Common questions about fluoride

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11. Has the momentum shifted against water fluoridation?

  • No. Although it’s true that some communities have chosen to stop fluoridating over the past year, the overall trend shows a continued increase in the number of Americans who receive fluoridated water. Between 2000 and 2008, an additional 34 million Americans gained access to fluoridated drinking water.
  • Since 1992, the percentage of people on public water systems who receive fluoridated drinking water has risen from 62 percent to 72 percent. The rate of this increase has picked up in the past eight years.
  • Since January 2011, Arkansas has enacted a state law guaranteeing access to fluoridated water for an additional 640,000 residents, and a water board in San Jose, Calif., has voted to fluoridate its water. The California vote means that more than 280,000 additional people will eventually gain access to fluoridated water.

12. Is fluoridated drinking water safe?

  • Yes. Over the past several decades, hundreds of studies have confirmed the safety of fluoride. According to the Centers for Disease Control and Prevention, “panels of experts from different health and scientific fields have provided strong evidence that water fluoridation is safe and effective.” This issue has been studied thoroughly, and there is no credible evidence to support the claims that anti-fluoride activists make.
  • The new recommended level for fluoridating water (0.7 milligrams per liter) should strengthen the public’s confidence that health officials are periodically reviewing standards and—when appropriate—updating them. The American Dental Association welcomed the new fluoride recommendation, noting that fluoridation remains “one of our most potent weapons in disease prevention.”
  • The American Academy of Family Physicians, the World Health Organization, the National Academy of Medicine and many other respected health and medical authorities have endorsed water fluoridation as a safe and effective practice.
  • What is true for calcium and potassium is also true for fluoride—even a beneficial mineral, if consumed at extraordinarily high levels, can potentially be detrimental to one’s health. The good news is that federal health standards guide local water companies, enabling them to fluoridate water at levels that are safe and effective.

13. Should we do more studies on fluoridation before continuing this practice?

  • More than 3,000 studies or research papers have been published on the subject of fluoridation, meaning few topics have been as thoroughly researched as fluoride. The overwhelming weight of the evidence—plus more than 65 years of experience—supports the safety and effectiveness of this public health practice.
  • It’s doubtful that even a hundred new studies would convince the anti-fluoride activists to reconsider the misleading attacks they make against fluoridation.
  • Although additional studies are always welcomed, the existing research—including several studies in the past decade—provides solid support for fluoridation. As the Centers for Disease Control and Prevention has written, “For many years, panels of experts from different health and scientific fields have provided strong evidence that water fluoridation is safe and effective.”

14. I read something on the Internet about a condition called “fluorosis.” Is that a reason not to fluoridate drinking water?

  • No. Nearly all fluorosis in the U.S. is a mild, cosmetic condition that leaves faint white streaks on teeth. It doesn’t cause pain, and it doesn’t affect the health or function of the teeth. In fact, it’s so subtle that it usually takes a dentist to even notice it.
  • Experts believe that in many cases fluorosis occurs because young children consume toothpaste while brushing their teeth. This is why dentists and health officials recommend that parents supervise young children while they are brushing their teeth. A study published in 2010 found that mild fluorosis was not an adverse health condition and that it might even have “favorable” effects on overall health. That’s why the study’s authors said there was no reason why parents should be advised not to use fluoridated water in infant formula.

15. I heard that the federal government reduced the level of fluoride recommended for drinking water in 2011. What was the reason for that change?

  • In January 2011, the U.S. Department of Health and Human Services (HHS) recommended that the optimal level of fluoride in public water systems should be 0.7 milligrams per liter of water. HHS’ new level reflects the fact that Americans today get fluoride from more sources—such as toothpaste and mouth rinses—than they received when the original level was set.
  • The HHS recommendation will continue to protect Americans’ dental health while minimizing the chance of fluorosis—a typically mild, cosmetic condition that causes faint white streaks on teeth. The effect of mild fluorosis is so subtle that only a dentist would notice it while doing an examination. This condition does not cause pain and does not affect the function or health of the teeth.