craziness about fluoride. As a pediatric dentist, on a daily basis, I have almost every single mom and dad asking me, "Dr. Olga, what is your honest opinion on fluoride?" And it's so hard for me to answer because there's so much information. So I spent couple of days researching all this fluoride frenzy. We are adding fluoride. We are removing fluoride. We are prohibiting fluoride. We are looking for new solutions which kind of exist and maybe not. So I will share with you my expert opinion on fluid situation in the United States in 2025. Welcome to the Ask the Dentist podcast with Dr. Olga Dogear where your smile meets your overall health. Before I start telling you my own opinion, I want you guys to have your own opinion and share with us. What do you think? Are we all getting poisoned? Have we been poisoned since 1950s and all of us now have low IQ? Is that the case? Are we all dying from cavities? And do we have a cavities almost 90% of our population and fluoride didn't work for the past 70 years? That's another question. So what is all this craziness about? Well, what is fluoride and when we started using it? So let's talk about history of fluoride. Where's this fluoride come from? That's uh history of adding fluoride to water. So actually it was added in 1945 first time at the city of Grand Rapids, Michigan. Why was it added on? Because um in Colorado Springs uh Colorado, they noticed there was a group of um one dentist, his name was Dr. McKay. He noticed that people have molted teeth. They had yellowish or brownish stain on all over the mouth. All the teeth were stained and but also in the contrast they didn't look good. The teeth were not that nice bright and white but they didn't have cavities with the frequency of decay was low. So then they started to kind of dig in deeper and deeper and then um another um public health doc advocate Dr. Dean he actually did the correlation between decay and fluoride. So in 1930s they started to see that fluoride actually changes mineralization of the teeth and people who are exposed to certain amount of fluoride um tend to have less cavities. So the conclusion was made that if we add fluoride to water maybe it would be huge benefits from overall for overall population um to fight the dental decay which was prevalent um during that time. So that's what they did. they started to add fluoride to water and according to the study based of the 1940s 1930s um they actually saw between 1945 and 1950s 70% decrease in childhood carriers decay in children 70% decrease so it's a huge number 70% that means technically we don't need dentists if 70% of population has no decay uh but and things started to change. So in 1960s uh toothpaste uh mouthwash started to be introduced in 1970s they started to see like what is the optimum level of fluoride. What is the optimum level and they were talking about uh one um part per million was optimum level for fluoride in water. They started to look at the fluoride concentration to space. So they kind of it sounds like there was a bulk of material, bulk of data and they started to kind of sort it out in 70s and 60s. In 80s some studies came out with like negative uh actually um content. They were talking about the cancer relationship with fluoride the relationship between bone density osteoporosis. So something else started to come out in 80s but back in '9s um the fluoride kind of started to go globally. So now already Australia adding fluoride to water. Now we have Canada, UK, everybody adding fluoride to water. Um Europe did not add fluoride to water everywhere because I think it was just a logistics uh for some reason they they did not do that. and world health organization started to support water flidation as a very effective measure for um car carriers reduction in 2000 um um they did long study in US long study in Australia with a great data and um that's when I went to dental school early 2000 I remember we were all taught that Florida only been efficient official for teeth And we didn't even describe any negative effects back then. New search, new research started to come out in 2015. So 2015 scientists uh actually started to look at numbers and they decided that the best way would be to decrease fluoride because now in mid 2015 they see a little bit of fluorosis. Fuosis is when you see white spots on kids teeth or adult teeth. Um and there is different form of fluorosis. It can be mild to severe. So mild one is just a couple of dots. Um moderate is more changes the structure of enamel. It becomes like crystallized. It's like little fluoride crystals um which are in enamel and changes it to structure changes the color. Um so in 15 they kind of backed off a little bit and they were start starting to say that maybe we should decrease the amount of fluoride and water and actually changed the guidelines and I believe it was.7 uh parts per million at that point. You're listening to the Ask the Dentist podcast because every healthy body starts with a healthy mouth. Now, we're back in 2019 and they was a huge controversial study when they first discovered that actual IQ um scientists found that IQ in kids who were exposed to fluoride when they were in uterro and as toddler the toddler's IQ were lower than kids who were not exposed to fluoride. So it was like a first sign of something may not be right what we all believe into. And then in 2025 they did a scientist did a huge meta analysis. Um G uh GMR pediatrics actually come up with um huge study and they did have some evidence that fluoride my lower IQ. And then I kind of look into that particular study. That study has some bias. Number one, it was completely outside of US. There was no that meta analysis was done by based on 74 different studies from different countries. So it was China, um, India, Iran, Mexico, non US uh, studies and um, some observation were correlated to evidence. So um it was um very high risk of bias because it was 52 study done by separate countries and um so the evidence were not 100% conclusive. I wish there could be bigger evidence and more deep analysis of um correlation between fluoride and IQ. You're listening to the Ask the Dentist podcast because every healthy body starts with a healthy mouth. So now the 2025 all the studies which we see we don't dig in into those studies and break down why are they are they good studies or not so good. My understanding that more studies needs to be done to have the clear correlation because think about it. Okay, this mother is pregnant in India for example. They measure the amount of fluoride in urine of the pregnant mother and then measure fluoride in kids um in toddlers in urine as well. So did these kids were exposed just to fluoride from water or toothpaste or were they eating food which was grown on the soil with high fluoride concentration? uh what exactly was concentration of fluoride in water and from what I see in India the concentration of fluoride in water is higher it's about one uh ppm so it's a very hard to judge and say conclusively that fluoride and the IQ are 100% correlated so I wish we can have more studies uh plus what is IQ IQ genetics is involved right this mom can be I mean genetically we are not all equal right some of us have higher IQ level born with technically some of us don't have such a uh IQ level or for example nutrition level nobody look into nutrition is this population in Mexico were they well nourished um did did they have enough uh minerals vitamins and everything else which contributes to brain development. So, it's so hard to do this study and come up with a conclusive evidence. Um, but I think it's a good idea to do alarm about the correlation between fluoride and IQ. And I think it's a good idea that we all look into this and kind of trying to figure out um uh is there truth and merits to it. So on opposite evidence um I found some studies from New Zealand and Sweden who found no IQ difference with in adulthood with non-fidated and fluidated community and in Spain study of 2021 they actually said that the IQ improved in boys who were exposed to fluoride. So there is so much controversy and I think we have to look at the big picture. That's my opinion. I gave you kind of breakdown what where is this fluoride coming from but let's let's talk about professional opinions here. So fluoride is well studied for over 70 years now right our grandparents our parents were exposed to fluorides throughout their lifetime. Do we all as a country have lower EQ than other countries? Um I don't think so. So I think we have to look at the bigger picture. Maybe fluidation um is a massive um mitigation of the population. Maybe it's not ideal. Um but I think that it's enough evidence to support that it's beneficial for teeth in particular. Um because now if we look what else it's out there what what what else is available and um a lot of parents asking oh my god xylitol we are using xylitol. Well, I have a bad news for you because another study came out and they said that if the scientists found that if it's a high amount of xylitol is actually changes your biome of your gut. So high concentration of xylitol you actually getting disbiosis of diarrhea actually regard with the xylitol. And there's some studies correlate the um sugar alcohols with increasing blood clotting. So it's just so much controversy with that. Xylitol again I think everything is good in moderation. So xylitol I think is beneficial if we periodically maybe chew chewing gum after we eat. I don't think it's harmful. I think it's beneficial because you create a lot of saliva flow. So from that standpoint of view, I would say xylitol is beneficial. Um would I brush my teeth only with xylitol? Probably not. Um because I don't think it's effective enough to actually improve remineralization. Um because if the cavity from cavity standpoint when as a dentist when I see white spot on the tooth or on X-ray it looks like a small shadow in between that means the process of remineral demineralization start demineralization is when we lose um calcium from the tooth and to add calcium back on. As far as we know, the best evidence is fluoride actually needs to bond to calcium and then it brings the calcium ion to the tooth back. So that's why fluoride is effective. Um xylitol is more like antibacterial effect not necessarily the remmineralization. If if we look at alternatives like hydroxy appetite is another one which we is big friends about. Okay, let's use hydroxy appetite. That's what our teeth are made out of. Um but hydroxy appetite um there is very limited data. So all the data I found it does have positive um evidence but is it a good research study? It doesn't have is like a broad meta analysis where we analyze thousands of kids like we did with fluoride. It's actually very limited data. And then uh some studies shows that um nano particles they are so small because nano hydroxy appatite it might um penetrate for example your gut barrier. So you might have like now it's the new thing leaky gut um um correlation and so it's so hard to say that that nanop particle does it does it does it cross your blood brain barrier I hope not there's no evidence of it that I can see but it's nanoparticle nanoparticle and microscopical so they can't go into places where you don't want them to go and there's limited research data on the hydroxyp peptide. So you have to think like fluoride yes we know IQ right which is not a good thing but then hydroxypeptide we don't know where is it going to end up and we also don't have good data telling us that it's effective so I still recommend like maybe using if if I see cases when it's a rampid decay and um I think diet is extremely important oral hygiene but if you're going towards the tooth I still for those rampid decicate cases I would recommend probably fluoridated to space in this case because I just hydroxy as alternative but I don't have a good data good back up to just say 100% that's very effective it does have good numbers but the amount of information we have of it is very limited and let me tell you this if you look at the big picture of United States after the um static came out meta meta analysis which is a very big study. The states Utah and Florida completely um prohibited fluoride uh from adding to the water. So they banned fluoride completely. But if you look and I started to look at the other states New Jersey and Connecticut actually they want to add fluoride. So because their population has very high risk of decay and they are states with the lowest number of population New Jersey is 14 to 23% of population actually u exposed to fluoride through water and connect is pretty low as well. So these two states want to add fluoride to the water. So me as a provider, as a practitioner, I have to sort out all this bias data. I want to to bring the best information to you um and trying to figure out where is the truth. I did my residency in uh Philadelphia and I did practice um on the border with New Jersey and I have a couple of dentists who practice in New Jersey and from it's again it's not a good study but what we saw was a very high amount of risk of decay. Every single kid will have decay everywhere. So New Jersey in particular have very very high decay rate. Is it because of the fluoride or is it because of diet? Uh I don't know. So you have to kind of look at the big picture again. So now we have the opposites, right? The Utah is dropping fluoride, Florida is dropping fluoride and New Jersey and connecting with adding fluoride. So as a dentist, my hair goes up my It's not easy, not easy to figure it out all of it. um and what to do. But I want you to understand that we're trying to find the best solution and it's very difficult because cavities are forming. It's not just fluoride or no fluoride. So if you have fluoride, you're not going to have cavity. You don't have it. You're going to have cavities. That's not the case. Believe it or not, usually um the bacteria which grows in your mouth, we call it um bofilm. It's what bacteria produces. But biome of your mouth and your gut is related. So I think um the relationship between gut bacteria and oral oral bacteria has really tight connection. Um I believe that I cannot tell you that sugar cause cavities necessarily but bacteria which is strap mutan in order to get to the tooth we have to have glue and the glue is actually the the simple carbs. So technically sugar. So in order for bacteria to stick to the tooth we need to have sugar. That's why that's not if you have no bacteria in the mouth and eat sugar, you're not going to have nothing going to stick to the tooth. But then you have to look at acid as well. Where this acid coming from? So acidity and sugars are two big enemies for of your mouth. I would say acidity is bigger enemy. Where is this acidity coming from? So you have uh your internal sources for example your gastric acid which you can have gird gust of a faggill reflux and we as a dentist actually if you look in the mouth we can tell you okay are you grinding your teeth or do you have acid attack in your mouth and this group of population me as a practitioner I see that they more prompted decay so the the acidity is definitely a big factor the question is how do we change the acidity well we can get a gast of agility reflux under control with medications also we can change pH of the mouse but it's very difficult to change because it depends on what kind of biome we have so we have about 700 different type of bacterias in the mouse and all of us have different levels different concentration of certain bacterias yes we can test you for what bacteria do you have But if we kill one bacteria then the another one going to go go grow more. So by doing antibacterial agent it might not be good solution because some studies shows that good bacteria dies out faster and bad bacteria grows back faster. So antibacterial might not be effective. Um probiotics. So some moms come in with toothpaste like literally with like um toothpaste and they are telling me okay look Dr. I found this one this has probiotic. Okay, some studies shows that probiotics are very beneficial but for a short period of time even for your gut bacteria to if you're consuming probiotics they do change the biome of your gut your GI tract your mouth but to maintain the gut bacteria for them to survive you have to have certain condition so and we still don't know how to alternate the environment. So from mouse stand point of view, we know if kids get tartar buildup calculus and they overall have good oral hygiene, so their pH of the mouse and is probably more basic than acidic. So these kids don't have as much decay technically. Sometimes we see both calculus, but it's from not brushing and also cavities. But a lot of times we even there's a joke oh they you even h either have perio or you have decay sometimes you have perio is a gum disease. So how to maintain good biome? I think acid plays huge role. So the biome should be maintained by good prebiotics. Prebiotics is what you eat for your guts for example um to maintain for example fiber that actually becomes more positive environment for good bacteria to proliferate and grow. So it's complicated. Um so this short answer can I use probiotic toothpaste or take probiotics and fight decay? You can alternate the biome of the mouse but we don't know for how long and how effective it would be long term wise. So we can introduce probiotics and there's companies which coming out with two three four different strains of probiotics which are beneficial but remember we have 700 type of different bacteria in the mouse. So those three and four might alternate it temporarily but they long-term effect we still we still don't know. Um I think diet plays huge role even if we go back to fluoride. Um I think the IQ study could have some merits to it because you cannot just look at water also what you eat. In US we eat a lot of processed food. So the ketchup for example is made some of the ketchups made in the factories using fluoridated water. So when you evaporize the tomato and make that ketchup paste you actually making fluoride more concentrated in ketchup. So if your kid is organic don't use fluoride toothpaste. They don't use fluoride in the office buying all the organic water, but eat ketchup with your fries. You got that concentrated fluoride going into your system. So now think about it. We eating all processed food which is used with fluoridated water, right? And now we actually introducing higher concentration of fluoride from different food sources. So that's why I think um maybe overall concentration of water fluoride could be lowered because we have different sources and it's so difficult to trace down those sources. So going back to diet, your diet should be more well balanced. So more natural foods, fruits, vegetables, um eating meats, eat different nuts and seeds, uh so certain type of seeds actually fight bad bacteria which cause cavities. So it's a more complex approach. So you can we can create protocol for you for example to introduce uh certain type of uh good snacks type um changing the way you consume your snacks because if you if you're a kid even eating good snack every 15 minutes your mouth every time we eat remember those bacteria we have fermentation process we're creating lactic acid in the mouth and then it's your mouth becomes acidic. So if your kiddo is sitting and eating um anything technically they the pH of the mouse keeping dropping and it never raise up to normal levels. So maybe having longer time between snacks. For example, some studies shows that your pH of the mouse actually bounce back to normal within two hours from the time you consume food. So the redoing the whole snacking pattern, redoing what we eat, analyzing what we drink, taking consideration your sources of fluoride of non-flloridated space and that would create kind of a bigger picture of your mouse health and remember mouse is part of your gut because that's how you start your GI tract by eating in the mouth. house and maybe it will improve overall health because I don't want you to think about dentistry as like a tooth we are tooth doctor technically but you have to look at overall body because you cannot um separate your mouth from the entire body and that's what I think we have to be trained more as a dentist is on systemic involvement because in US every single specialty. Every single profession is very compartmentalized like okay you have problem with GI you go to GI doctor you have problems with your tons to your tonsel doctor but I think if you would look at the big picture why do you even have problems with your tonsils so now I'm going into different part why do we have for example mouse breathers right now we're looking at the facial structure of this kid and do we have cav cavities do we have from not efficient fluoride consumption? Do we have cavities from bad diet? Or do we have cavities because of his facial features? Because he is congested all the time. Why is he congested all the time? Is he allergic to certain um to certain things? Is he tongue timer has a poor posture of the tongue and it shapes his mouth which another controversial topic. Not everybody needs tongue tie release. Not everybody has different type of facial features because only because of the tongue tie. So it kind of opens us up to a different conversation about breathing, about airway, about systemic involvement of your face, mouth structure to your overall health. Is this kid I see at two weeks for lip tie and tongue tie release is he going to develop sleep apnnea when he is 80? I cannot guarantee that. It has some controversy to everything. So this is my first topic today talking about deep diving deep deep deep into fluoride because that's number one question we see from the parents but there's so much to discover. If you love my podcasts, please like us and share with people who are interested. I'm not sponsored by any companies. I'm giving you 100% honest information which I'm doing research myself because my goal is to dig through the whole turmoil of misinformation, good information, sponsor information, and bring the best to your child that they can stay healthy for life. Thanks for tuning in to the Ask the Dentist podcast with Dr. Olga Dogear. 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