Why is fluoride added to US water?

The U.S. Environmental Protection Agency released its plan for determining safe levels of Fluoride in Drinking Water and is soliciting public comments until February 27, 2019.

The EPA said it could use the information to update the current fluoride standard for drinking water under the Safe Drinking Water Act. Robert?F, a fluoride critic, has made the issue a top priority. Kennedy Jr., who is the head of the U.S. Department of Health and Human Services and called fluoride an "industrial waste,"

Fluoride promotes dental health and strengthens enamel. What you need to know about the public health measure of fluoridating drinking water:

What is fluoride and what are its benefits?

It has been proven that fluoride, which is found in water, soil, and the air, can prevent dental decay. It strengthens the enamel of the tooth, which is its outer hard surface. This makes it more resistant against the acid that bacteria produce to cause decay. Fluoride can also reverse early tooth decay, by replacing minerals and preventing their loss.

Before the introduction of fluoridation in community water, American tooth decay was severe and widespread. According to federal officials, after fluoride was added to water supplies in the United States in many locations, tooth decay decreased in children and adults. Complete tooth loss among older adults also became less common.

When did water fluoridation as a policy begin?

Researchers in the United States noticed that those who lived near water sources that contained high fluoride levels naturally were more likely to have teeth that are resistant to decay. Grand Rapids, Michigan, became the first city to add fluoride in a controlled way to its water in 1945. This was the beginning of a massive public health experiment. Over a period of 15 years, data showed that fluoride reduced tooth decay by more than 60% among 30,000 Grand Rapids children.

In the 1950s the U.S. Public Health Service, and the American Dental Association recognized the effectiveness of water fluoridation to reduce cavities. This led to the widespread adoption of fluoride as a component in water supplies in the United States and its eventual inclusion in dental products like toothpaste and mouthwash.

Fluoridation is not a federally mandated practice. Municipal governments, city councils and local water authorities are typically the ones who decide whether to fluoridate their water.

How widespread is fluoridation in the U.S. According to CDC data, as of 2022, fluoride is present in the community water systems of 63% of Americans. This was before Utah, Florida and other states banned water fluoridation by 2025. According to the American Dental Association 'the average annual cost for U.S. municipalities to fluoridate water supplies ranges from $50 per person in large communities up to $3 per individual for small communities.

Fluoride is not added in most countries to public water supplies. In some countries, fluoride is added to salt. Fluoride levels are high in some areas of the world.

Are the levels of fluoride regulated?

The U.S. Public Health Service suggests that fluoride levels in drinking water should not exceed 0.7 milligrams/liter. It is known that levels above 1.5 mg/L can increase health risks, such as thyroid disease and nerve system damage. According to the U.S. Environmental Protection Agency, this limit is 4.0mg/L. Recently, a federal judge in California ordered the EPA's regulations to be strengthened.

What companies make fluoride?

The compound Fluorosilicic Acid is most commonly used in water systems because it releases free fluoride quickly when mixed with water. According to the EPA, J.R. Simplot and Nutrien’s PCS Phosphate Company manufacture this product.

According to EPA data, the total domestic production in 2019 of fluorosilicic acids from phosphate rocks was around 29 million kilograms (32 thousand tons).

What did Kennedy say?

Kennedy claims that in the absence conclusive proof, water fluoridation is linked to numerous health problems including cancer.

What do public health experts say? The Centers for Disease Control and Prevention in the United States have named fluoridation as one of the top 10 achievements of public health of the 20th Century. They note that it prevents tooth decay irrespective of socioeconomic status, or the ability to access care. The American Dental Association has reiterated their support for water fluoridation in communities to prevent tooth decay. The association stated that studies show community water fluoridation can reduce tooth decay in adults and children by over 25%, even when fluoride is widely available in toothpaste.

What questions do recent studies raise about?FLUORIDE'? In October 2024, a review by Cochrane Database of Systematic Reviews based on 157 studies raised questions regarding the benefits of fluoridating public drinking water in rich countries. According to the research, since fluoride has been added to toothpastes since 1975, the benefits of community water fluoridation in terms of reducing tooth decay or increasing the number cavity-free kids may be modest compared to earlier studies. However, new lawsuits are also challenging the manufacturers over the safety of fluoride in toothpaste.

Reviewers also concluded that there was not enough evidence available to assess the impact of ending fluoridation on dental health or the effect it would have on disparities in socioeconomic status. Researchers at the U.S. National Institutes of Health analyzed 74 studies in 10 countries and found that children who were exposed to more fluoride had lower IQ scores. Researchers reported that in four studies with a very low bias risk, involving?4,179 kids, urine fluoride levels at levels reportedly found in developed countries, were associated with lower IQs. According to an editorial that was published along with the report, these results "support concern for vulnerable populations who live in communities with water fluoridated." The second editorial, on the other hand, outlines the multiple flaws in the NIH analysis and warns against public policy regarding fluoride being affected by study results.

(source: Reuters)