Smooth Tooth Surfaces
It appears that Research on Pit and Fissure Tooth Decay and Fluoridation casts doubt on fluoride's supposed benefit when added to a water system.
"Fluoride primarily protects the smooth surfaces of teeth, and sealants protect the pits and fissures (grooves), mainly 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."
Source: The Oral Health of California's Children A NEGLECTED EPIDEMIC: Selected Findings and Recommendations from the California Oral Health Needs Assessment of Children, 1993-94. p. 14.
"Because the surface-specific analysis was used, we learned that almost 90 percent of the remaining decay is found in the pits and fissures (chewing surfaces) of children's teeth; those surfaces that are not as affected by the protective benefit of fluoride."
Source: Letter, August 8, 2000, from Jeffrey P. Koplan, M.D., M.P.H. Director Centers for Disease Control and Prevention (CDC) Atlanta GA to Congressman Kenneth Calvert, Chairman, Subcommittee on Energy and Environment, Committee on Science, Washington, D.C.
"Nearly 90 percent of cavities in school children occur in the surfaces of teeth with vulnerable pits and grooves, where fluoride is least effective."
Source: Facts From The National Institute of Dental Research. Marshall Independent Marshall, Minnesota. May 28, 1992.
"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."
Source: Hearings: Subcommittee of the Committee on Appropriations, House of Representatives. March 1984. Dr. Harald Loe, Director of the National Institute of Dental Research.
"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."
Source: Toward Improving the Oral Health of Americans. Public Health Reports. Vol 108, No 6. Nov 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."
Source: Dental study upsets the accepted wisdom. Science News. Vol. 125, No. 1. Jan.7, 1984.
"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."
Source: Preserving the perfect tooth. Editorial. J American Dental Association Vol. 108. March 1984.
"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."
Source: Fluoridation: Time For A New Base Line? A.S. Gray, DDS, FRCD(C), J Canadian Dental Asso. No. 10, 1987.
References available: Maureen Jones (408) 297-8487
Prevention of Tooth Decay
This study from the National Institutes of Health states that systemic and topical fluoride is not effective in Pit and Fissure tooth decay where 84% of the cavities occur. Click on the above link to read the whole article.