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There was growing concern recently over fluoride usage, particularly in water, after a controversial US study was published in January linking higher fluoride exposure levels to lower IQ in children.
The study has sparked pushback since its publication in the Journal Of The American Medical Association Paediatrics, with some scientists criticising the study's methods and defending the mineral's proven dental benefits, according to an AFP article.
The debate has even reached Singapore, with Minister for Health Ong Ye Kung taking to Facebook on Jan 30 to address the US study as well as concerns over fluoride usage.
But what exactly is fluoride, and how do Singaporeans encounter it in our daily lives?
Dr Liau Chen Hong, a dental surgeon at Raffles Dental, told AsiaOne that fluoride is "a mineral commonly found in small amounts in food and is also available in supplements".
"In dentistry, fluoride is used to inhibit and reverse the initiation and progression of dental caries, also known as tooth decay," he added.
"Fluoride is also an important element for the formation of strong bones."
It can be found mainly in dental products like toothpaste and mouthwash.
According to the Ministry of Health (MOH), the mineral is also added into the water supply of many countries including Singapore, in a process called water fluoridation as a measure to improve the dental health of the population.
National water agency (PUB) notes on its website that Singapore has been carrying out the practice since 1957.
But if it's so commonly used in everyday products and is helpful, why are people worried?
This could stem from common misconceptions about the mineral and a lack of context.
According to experts AsiaOne spoke to, including Dr Liau, some common misconceptions about the mineral are that it could cause cancer and lower IQ.
Regarding the former, Dr Eunice Foo from Q&M Dental Surgery, told AsiaOne: "Studies have reported some evidence of genotoxicity (harmful substances damaging genetic information in cells) at large concentrations, but no causal link between high fluoride intake and increased human cancer risk has been established."
Dr Sharon Tan and Dr Felicia Sundram, chairpersons of the Singapore Dental Association's Dental Public Health Committee, wrote in a column for The Straits Times earlier this month that there was a need for context when looking at studies pertaining to fluoride, so as to "understand the facts".
They noted that the January study found a correlation between fluoride exposure and IQ scores "only in areas where the fluoride concentration was above 1.5mg per litre".
This is considerably higher than the levels recommended by global health authorities, they explained.
According to PUB, the current fluoride levels in Singapore's water supply do not exceed 0.7mg per litre — which is much lower than the maximum level of 1.5mg per litre recommended by the World Health Organisation.
Should Singaporeans be concerned about fluoride usage?
Experts have advised that there's little to no reason to be concerned as long as safe practices are in place.
"Fluoride-containing products like toothpaste and mouth rinse are safe as long as they are used correctly," said Dr Liau.
His sentiment is echoed by Dr Foo, who said that there is no need for Singaporeans to be worried about fluoride usage in general, as there would have to be an "excessive amount" of exposure.
"Given that Singapore has government [bodies and] agencies like the Ministry of Health and Health Sciences Authority that enforce evidence-based guidelines and regulate products that become available to us, I think there are not many avenues for the average Singaporean to consume an excessive amount of fluoride to the point where adverse effects might result," she said.
If there's anything to be worried about, it would be that your child might be accidentally swallowing a bit more toothpaste than intended."
Similarly, in their column, Dr Tan and Dr Sundram noted the importance of adhering to the "recommended amounts of fluoridated toothpaste when brushing teeth".
"Excessive fluoride exposure can lead to dental fluorosis (discolouration of the teeth), or, in extreme cases, skeletal fluorosis," they added.
"Fortunately, the authorities in Singapore carefully monitor and regulate fluoride levels to ensure they remain within safe and effective limits."
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