Open Wide: PFAS in the Dental Office
Dental health—maintained through regular professional cleanings, examinations, and treatments—involves closer physical interaction between patients and fluoropolymer-containing materials than almost any other routine healthcare encounter. PFAS coatings on dental floss, fluoropolymer components in dental instruments, PFAS-treated clinical materials, and dental barriers used in infection control all represent potential PFAS exposure sources for both patients and dental practitioners. As awareness of PFAS health risks grows, dental patients and oral health professionals are asking questions that the dental profession is only beginning to systematically address.
PFAS-Coated Dental Floss: The Evidence
A 2019 study in the Journal of Exposure Science and Environmental Epidemiology analyzed dental floss products for PFAS content and found that certain premium dental floss products—particularly those marketed with smooth, glide-style coatings—tested positive for PTFE and related PFAS compounds. The study, which also measured PFAS blood levels in women who reported using different floss types, found that users of PTFE-coated floss had higher blood levels of specific PFAS compounds (particularly PFHxS) than users of uncoated floss, suggesting that floss PFAS absorption—through gum tissue during flossing—contributes to body burden.
Oral mucosal absorption of PFAS from PTFE-coated floss represents a direct route to systemic circulation, bypassing the digestive system’s potential partial barrier to absorption. Gum tissue is highly vascularized with permeable mucous membranes, potentially enabling efficient PFAS absorption during the mechanical disruption of flossing. The dose from flossing is likely small relative to waterborne PFAS exposures for most people, but represents an avoidable exposure for patients who choose uncoated floss or floss certified as PFAS-free. Several oral health product companies responded to the 2019 study by reformulating their floss products with non-PFAS coatings or by providing ingredient transparency that allows consumers to make informed choices.
Dental Materials and Professional Exposures
Dental impression materials—used to create molds of patients’ teeth for crown fabrication, orthodontic appliances, and dentures—include some formulations that incorporate PTFE or fluoropolymer components for dimensional stability and release properties. Composite resin dental filling materials may contain fluorinated monomers as performance modifiers. Dental dam materials and protective barriers used in infection control are often made from latex or nitrile rubber that may incorporate PFAS processing aids. For dental practitioners who handle these materials repeatedly throughout their careers, the aggregate occupational PFAS exposure from dental material handling—though likely lower than occupational PFAS exposures in industrial settings—represents an occupational health consideration that dental professional associations are beginning to evaluate.
Dental sterilization procedures—including autoclave steam sterilization of reusable instruments—may affect PFAS compounds in instrument coatings, potentially altering their chemical form or release characteristics. The combination of high-temperature steam and pressure in autoclave cycles can degrade certain PFAS compounds, but whether this degradation produces more or less toxic products depends on the specific compounds involved. Dental infection control protocols, which govern instrument sterilization and material disposal, do not currently include PFAS-specific considerations—a gap that occupational health and dental professional societies may address as PFAS awareness in clinical settings grows.
Implications for Dental Practice
Dental practices seeking to minimize PFAS exposures for patients and staff can take several practical steps. Sourcing PFAS-free dental floss for in-office patient samples and retail sale is straightforward—several mainstream floss products are available without PTFE coatings. Evaluating dental material suppliers’ PFAS transparency and requesting disclosure of PFAS content in materials used in clinical practice enables informed purchasing decisions. Staying informed about emerging professional guidance on PFAS in dental materials from the American Dental Association (ADA) and international dental professional bodies will ensure that practices remain aligned with evolving standards of care in this area as the evidence base develops.