Bottled water and its link to tooth decay

Favoring bottled water over tap could be causing children to get more cavities.

When the dentist had to fill six cavities in her 4-year-old son’s baby teeth, Amy Wilson was shocked.

The New York City mother of three scanned her family’s habits, trying to figure how Seamus, now 7, could have developed such tooth decay so early.

“We said, 'No, no, no, hey don’t have candy or gum or soda regularly,'” recalled Wilson, 42, an actress, author and blogger.

But then, at a party, a dentist friend posed a surprising question: Did Wilson’s children drink bottled water?

“I had a dentist tell me to make sure to give my kids tap water and not bottled because the latter isn’t fluoridated, and he’s seeing kids with more cavities,” said Wilson. 

It turns out that many dentists and government health officials suspect that the practice of skipping tap water in favor of bottled water may be contributing to rising rates of tooth decay in young children.

Courtesy Amy Wilson

Amy Wilson, 42, of New York, was shocked when Seamus, far left, had to have six cavities filled at age 4. She now makes sure Seamus, now 7, as well as Connor, 9, and Maggie, 4, drink fluoridated filtered water from the family tap.

“You should brush twice a day with a fluoride toothpaste, see the dentist twice a year for fluoride treatment and get fluoride in your drinking water,” said Jonathan D. Shenkin, spokesman on pediatric dentistry for the American Dental Association. “If you’re not getting it in your drinking water, that takes out a component of the effectiveness of that triad.”

The Centers for Disease Control and Prevention, too, warns that “bottled water may not have a sufficient amount of fluoride, which is important for preventing tooth decay and promoting oral health.”

No question, many kids do drink bottled water. One recent study in the Archives of Pediatrics found that about 45 percent of parents give their kids only or primarily bottled water, while another in the journal Pediatric Dentistry found that nearly 70 percent of parents gave bottled water either alone or with tap water.

More than 65 percent of parents using bottled water did not know what levels of fluoride it contained, that study showed.

At the same time, tooth decay appears to affect a huge swath of the nation’s young children. About 42 percent of children ages 2 to 11 in the U.S. had cavities in their baby teeth, according to a 2007 prevalence study, the most recent data from the Centers for Disease Control and Prevention.

The study tracked rising decay from 1988 to 1994 and then from 1999 to 2004, when it was up overall about 2 percent. The data showed that decay affected not only more than half of children at the lowest income levels, but also nearly a third of kids in higher-income families.

That supports additional research by Bruce Dye, a dental epidemiology officer with the National Center for Health Statistics, which actually found that boys in higher income families had the greatest prevalence of decay. Whether that's because it's harder to get those boys to brush, or because parents in higher-income families are more likely to provide more beverages, such as juice, sports drinks -- and bottled water -- isn't clear.