June 3rd, 2009
Fluoride is a natural element found in rocks and soil and in fresh and ocean water. Waters in and around the United States have natural fluoride levels that range from 0.1 to more than 12 parts per million, according to the CDC. The optimal level for preventing tooth decay is a range from 0.7 to 1.2 parts per million, according to the CDC.
The CDC cites studies showing that water fluoridation can reduce the amount of decay in children’s teeth by as much as 60%. Today, even with the widespread use of fluoride toothpaste, mouth rinse, and professional fluoride treatments — topical treatments that also work well to reduce tooth decay — researchers say systemic, water fluoridation has been shown to reduce tooth decay by 18-40% among children and by 35% among adults.
Over 405 million people in approximately 60 countries drink water with added fluoride.
While those drinking “optimally” fluoridated water have seen tooth decay rates decline, questions remain about other impacts of fluoride in the body.
In addition to fluoride in tap water and toothpaste (which is not supposed to be ingested), the element can be found in a number of beverages (tea is naturally high in fluoride) and food. The United States Department of Agriculture maintains a fluoride database.
The Environmental Protection Agency (EPA) has set a “maximum contaminant level” of 4ppm of fluoride in drinking water. And the CDC recommends a range in the drinking water of 0.7 to 1.2 ppm fluoride as the optimal amount to prevent tooth decay and minimize fluorosis. The range was developed based on average fluid consumption in regions of various ambient air temperature (i.e. lower fluoride range in hot areas where you would expect higher fluid consumption and higher fluoride range in colder climates.)
However, CDC scientists note it’s a complex issue. They are currently re-examining the fluid consumption assumptions because outdoor activity has decreased, indoor air temperature control is prevalent and there is widespread consumption of fluids other than water.
TOO MUCH FLUORIDE CAN HURT
But scientists do agree that too much fluoride is dangerous and can cause fluorosis — a condition that causes staining and pitting of the enamel surface of teeth when small children get too much fluoride.
A 2007 recommendation from the American Dental Association urged parents not to use fluoridated tap water to mix infant formula. Researchers say the amount of fluoride in safe tap water is still too much for an infant when ingested as the primary source of nutrition. The child may develop very mild or mild fluorosis, according to the ADA.
This warning does not extend to older children.
A report by the World Health Organization focused on the problem of too much natural occurring fluoride and the (sometimes severe) damage it does to the bones. The report noted that low concentrations provide protection against dental caries (cavities), especially in children.
Opponents, such as the Fluoride Action Network, contend that adding fluoride to the water is becoming unnecessary. They cite this 2006 British Medical Journal report:
“Consistent with the British Medical Journal review…it is now accepted that systemic fluoride plays a limited role in caries prevention. Several epidemiologic studies conducted in fluoridated and non-fluoridated communities clearly indicated that CWF (Community Water Fluoridation) may be unnecessary for caries prevention, particularly in the industrialized countries where the caries level has [become] low.”
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