.
According to Marco Antonio Manfredini, a dentist and doctor from the Faculty of Public Health at the University of São Paulo, it is important to clarify that fluoride has been applied in dentistry for at least 80 years.
In supply water, its use began in the late 1940s, in the city of Grand Rapids, in the United States. During this entire period, its use has been shown to be safe both in public water supply and in fluoride toothpastes or in the form of other products.
To get an idea of the importance and safety of using fluoride, the dentist cites a survey conducted by the American Center for Disease Control (CDC). According to him, through studies carried out by the agency, the ten main factors that benefited public health in the 20th century were identified – one of them the fluoridation of public water supplies.
“In Brazil, we have had a significant reduction in caries. We do not have more recent data, but the last National Epidemiological Survey, which was carried out in 2010, found a reduction in caries in children aged 5, 6 and 12 years, as well as in adolescents and adults”.
The DMFT index is used by the World Health Organization (WHO) to assess the prevalence of dental caries in several countries. The acronym CPO comes from the words “decayed”, “lost” and “obturated” and the D indicates the unit of measurement (the tooth).
In Brazil, the DMFT value was almost 7 in 1986. In the survey carried out in 2010, it dropped to 2 – that is, 12-year-old children have a DMFT equal to 2. One of the main factors for this reduction, according to Manfredini, is the use of fluoride in water and toothpaste – and also the preventive actions that are carried out in public and private offices.
Regarding the use of fluoride, Manfredini confirms its safety, but reminds that its use in children under 5 years old needs attention and some care, as it has to be used according to professional guidelines.
“If we associate, for example, fluoride in water with fluoride toothpaste in a large amount in a child up to 5 years of age, floor sode can generate fluorosis (white spots on the teeth). So, what is recommended for children in this age group is that the fluoride toothpaste be placed in the transversal direction of the brush, and not in the longitudinal direction, which would accompany the size of the brush. The equivalent of a pea grain, more or less, is enough so that there is no risk of fluorosis and that the benefit of toothpaste is obtained”, he details.
With regard to public water supply, he recalls that there is no such risk and that, therefore, everyone can drink it daily.
It is worth mentioning that the use of fluoride is a cheap measure, as evidenced by the study conducted in the city of São Paulo by the professor of the USP Dental School, the dentist Antonio Carlos Frias, which covered the period from 1985 to 2003. The data showed that water fluoridation costs R$ 1.00 per inhabitant per year. According to Manfredini, it is a very low value and has a great impact from the point of view of collective health and public health.
Therefore, when used in the correct form and amount, fluoride does not present any contraindication, whether in water or toothpaste. (observing the recommendation for children under 5 years of age). As for fluoride for professional use, this one needs a precise indication.
As for the fake news regarding fluoridation, Manfredini recalls that they started in the last century. At that time, there were ideas such as that fluoride in water would influence people in many ways. For the specialist in public health, the fact that there are anti-fluoridation movements is extremely serious for public health, as these people are preventing many from accessing and benefiting from the positive effects of fluoride. Scientific studies, including scientific evidence, are very clear and well established regarding the benefits that fluoride can bring – and also the safety aspects of its use.
Manfredini reinforces the importance of fluoride and warns: “Fluoride is an important ally in improving the oral health of populations. Thousands of studies done worldwide attest to its importance in reducing tooth decay, as well as its safety. So don’t believe fake news. If you want to search for correct information, access the CRSP website”.
What is fluoride and how does it work?
Fluorine is a chemical element of the halogen family, a natural mineral found easily in nature, throughout the earth’s crust. The material can be synthesized in the laboratory and added to a range of products, such as toothpastes and water provided by public sanitation companies.
Its use is recommended by the World Health Organization (WHO), by the Pan American Health Organization (PAHO), by the Ministry of Health and also by the Regional Council of Dentistry of São Paulo (CROSP) thanks to its benefits and its performance in oral health.
Fluoride works on the demineralization and remineralization processes that naturally occur in the mouth. In addition, it has an anti-enzymatic, antimicrobial and bactericidal effect, eliminating some bacteria and preventing their multiplication.
It is worth mentioning that proper oral hygiene should contain brushing three times a day, with the use of a fluoride toothpaste. In addition, the dentist may indicate, if necessary, complementary treatments with fluoride. Regardless of the way used to obtain fluoride – whether through fluoridated water, toothpaste or application by a professional – the product remains essential in the fight against caries.
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