ARE YOU GETTING ENOUGH FLUORIDE? SUPPLEMENTS OFTEN RECOMMENDED FOR BOTTLED WATER DRINKERS

With the increasing popularity of bottled water, some concerns are being raised about the effect this trend could have on oral health.

Dr. Jeffrey Patton, a Cape Girardeau dentist, said as more people drink primarily bottled water they are ingesting less fluoride, a compound widely recognized for its teeth strengthening qualities.

"What we're seeing now with bottled water, there is less fluoride in the water supply and we're starting to see more tooth decay," Patton said.

Fluoride, a naturally occurring substance, is present to some extent in all foods and beverages in varying concentrations. Most water contains fluoride naturally, but water systems throughout the country usually increase the concentration to enhance the tooth-decay preventing properties.

Since 1950, the American Dental Association has endorsed fluoridation of public water supplies. The ADA maintains that tooth decay rates have dropped substantially as a result.

Patton, who admits that he enjoys bottled water, said the lack of fluoride in bottled water isn't a serious problem, but a fact of which people should be aware.

"There are a lot of benefits to bottled water, but one of the downsides we're seeing is it doesn't have the decay preventing properties," Patton said.

In the May 4 edition of the ADA News Daily, Dr. Michael Easley, said dentists should take note of the bottled water trend.

"Although we're not talking about a major public health crisis here, dentists should at least be aware that many patients may not be taking full advantage of optimal fluoride levels available in some public water supplies," Easley said.

People shouldn't stop drinking bottled water, Patton said, but they should take some simple and effective steps to ensure that they are getting enough fluoride.

Numerous fluoride rinses, gels and other products are available over the counter. Prescription supplements, which are somewhat stronger, are also available.

"It is not expensive to do and you can do it at home," Patton said.

In recent months, he has started recommending fluoride supplements to all of his patients.

According to the Beverage Marketing Corp., per capita bottled water consumption in the U.S. more than doubled between 1986 and 1996.

Some brands contain no fluoride, some contain it naturally and some have fluoride added by the producer.

The Food and Drug Administration doesn't require manufacturers to list fluoride content on product labels unless it has been added.

The ADA recommends fluoride levels of 0.7 to 1.2 parts per million.

Cape Girardeau's city water system fluoridates at a level of 1.0 parts per million, according to a system spokesman.

Fluoride works by strengthening the enamel in teeth.

"The way fluoride works is it replaces the calcium ion with a fluoride ion," Patton said. "It makes teeth more resistant to the acids that cause decay."

Particularly among children, whose teeth are softer than adults, fluoride treatment is an important part of a visit to the dentist.

By the time most people reach their late teens, the need for fluoride treatments decrease.

Use of fluoride toothpaste and drinking fluoridated water is usually sufficient to maintain fluoride levels in adults. However, older patients often face increased risk of decay and must resume fluoride treatments at the direction of their dentists.