By Barbara Kessler
Green Right Now
After decades of promoting water fluoridation, the U.S. government today announced it wants to lower the amount of fluoride recommended for drinking water.
The U.S. Department of Health and Human Services is proposing that a new “safe” level for fluoride be set at the lowest end of the “current optimal range,” according to a news release. The new level would lower the top threshold for fluoride to .7 milligrams per liter from the currently allowed 1.2 milligrams per liter to better protect people from “excess exposure.”
The EPA, which regulates water authorities, will be reviewing the issue while HHS takes comments before finalizing its position.
Department officials cited mild mottling or spots on children’s teeth as the reason to cut back on fluoridation. The spots indicate that these American children have absorbed more fluoride than necessary, during the formative years up through age 8, because they are exposed to fluoride from a variety of sources, from toothpaste to mouthwash to fruit drinks and bottled water made with fluoridated water.
Most dental fluorosis among Americans is mild, the HHS noted, and is “barely visible lacy white markings or spots on the enamel. “The severe form of dental fluorosis, with staining and pitting of the tooth surface, is rare in the United States.”
Environmentalists who have been advocating for a reconsideration of wholesale water fluoridation – not just because of mottled teeth, but because of concerns that fluoride exposure weakens bones, contributes to bone cancer and could cause thyroid problems — praised the federal government for moving to reduce fluoride levels.
The Environmental Working Group, which lobbies for reducing chemical exposures in a variety of foods and products, welcomed the “belated recognition” of the potential problems caused by fluoride, announcing that the decision was a sign the government was heeding the emerging science on fluoride.
“This decision is another signal to the public to take care when it comes to exposures to industrial chemicals; what is considered safe today won’t necessarily be thought safe tomorrow. New science usually reveals new risks and drives more protective standards, as we’ve seen today with the government’s fluoride announcement,” said Jane Houlihan, senior vice president for research at EWG.
Fluoride: The good and the bad
While the government announcement referred to the “unwanted health effects” of “excess fluoride exposure,” it also hailed water fluoridation as having been called one of the 10 top public health achievements of the 20th Century by the Centers for Disease Control. The joint HHS and EPA statement issued today called fluoridation “an important tool in the prevention of tooth decay.”
The government has long maintained that water fluoridation was vital to dental health and helped assures that children of all strata, even those who don’t often see a dentist, got fluoride during their formative years — an idea reiterated by HHS today.
“One of water fluoridation’s biggest advantages is that it benefits all residents of a community—at home, work, school, or play,” said HHS Assistant Secretary for Health Howard K. Koh, MD, MPH. “Today’s announcement is part of our ongoing support of appropriate fluoridation for community water systems, and its effectiveness in preventing tooth decay throughout one’s lifetime.”
But fluoride critics, such as the EWG and the New York-based Fluoride Action Network, are advocating for a broader change: They want water systems cleared of any added fluoride (some fluoride occurs natural in groundwater) because many studies have raised questions about the safety of ingesting fluoride.
“We have fluoride in toothpaste and mouthwash, it’s not needed in drinking water, and it appears to pose risks,” said Houlihan, noting that the current science on fluoride shows that it strengthens tooth enamel when applied topically, but that its effects when ingested are not clear – either on teeth or other ailments.
Studies have shown that excessive fluoride exposure can weaken bones, and could have neuro-toxic effects, she said.
In 2006, the National Academy of Scientists expressed concerns about fluoride exposure, saying that people drinking water at the EPA’s top safety level of 4 milligrams per liter “are likely at increased risk for bone fractures.” Though the NAS noted that municipal water systems do not contain that much fluoride.
The Fluoride Action Network maintains that fluoride added to city water systems has been linked to negative health effects in a variety of studies — and was not the factor that lifted society into a period of better dental health.
FAN, which has worked with dozens of cities in recent years to stop fluoridation (see the list of cities that have dropped the additive), reports that dental health has risen around the world in developed countries, regardless of whether they fluoridate their water.
Despite growing evidence that ingested fluoride risks unhealthy side effects, the American Dental Association has stood behind water fluoridation as a way to reduce dental caries, though in recent years, the ADA has agreed that children under 12 months do not need added fluoride, following studies that showed early exposure lead to noticeable mottling.
Today, the ADA spokesman Dr. Matthew Messina said, “We are excited that they continue to advocate the safety and effectiveness of fluoride and its value as a public health measure in preventing dental decay.”
In 2010, a study in the Journal of the American Dental Association, found that babies who ingested more fluoride, via formula mixed with water, had worse dental fluorosis or teeth mottling. The study prompted the Fluoride Action Network and some health providers to warn mothers against using fluoridated tap water to reconstitute formula, fearing that the cosmetic damage to teeth was the least of the potential health effects.
“Parents should be warned not to give fluoridated water to babies and children, and they should know that fluoride is also present in juice and other water-reconstituted beverages. I diagnose dental fluorosis on average 5 times daily, but fluoride doesn’t only affect teeth, it can potentially affect the brain and nervous system, kidneys, bones, and other tissues in young children during their critical stages of organ development. A public awareness campaign is urgently needed,” said Dr. Yolanda Whyte, a pediatrician in Georgia, speaking on behalf of a FAN statement at the time.
About 72 percent of Americans drink “optimally fluoridated” water via public water systems, according to the CDC.
Ways to reduce fluoride exposure
Houlihan offered some tips for people wishing to reduce their fluoride exposure.
- Read your annual water quality report. Google your water utility and look for their test results of fluoride, so you can see the into which it falls.
- Install a reverse osmosis filter or another type of filter that is certified to remove fluoride. (To save water you can use the filter only on drinking and cooking water.)
- Remember that bottled water isn’t necessarily any better. Many brands draw on city systems that are fluoridated.
- Check your pet’s food for bone meal content. The EWG found in a study two years ago that bone meal caused some pet foods to be high in fluoride, which could contribute to bone problems for your dog or kitty.
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