Too much of a good thing could be bad...

The Department of Human Services announced on January 7^th that revisions were made to the recommended optimal levels of fluoride in community drinking water.  Historically, the recommended optimal level for water fluoridation has been 0.7-1.2 parts per million (ppm).  The new recommendation for fluoride levels is 0.7ppm.  The federal government is not recommending that communities stop adding fluoride to drinking water, rather, it has recalibrated the recommended amount needed in drinking water to reduce the incidence of decay while minimizing the rate of fluorosis. 

Fluorosis is a condition caused by a child receiving too much systemic fluoride (fluoride in drinking water) during tooth development.  The critical period of exposure is between 3 months to 8 years old.  In its mild form, fluorosis appears as tiny white streaks or specks that are often unnoticeable.  In the most severe form fluorosis is characterized by black or brown stains and cracked and pitted enamel.  Severe fluorosis can pose difficulties when your dentist performs restorative procedures (filling, sealants, and crowns etc).  The mottled or pitted enamel does not bond as well to filling and sealant material as does healthy enamel. 

Lubbock’s municipal drinking water comes from Lake Meredith and is optimally fluoridated to the Federal government’s specifications, in 2010 the average level of fluoride was 0.77 ppm.  The fluoride (and other mineral) levels are tested daily to insure that municipal drinking water has enough fluoride to be effective and safe.  If your drinking water is from a well, the amount of fluoride can vary vastly.   Water from a well goes though several layers of rock and soil before it gets to the well.  Rock and soil in west Texas is very fluoride rich, so many families drinking well water are ingesting too much fluoride from their drinking and cooking water.  Our recommendation is to have your well checked frequently for fluoride levels, because they can change from year to year, and wells that are close together can have very different levels of fluoride.  We also recommend balancing the amount of fluoride that your kids take in from well water, for instance, cook with well water, but drink bottled water.  Potentially your kids will be getting enough fluoride to be effective, and not too much that can cause fluorosis.  If you live in Lubbock and have municipal water service, drink and cook with tap water, the amount of fluoride in Lubbock water is effective and safe. 

If you or kids already have fluorosis, it is important to receive topical fluoride treatments to strengthen the enamel of the affected teeth.  Your dentist may prescribe a toothpaste or mouth rinse with higher levels of fluoride for prevention of decay.  It is also extremely important to maintain oral hygiene.  It is easier for plaque to stick to the roughened surfaces of enamel affected by fluorosis than normal enamel that is smooth. 

Please let us know if you have any concerns for yourself or children, we would be happy to take a look and make sure all is well!!

Check out this article in the Lubbock Avalanche Journal:

http://lubbockonline.com/health/2011-02-07/area-waters-fluoride-level-too-high

See pics of "fluorosis":

http://www.google.com/images?client=safari&rls=en&q=fluorosis&oe=UTF-8&um=1&ie=UTF-8&source=univ&ei=BUdQTcrAL4ycgQfAg5kk&sa=X&oi=image_result_group&ct=title&resnum=2&ved=0CDoQsAQwAQ&biw=1024&bih=664

Confusion About Dental X-rays

Over the holiday break Shay, one of our amazing dental hygienists, watched a Dr Oz show regarding medical and dental x-rays.  Dr Oz said that he would not have dental x-rays done unless he had some sort of dental pain.  His reservation is due to the risk of thyroid cancer from the radiation needed to expose dental X-rays.  We couldn’t disagree more!

With this recent controversy in the media regarding dental X-rays, we wanted our patients to know our position on the topic and give you some helpful information from reputable publications to aid in your decision in receiving a dental x-ray examination.

Dental X-rays provide valuable information that helps your dentist evaluate and diagnose your oral condition.  Many diseases of the teeth and surrounding tissues are not in plain sight.  X-rays aid in diagnosis of decay in between your teeth and below existing fillings and crowns, infections in the bone of your jaw, periodontal (gum) disease, abscesses or cysts, developmental abnormalities, and some types of tumors.   Finding and treating dental problems at an early stage can save time, money, and possibly decrease the severity of disease.

The concern with dental X-rays is the associated radiation dose.  The amount of radiation that we are exposed to from dental x-rays is very small compared to our natural daily exposure from things like cosmic radiation, sun light, a cross country flight, or even cooking with natural gas.  The American Dental Association reported in 1995 that an annual full series of dental x-rays (conventional x-rays, not digital x-rays) expose a patient to 0.150 mSv.  Average annual radiation in the US from natural sources a person is exposed to is 3.00 mSv.  Just for a reference, some medical x-rays, such as lower GI tract radiographs, can emit up to 4.06 mSv of radiation!! 

Radiation safety should, and is, always a primary concern in our office. X-rays and radiation exposure should always be kept to a minimum.  Although newer dental x-ray units, like ours, have very little scatter radiation (the radiation that gets away from our target), a lead apron is still used to protect other areas of the body from any additional radiation. There is also a continuous strive in dentistry and medicine to decrease radiation used at all.  With digital x-ray systems radiation exposed to the patient is one fourth the amount used to expose conventional films!! 

When you weigh the pros and cons of dental x-rays, we find that in virtually every situation, a conservative yet thorough exam is in the best interest of the patient.  X-ray exams will vary in frequency and number of x-rays taken from patient to patient.  Seeing what lurks behind gums and in between teeth is so important to treat early so that little mouth problems will not turn into a big systemic health problem!

We hope you have a wonderful day, and we look forward to seeing you soon!