People seem to be more interested in health and wellbeing today than they ever have been before. The use of fluoride, in particular, has been a topic of much debate in recent years. Google searches for several variations of the term have increased by up to 10-30% in the last 5 years alone.[i] For dental professionals, this presents an opportunity to engage with patients about their dental and systemic health, and help them to make properly informed decisions.
Widespread concerns
Many of the concerns regarding fluoride stem from the potential or current implementation of community water fluoridation. For many, this is seen as a complete loss of control over their personal health, with the choice to consume fluoridated water taken away from them.
The controversial solution has been implemented around the globe since its introduction in the US in 1945. Fast forward to 2012 and approximately 378 million people across nine countries had access to fluoridated water. In modern Europe, only Ireland, Poland, Serbia, Spain, and the UK artificially fluoridate their main water supplies.[ii] An estimated 10% of England’s population (6 million people) have a fluoridated water supply, including areas in the West Midlands and North East.[iii] These tend to be regions with high oral health needs and often reduced oral health-related quality of life.[iv]
Another issue for many people is the potential for negative side effects due to excess fluoride. These include fluorosis, neurological development complications, and more.
The evidence to date
To understand both sides of the debate, it’s important to remain abreast of the latest research in the field. Of course, nationwide water fluoridation schemes would never have been rolled out without extensive evidence supporting their benefits.
The World Health Organization (WHO) recommends a safe fluoride limit of 1.5 mg/litre in drinking water, though artificial water fluoridation is typically below 1.0 mg/litre.[v] Strong evidence supports a lack of negative health effects for community water fluoridation at concentrations of 0.7 to 1.0 mg/litre.[vi]
Systematic reviews demonstrate that water fluoridation leads to a reduction in caries[vii] – by up to 35% in deciduous teeth[viii] – with the recommended fluoride concentrations helping to strengthen enamel and protect individuals from future decay.[ix] There is also evidence that community water fluoridation reduces the incidence of decayed, missing, or failing teeth (DMFT) over time, benefiting children in particular.[x]
In addition, studies do not establish a strong correlation between fluoride and developmental neurotoxicity in humans.[xi] There is some research linking neurological disorders and IQ damage to fluoride consumption, but the quality of the evidence is low and only applicable at fluoride concentrations above the recommended levels.[xii]
Interestingly, the positive impact of water fluoridation seems to be lower than it was a few decades ago, indicating that this may not be the most effective approach to widespread oral health.x
The great fluoride debate: Too much, too little, or just right?
For decades, toothpaste guidance has focused on fluoride concentration, recommending conventional formulations that deliver most of their soluble fluoride during and shortly after brushing. Yet concentration alone does not reveal how effectively fluoride is delivered.
In response to concerns about safety and autonomy, some patients use fluoride-free toothpastes. Therefore, individuals usually choose between conventional fluoride levels and no fluoride at all. Sustained-release technology offers a middle ground, allowing lower concentrations to be delivered gradually.
Clinicians should therefore consider both how much fluoride a toothpaste contains, and how effectively – and for how long – it is delivered.
It is crucial to be specific when recommending solutions to patients. These should be tailored to their oral health requirements, but also their personal preferences, providing an opportunity to discuss the impact of fluoride and any concerns they may have. BioMin F is an excellent choice, designed specifically to strengthen and protect the teeth. Its unique formula contains approximately 60% less fluoride than the average toothpaste, but with no compromise in health advantages. The solution offers longer-lasting therapeutic benefits by providing a gradual-release mechanism that continuously deposits an optimal concentration of calcium, phosphate and fluoride for up to 12 hours after brushing.
Fluoride done right
The fluoride debate is unlikely to reach a conclusion in the near future, but it is important for dental professionals to appreciate how patients on either side of the fence may feel. It is crucial to share evidence-based information and guidance, but clinicians should also be prepared to discuss suitable alternatives. Whether you are based in a community water fluoridation area or not, appropriate fluoride exposure can have a significant effect on patients’ caries risk. Recommending solutions that they are comfortable with is key to their compliance and improved oral health.
The science is clear. The solution is simple.
www.biomin.co.uk
2026 Supply Update
BioMin toothpastes are currently unavailable across many of our usual stockists. This pause ensures we continue to meet the highest standards of quality and regulatory compliance for all our products.
We understand that this may be inconvenient, and we sincerely appreciate your patience and support during this period. We are working hard behind the scenes to resolve the situation and will share updates on our website as soon as we have a clearer timeline.
Thank you for continuing to trust BioMin® for your oral health needs.
Author: Alec Hilton, CEO of BioMin Technologies Ltd
[i] Google Trends. Top queries. Change in past 5 years. Search term “Fluoride toothpaste”, “toothpaste fluoride”, “what is fluoride”.
[ii] Aoun A, Darwiche F, Al Hayek S, Doumit J. The Fluoride Debate: The Pros and Cons of Fluoridation. Prev Nutr Food Sci. 2018 Sep;23(3):171-180. doi: 10.3746/pnf.2018.23.3.171. Epub 2018 Sep 30. PMID: 30386744; PMCID: PMC6195894.
[iii] Chapter 9: fluoride. Guidance. September 2025. Department of Health & Social Care. NHS England. https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention/chapter-9-fluoride [Accessed May 2026]
[iv] Inequalities in oral health in England. Public Health England. https://assets.publishing.service.gov.uk/media/6051f994d3bf7f0453f7b9a9/Inequalities_in_oral_health_in_England.pdf [Accessed May 2026]
[v] Fluoride in drinking water. Background document for development of WHO guidelines for Drinking Water Quality. World Health Organization. https://www.who.int/docs/default-source/wash-documents/wash-chemicals/fluoride-background-document.pdf [Accessed May 2026]
[vi] Zohoori FV, Kumah EA, Kronic J, Drinnan M, Morris AJ. Public Health Impacts of Water Fluorides: Current Evidence from a Rapid Systematic Review. Adv Nutr. 2025 Dec;16(12):100547. doi: 10.1016/j.advnut.2025.100547. Epub 2025 Oct 22. PMID: 41135657; PMCID: PMC12662105.
[vii] McDonagh MS, Whiting PF, Wilson PM, Sutton AJ, Chestnutt I, Cooper J, Misso K, Bradley M, Treasure E, Kleijnen J. Systematic review of water fluoridation. BMJ. 2000 Oct 7;321(7265):855-9. doi: 10.1136/bmj.321.7265.855. PMID: 11021861; PMCID: PMC27492.
[viii] Wordley V, Bedi R. A review of water fluoridation implementation strategy in England 2002-2005. BMC Oral Health. 2020 Apr 15;20(1):105. doi: 10.1186/s12903-020-01102-w. PMID: 32293421; PMCID: PMC7158021.
[ix] Water fluoridation and dental health: 2024 update. UK Parliament POST brief 63. December 2024. https://researchbriefings.files.parliament.uk/documents/POST-PB-0063/POST-PB-0063.pdf [Accessed may 2026]
[x] Iheozor-Ejiofor Z, Walsh T, Lewis SR, Riley P, Boyers D, Clarkson JE, Worthington HV, Glenny A-M, O’Malley L. Water fluoridation for the prevention of dental caries. Cochrane Database of Systematic Reviews 2024, Issue 10. Art. No.: CD010856. DOI: 10.1002/14651858.CD010856.pub3. Accessed 27 May 2026.
[xi] Guth S, Hüser S, Roth A, Degen G, Diel P, Edlund K, Eisenbrand G, Engel KH, Epe B, Grune T, Heinz V, Henle T, Humpf HU, Jäger H, Joost HG, Kulling SE, Lampen A, Mally A, Marchan R, Marko D, Mühle E, Nitsche MA, Röhrdanz E, Stadler R, van Thriel C, Vieths S, Vogel RF, Wascher E, Watzl C, Nöthlings U, Hengstler JG. Toxicity of fluoride: critical evaluation of evidence for human developmental neurotoxicity in epidemiological studies, animal experiments and in vitro analyses. Arch Toxicol. 2020 May;94(5):1375-1415. doi: 10.1007/s00204-020-02725-2. Epub 2020 May 8. PMID: 32382957; PMCID: PMC7261729.
[xii] Miranda, G.H.N., Alvarenga, M.O.P., Ferreira, M.K.M. et al. A systematic review and meta-analysis of the association between fluoride exposure and neurological disorders. Sci Rep 11, 22659 (2021). https://doi.org/10.1038/s41598-021-99688-w
