In 1945, the U.S. government added fluoride to the public water supply in Grand Rapids, Michigan as a way to improve dental health. When children started experiencing fewer cavities due to water fluoridation, several other areas throughout the country began to also fluoridate their public water systems.
While the government continues to claim that water fluoridation is safe and effective, it has become a controversial topic in the public eye. Scientific research has found that most of the concerns the public brought up with water fluoridation were in “identifying benefits and harms, whether fluoride is a medicine, and the ethical implications.”
The government implements a strict set of regulations when adding fluoride to public water systems. Scientific evidence tends to show that as long as proper regulations are followed, any possible risks of having fluoride in public water systems are mitigated or eliminated. However, some still feel this practice isn’t safe and may lead to negative health effects. Exploring these public concerns and the scientific findings related to water fluoridation will help you to better understand this issue.
What Is Fluoride?
Fluoride is a mineral that’s present in rocks and soil and is also naturally released into the water and air. It’s been proven to prevent tooth decay and cavities when used properly. Some natural springs and groundwater have high enough levels of fluoride that they could provide these benefits when consumed.
However, public water systems only absorb trace amounts of fluoride naturally, which isn’t enough to offer dental health benefits. For this reason, the U.S. government made the decision to increase the amount of fluoride in the public water system so it could help those who consume it keep their tooth enamel strong and prevent dental problems, such as cavities.
While excessive consumption of fluoride may have negative health effects, the government adheres to strict regulations with the amount of fluoride it adds to the water system to ensure these risks are minimized.
When you visit a dentist or orthodontist, they may recommend a fluoride treatment so you can reap the benefits of this mineral. A dentist may apply a concentrated amount of fluoride to your teeth and suggest you repeat this treatment every three, six, or 12 months depending on your personal oral health.
Why Is Fluoride Found in Tap Water?
Oral health is directly linked to overall health in many ways. Due to this connection, scientists began to examine the relationship between water with high levels of fluoride and the prevention of cavities and tooth decay in children as early as the 1930s. After experimentation with the water system in Grand Rapids, Michigan proved to be a success, fluoride was added to many other public water systems.
According to the Centers for Disease Control and Prevention (CDC), by 2016, 73% of the community water systems in the U.S. had fluoridated water. The U.S. government’s goal has been to fluoridate the water in at least 80% of the country’s community water systems by 2020.
While some public concerns still surround water fluoridation, the government is focused on continuing this program based on scientific evidence and following strict regulatory practices. Fluoride in water may be beneficial by:
- Reducing the amount of tooth decay and cavities young children experience in their primary teeth.
- Reducing the decay and cavities children experience with their permanent teeth.
- Preventing tooth decay in adults.
CDC data shows that community water fluoridation reduces the cavities a person may experience over their lifetime by about 25%. This decreases the costs of dental treatments and the susceptibility for other health problems related to dental health. Along with practicing basic dental hygiene, fluoride has become an accepted, science-based means of improving oral health in individuals of all ages.
Public Concerns Regarding Fluoride in Drinking Water
While fluoride in water has its proven benefits, there are public concerns over consuming too much fluoride. World Health Organization (WHO) studies have found that “fluoride can also have an adverse effect on tooth enamel and may give rise to mild dental fluorosis.” This is a condition that children can experience when they’re exposed to an excess of fluoride at a young age.
Mild dental fluorosis changes the tooth enamel and may cause white spots on teeth. More severe cases occur when the tooth enamel is dramatically affected and small pits in the teeth may become prevalent. However, severe cases are not common in communities where the water fluoridation level is 2 milligrams or less per liter of water, and in the U.S. most cases are limited to the mild form involving small white spots.
One public concern is the relation of fluoride consumption to osteosarcoma, a rare form of bone cancer. A 1990 study by the US National Toxicology Program (NTP) found potential evidence for this link. However, subsequent studies have found that if fluoride is consumed according to federal regulations, there may not be a correlation between fluoridated water and osteosarcoma.
The World Health Organization (WHO) confirms that excessive consumption of fluoride in water leads to fluorosis. However, the American Dental Association (ADA) claims that exposure to the proper amount of fluoride throughout childhood is safe and leads to less tooth decay and fewer dental problems. The amount of fluoride added to the community water system and its regulation are generally what determine whether this practice is safe for the general public.
Regulations for Public Drinking Water
The primary law related to fluoride at the federal level is the 1974 Safe Drinking Water Act. This law set general rules for protecting public water supplies against contaminants and allowed the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) to set and enforce broad standards for water quality.
Local and state governments are responsible for following these regulations for the management of community public water systems. The amount of fluoride in water can vary by region because it is a voluntary decision; state or local regulations may be different in certain areas, and potential exposure to fluoride through other sources can impact the amount that is added to local water supplies.
The federal government recommendations on water fluoridation levels must be followed by all local governments. The WHO states, “The amounts added to drinking-water are such that final concentrations are usually between 0.5 and 1 mg/l.” The U.S. Public Health Service (PHS) recommends that public water systems have 0.7 milligrams of fluoride per liter of water — less than the 2 milligrams per liter associated with fluorosis.
The fluoridation of public water remains a controversial topic. Some theorists claim excessive fluoridation leads to health problems, but scientific evidence shows that when local water systems follow federal regulations, fluoride in water can be safe and effective.