Fluoride: The Pit & Fissure Factor


"Let me begin by saying that fluorides are most effective in preventing decay on the smooth surfaces of teeth. However, the chewing surfaces of posterior are not smooth. They have crevices and pits and it is our experience that fluorides don't really get access to these pitted areas." - Hearings: Subcommittee of the Committee on Appropriations, House of Representatives. March 1984. Dr. Harald Loe, Director of the National Institute of Dental Research.

"It is estimated that 84% of the caries experience in the 5 to 17 year-old population involves tooth surfaces with pits and fissures. Although fluorides cannot be expected appreciably to reduce our incidence of caries on these surfaces, sealants can." - Preserving the perfect tooth. Editorial. Journal of the American Dental Association. Vol. 108. March 1984.

"[E]namel surfaces with pits and fissures receive minimal caries protection from either systemic or topical fluoride agents." - Pinkham, JR, (Head of Pediatric Dentistry, U of Iowa College of Dentistry) Senior Editor. (1999). Pediatric Dentistry Infancy Through Adolescence, Third Edition. WB Saunders Co.

"Fluoride primarily protects the smooth surfaces of teeth, and sealants protect the pits and fissures (grooves), primarily on the chewing surfaces of the back teeth. Although pit and fissure tooth surfaces only comprise about 15% of all permanent tooth surfaces, they were the site of 83% of tooth decay in U.S. children in 1986-87." - The Oral Health of California's Children: A Neglected Epidemic. Selected Findings and Recommendations from the California Oral Health Needs Assessment of Children, 1993-1994.

"The type of caries now seen in British Columbia's children of 13 years of age, is mostly the pit and fissure type. Knudsen in 1940, suggested that 70 percent of the caries in children was in pits and fissures. Recent reports indicate that today, 83 percent of all caries in North American children is of this type. Pit and fissure cavities aren't considered to be preventable by fluorides, they are prevented by sealants." - Fluoridation: Time For A New Base Line? A.S. Gray, DDS, FRCD(C), Journal of the Canadian Dental Association. No. 10, 1987.

"Fluoridation and the use of other fluorides have been successful in decreasing the prevalence of dental caries on the smooth surfaces of teeth. Unfortunately, these efforts have much less effect on dental caries that occur in the pits and fissures of teeth (particularly on the biting surfaces of teeth) where more than 85 percent of dental caries now occur." - Toward Improving the Oral Health of Americans. Public Health Reports. Vol. 108, No. 6. Nov. - Dec. 1993.

"The program focused on four caries-prevention techniques: sealants, a plastic-like coating applied to the chewing surfaces of back teeth and to pits and fissures on the sides of teeth (these surfaces are most prone to decay and ones which fluorides cannot protect adequately)". - Dental study upsets the accepted wisdom. Science News. Vol. 125, No. 1. Jan.7, 1984.

Quotes compiled by Maureen Jones, Citizens for Safe Drinking Water (408) 297-8487 maureenj@pacbell.net