Is Bottled Water the Problem?

During the 70's, 80's & early 90's tooth decay in children aged 2-11 was on the decline. It is thought that this was a reflection of increased awareness, school programs, fluoridated water, and possibly higher economic levels. From the mid 90's to today, that trend has reversed and tooth decay is on the increase. Today, according to the National Center for Health Statistics, 42% of children aged 2-11 have had dental caries in their primary teeth. In addition, 17% of children between 5-19 years of age have untreated cavities and 46% of this age group have had some sort of restoration.

Former Surgeon General David Satcher says that over 50 millio
Americans live in areas that make it difficult to see a dentist. Today there is a shortage of about 10,000 dentists according to the Federal Health Resources Services Administration. Because bacteria in the mouth creates inflammatory disease and with the increase in evidence that oral health effects your lungs, liver, heart, bones, kidneys and other organs, this all spells a crisis in oral health in the US.

Many believe one of the major problems with the increase in tooth decay, especially in children, is the increase in the consumption of bottled water. Why? Most municipalities fluoridate their water. Consequently, 20, 30 and 40 years ago most children drank fluoridated water. In addition, there was a big push for public health organizations to give fluoride treatments to children. Fluoride prevents cavities in several ways. In young children, the consumption of fluoride systemically works by strengthening the developing enamel and dentin even before the teeth erupt. In existing teeth, the topical fluoride either in water or applied by a dentist, remineralizes the teeth and reduces the solubility of tooth enamel in acid. (Adults benefit from fluoride as well.)

Although there is existing controversy about the use of fluoridated water, there has been over 50 years of research and studies showing the safety and efficacy of water treated with fluoride. There are not many other substances that have had that kind of scrutiny. As with any substance there are toxic levels. With fluoride, one would have to drink 25 gallons of water at one time to get a toxic dose.

What started out as a status symbol, in drinking bottled water, has turned into conventional practice across all American demographics. Consumption in the US is over 8 billion gallons a year with 54% of the population drinking bottled water according to the Natural Resources Defense Council. Almost all bottled water does not contain fluoride. And many that do contain fluoride do not contain enough to impact oral health.

To give a glimpse of the impact of fluoride on tooth decay, the American Dental Association reported on a study in Antigo, Wisconsin. This community discontinued water fluoridation in 1960. By 1965, 2nd grade children had 200% more tooth decay, and 4th graders had 70% more. Antigo reinstituted fluoridation. Studies in other communities (not only in the US, but all over the world), show similar results.

However, with all this information on what appears to be criticizing bottled water, it is still much better to hand your child a bottle of water instead of a bottle of soda or energy drink. The sugars in these products feed the bugs in the mouth that lead to cavities.