Do fluorine supplements harm children? The FDA round table turns into a heated debate

A Meeting Wednesday At the Food and Drug Administration on fluoride supplements, at some point became a controversial back and forth on the question of whether unmanageable tablets harm children’s microbiomas or play a vital role to help protect them from dental caries.

Pediatric dentists consider chewable tablets, available only by prescription, as particularly important for families who live Fluoride -free areas in drinking waterWho do not have dental insurance or cannot afford regular visits to dentists.

Under Commissioner Marty Makary, however, the FDA was Take measures to eliminate fluorine supplements market. A final decision is not expected before October, although the defenders and criticism of the meeting do not agree on basic scientific methods or even responsible dental practices.

During the public meeting held in Silver Spring, Maryland, dental experts highlighted the meticulous balance of obtaining the right amount of fluoride to their patients. Too little can cause weakened dental enamel, said Dr. James Bekker, member of UTAH Dental Association. Too much can lead to fluorosis, a condition that leaves white or brown spots on the teeth.

“There are areas where we have community water fluoridation. We do not need supplements in these areas, “said Bekker, who was invited to speak at Wednesday’s meeting. “But there are many regions of our country where we do not have fluoridation of community water or we have no natural fluoride. In these places, supplements are the key to achieving this balance. ”

Pandalist, Dr. Bill Osmunon, a retired dentist who is now working for Fluoride Action Network, an anti-flower group, dotted Bekker on the way he determines if a child needs fluoride supplements.

“Where are you asking for?” Osmunon asked. “Where are you asking for school?”

Bekker explained how he performs complete assessments of his young patients, in particular by examining food problems and if they use other supplements, before prescribing the tablets or drops of fluorine.

“Really, ask all these questions?” Osmunon said.

“You are betting,” said Bekker.

The “Inquisition of Dr. Bekker of Osmunon was a tactic to try to make it appear incompetent,” said Dr. Johnny Johnson, president of the American Fluoridation Society. “This type of exchange is designed as a popularity competition.” Johnson maintained himself in favor of the supplement during a public comments session.

Osmunon and other criticisms relied on data that did not necessarily prove their criticism of the products.

For example, Makary, the FDA commissioner, said that the fluoride ingested changes the intestinal microbiome. His statement seems to stop on a 2023 Research review by scientists in Ireland.

This analysis noted that animal studies have suggested that the ingestion of fluoride affected the microbiome but that none of the studies examined the fluoride and the human microbiome. Researchers have concluded that any possible effect of fluoride on the microbiome is “still in its infancy, and studies studying the impact of fluoride on the human microbiome only happened to appear in the literature.”

One of the authors of this study also spoke at the meeting on Wednesday. “The consumption of fluorine at levels that we consider good to maintain good oral health probably has a limited impact on oral and intestinal microbiobs,” said Gary Moran of Trinity College Dublin in Ireland. But, he added, “we certainly need more studies.”

There was no vote for or against fluorine supplements.

Dr. David Krol, a representative of the American Academy of Pediatrics, spoke in favor of fluorine supplements as one of the many tools that doctors need to ensure that their patients’ teeth are as strong as possible.

“Fluor supplementation, as well as diet and hygiene conversations, are the kind of thing that takes place between pediatricians and patients,” said Krol. “We must have the opportunity to continue these conversations and have these multifactorial tools to resolve this disease.”

Even if Medicaid covers oral health for children, less than half I went to the dentist at least once a year.

The cavities that burst into the mouths of these children and they are not treated, and they can cause generalized damage. The “eaten bone” decomposition around the tooth and sometimes enters the blood circulation, said Dr. Steven Levy, professor of preventive and community dentistry at the Iowa University.

“It’s more than just a garden variety, the experience of a person in the middle class with a cavity,” he said.

Large public health groups, including the American Academy of Pediatrics and US preventive services working groupRecommend prescription supplements for children from 6 months if the water supply is not fluorinated.

Fluor supplements are often given to 5 -year -old children until they have their permanent teeth around 13 or 14, said Bekker in an interview before the meeting. Babies get drops until they are old enough to chew tablets. They are generally inexpensive.

Vitamins and over -the -counter supplements do not contain fluorine. Fluoride is available over the counter only in toothpaste and mouthwash.

Makary also opposes fluorine supplements because they are not approved by the FDA. Because supplements have been used for decades before Mandated congress That drug manufacturers show that their products were not only safe but also effective, they have never been required to go through the approval process. For almost as long as supplements have been prescribed, criticism has been concerned with the lack of rigorous data showing their potential health effects and how they protect the teeth of children.

“I think we really have to understand the advantages,” said Linda Birnbaum, toxicologist and former director of the National Institute of Environmental Health Sciences and the National Toxicology Program. Birnbaum also spoke during the FDA meeting.

Dr. Brett Kessler of the American Dental Association recognized that supplements of prescription fluoride should only be administered after a “thoughtful decision” based on conversations between doctors and families.

“I hope we can all breathe, filter all the noise and not give in to anti-fluoride hysteria,” he said at the meeting.