Start writing...I drink New York City tap water. Each liter contains 8 mg of fluoride. Fluoride is important for oral health. It helps protect against cavities. That’s why it is in many toothpastes and mouthwashes. Around 63% of Americans also have fluoride in their drinking water.
Recently, a person with controversial public health views may lead a top public health agency. This individual believes we should remove fluoride from public water systems. The addition of fluoride has spurred conspiracy theories. However, scientific research is still evolving, and new findings have emerged that question the necessity of fluoride in water.
Fluoride supports dental health by remineralizing tooth enamel. It forms a barrier against the acids produced by bacteria in our mouths. When consumed, about half of the fluoride remains in the body. Some binds to bones, while some is transferred to teeth via saliva.
Fluoride is naturally found in soil and air. Some regions have high levels of naturally occurring fluoride in their water. Nearly 100 years ago, dentists discovered that high fluoride levels could stain children's teeth but also prevent tooth decay. In 1945, Grand Rapids, Michigan, and Newberg, New York, began artificial fluoridation. Researchers monitored about 30,000 children over 15 years and found tooth decay rates fell by over 60%. Other communities followed suit. Fluoride was later added to toothpaste, which works topically. The goal of fluoridation is to guarantee everyone has fluoride protection, regardless of their dental care access.
To assess the effectiveness of fluoride in our water, we can look at communities that have stopped adding it. Supporters highlight studies from Calgary, Canada. After ceasing fluoridation in 2011, child dental decay rates increased sharply. A 2024 review of 21 studies determined that fluoridation might only slightly reduce tooth decay today. Prior to 1975, fluoridation had a clear impact on cavity prevention. However, widespread access to fluoride in toothpaste has changed the situation.
Today, experts are reevaluating how much fluoride is safe. Fluoride is commonly added to water as fluosilicic acid. The World Health Organization suggests a maximum of 1.5 mg per liter. That is roughly equivalent to 1 gallon of fluoride in an Olympic swimming pool. The CDC recommends 0.7 mg per liter, which is about half that amount. Local governments set their own fluoride levels, typically around this figure, such as in New York City water.
The CDC's recommendation aims to balance cavity protection with limiting dental fluorosis, which is mostly benign teeth staining. However, current research is also focusing on fluoride’s potential impact on developing brains, especially during pregnancy and early childhood. Early studies, mostly from China, indicated a concerning link between high fluoride levels and lower IQ.
In reviewing 74 studies, a recent U.S. analysis found a small number of high-quality studies linked lower IQ with fluoride levels below 1.5 mg per liter. However, the small number of studies limited definitive conclusions about U.S. fluoridation levels.
Bruce Lamere from Simon Fraser University explained that the new meta-analysis sought to clarify existing data on fluoride and IQ. The findings suggested that urinary fluoride levels below 1.5 mg per liter could correlate with a loss of roughly 1.6 IQ points per milligram of fluoride consumed.
Fluoride exposure also comes from other sources. Black and green teas, certain foods, and even swallowed toothpaste contribute to fluoride intake. Additionally, about 3 million Americans use groundwater that may have naturally high fluoride levels.
Experts are especially worried about infants consuming formula mixed with fluoridated water. Many infants are exposed to fluoride levels above recommended limits.
In summary, topical fluoride is important for dental health. For non-pregnant adults, ingesting fluoride seems safe. But there is some evidence for pregnant women, babies, and young children to monitor their fluoride consumption. Pregnant individuals may be advised to drink bottled water if their tap water is fluoridated. The safety of continuing water fluoridation is still under debate, causing confusion regarding its risks and benefits.
I support the precautionary principle. This principle advises action in the face of concerning evidence, not in its absence. Based on current literature, there are valid reasons for concern regarding fluoride safety.
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