Edelstein seconded the notion that fluoride is an important tool in the fight against tooth decay.
"Fluoride -- no matter how it gets to the tooth surfaces -- toothpaste, water, rinses, varnishes, gels, is effective in a multitude of ways," he said. "It strengthens the tooth structure while also inhibiting the bacteria's capacity to produce acids from sugars. It is most effective when delivered multiple times throughout the day, by using fluoridated toothpastes twice daily and by drinking fluoridated water."
Edelstein noted that "the advantage of water is that it is consumed multiple times a day," adding that tap water is both convenient and free.
"[But] when bottled water without fluoride is substituted for fluoridated tap water, the advantage of regular, small amounts of healing fluoride is lost and children and adults will be more prone to cavity activity on the surfaces of their teeth," he warned.
That said, Edelstein -- like Shenkin -- also noted that no studies have as yet directly linked a higher risk for cavities to the consumption of bottled water in place of tap water.
"Some have attributed this increase and prevalence to bottled water substitution," he said. "But that remains conjecture as other factors -- increased sugar in diets, changes in demography, dental intervention -- may account for the change."
In a news release issued in March, the International Bottled Water Association (IBWA) denied that bottled-water consumption is associated with an increased risk for tooth decay.
"There is absolutely no correlation between consumption of bottled water and an increase in cavities," the IBWA stated. "In fact, bottled water does not contain ingredients that cause cavities, such as sugar." The organization also noted that about 20 of its member manufacturers actually produce "clearly labeled" fluoridated bottled water.
"Consumers," the IBWA added, "should therefore look at how much fluoride they are receiving as part of an overall diet and should contact their health-care provider or dental-care provider for their recommendation."
For more on fluoride and tap water, visit the U.S. Environmental Protection Agency.
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