The Pacific Northwest has seen a sudden increase in anti-fluoride patients in recent years. Portland, OR, in particular has become synonymous with this unhealthy movement. Last May, a measure to add fluoride to Portland's city water supply hit voter ballots with considerable turmoil. Needless to say, a large portion of Portland's residents opposed adding fluoride to the local water supply. That didn't surprise long-time residents. The city has tried, and failed, four times since 1956 to add fluoride to the water supply. Portland is currently the largest city in America without fluoride in its water supply.
A community-based response to municipal water defluoridation
This trend may stay localized to the Pacific Northwest, or it may already be spreading to other areas of the country. You may have already encountered several patients who are anti-fluoride in your dental practice. Regardless of what patients believe about the use of fluoride, it is our job as dental professionals to keep patients healthy and cavity free. Here I will discuss several ways to educate and calm patients about the use of fluoride.
Listen to your patients’ concerns about their opposition to fluoride. It can be hard to listen to someone who is reciting junk science (or simply doesn’t understand the correct information about fluoride), but remember to stay professional. If a patient becomes upset or even hostile, keep your cool. Prove to yourself and your coworkers that you can handle particularly difficult patients with poise.
Never shame or humiliate a patient about their beliefs regarding the use of fluoride. Once you’ve learned why a patient is anti-fluoride, you can use that information in a positive way to educate the person with correct and factual information.
Here are a few anti-fluoride topics your patients may bring up.
"Fluoride causes stomach cancer and other problems. I do not want you to place the varnish on my teeth."
Explain that fluoride may cause temporary stomach upset, but there are no links between stomach cancer and fluoride. The amount of fluoride in the varnish is controlled and safe for use. Remind the patient that the benefits of fluoride outweigh the temporary discomfort of a stomach upset.
"Fluoride causes cavities. I read a study linking fluoride to tooth decay. I'm not going to use it."
This can be a tricky topic to discuss with a patient. More often than not, a patient who thinks this way will assume that dental professionals are the "bad guys." Giving the patient literature about the benefits of fluoride can be a non-threatening move on your part. If the patient seems open to a discussion, explain that fluoride is beneficial to teeth. Explaining how fluoride works with other minerals to protect teeth can quickly quell fears and concerns.
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"I don't want to get dental fluorosis. I'm not going to use fluoride at all, because I don't want my teeth to become discolored."
Let patients know that you understand how important the appearance of their teeth is to them. Explain that dental fluorosis can happen at any age, however, the majority of dental fluorosis cases happen while teeth are still developing. If someone is an adult, then the person has little to worry about. Offer literature on the benefits of fluoride, and be kind. More often than not, patients who think this way are just concerned about their smile, which is understandable.
These are just a few scenarios that you may have encountered, or could encounter in the future. It’s important to remember that there are some patients who will not be persuaded. You cannot change their minds, and that is OK. You know that you have done your job to the best of your ability, and you should focus on a job well done.
Ashley Pero is a dental assistant who lives in Portland, OR. She has most recently been working for Dental Staffing Inc. while on maternity leave. She enjoys reading, writing, and learning about new things in dentistry.
