Whole Tooth: First Bite

I’m Dr. Wallace Dick, and I’d like to share my perspective on fluoride use from the practical standpoint of a dentist. I work alongside Dr. Michelle Aldrich, owner of Riverbend Dental in West Salem. Between us, we bring 48 years of combined experience in dentistry, and Dr. Aldrich adds another 12 years from her previous work as a dental hygienist — totaling 60 years of experience in oral healthcare.

We’ve seen the fluoride conversation evolve over the years, but never with the intensity we’re seeing today. In our practice, we routinely use topical fluoride when we detect early cavity formation. Why? Because fluoride-enriched enamel is significantly more resistant to acid damage than enamel without it. In some cases, we also recommend high-strength fluoride toothpaste to support our shared goal - reducing cavities -  with patients.

Fluoridated municipal water offers protection even before a child visits the dentist. It helps build stronger enamel during tooth development, setting the stage for long-term oral health.

So What’s the Truth About Fluoride?

There are passionate voices on both sides of this debate. Ultimately, the decision to use fluoride is yours — and we fully respect your autonomy. That said, we believe there’s one place we should all turn to in the search for truth: well-designed scientific studies. These studies, especially those with large populations over extended periods, offer the best insight into fluoride’s effects.

Key Questions to Consider

1. When fluoride is ingested, where does it go?When you drink fluoridated water, most of the fluoride is absorbed through your stomach and small intestine into your bloodstream. This leads to a temporary rise in plasma fluoride levels, typically peaking between 20 and 60 minutes. From there, it’s distributed mainly to calcified tissues — such as bones and developing teeth — where about 99% of the body’s fluoride is stored. The rest is excreted through the urine.

Fluoride incorporated into developing teeth offers long-lasting protection against decay. Once deposited, fluoride continues to circulate between blood plasma and calcified tissues in a near steady-state throughout life.

2. Is fluoride toxic?The short answer: no — not at the levels used in public water systems. Like salt, iron, or even oxygen, any substance can become toxic at high enough doses. The commonly recommended concentration of fluoride in community water systems is 0.7 parts per million (ppm). At that level, a 155-pound adult would need to drink nearly 120 gallons of water in one sitting to reach a toxic dose. That’s hardly realistic.

As dental professionals, our primary role is to help prevent tooth decay and restore dental health. Fluoride is just one of the many tools we use in this mission. The science supports its safety and effectiveness when used appropriately — and we encourage everyone to explore the data before drawing conclusions.

We’re here for your questions and your care, always committed to your dental health.

—Dr. Wallace DickRiverbend Dental, West Salem

References for these studies are available upon request.