The appointment of Robert F. Kennedy, Jr. as secretary of Health and Human Services has attracted newfound national attention to fluoride.
Kennedy and other scientific skeptics suggest that this mineral, embraced for generations to improve oral health, is a highly dangerous neurotoxin that should be removed from our water supplies. This fear of fluoride taps into the increasing distrust of authorities and the rise of the anti-science movement. The value of fluoride for strengthening teeth is not where the controversy lies: Skeptics oppose the mandatory addition of fluoride to our public water supply. Here are the facts on fluoride:
Fluoride is a mineral found naturally in water, soil, air, and some foods. It is beneficial to human health specifically because it strengthens tooth enamel—the thin layer coating the teeth—which helps prevent bacteria from causing cavities.
What are the benefits of fluoridating water?
Drinking fluoridated water strengthens teeth and prevents tooth decay. Water fluoridation has been used in the United States to prevent tooth decay since 1945. It is a highly effective population-level intervention and is lauded as one of the greatest public health achievements of the 20th century. Water fluoridation continues to be supported by the American Dental Association and the American Academy of Pediatrics.
Fluoride toxicity (primarily affecting bone health, not cognitive ability, cancer risk, or thyroid function) can occur at extremely high consumption levels. To put this in perspective, the fluoride concentration for dental health promotion is 0.7 parts per million in drinking water. Fluoride toxicity occurs with exposure of 5 milligrams (mg) per kilogram (kg) of body weight per day. This means that a 40 kg child (88 pounds) would have to drink 300 quarts of water a day to reach toxicity, and they would die from water intoxication before reaching that level.
The choice to add fluoride to the water supply is mainly a local decision—your city or county decides—but some states have banned the practice. Currently, about 75 percent of Americans drink fluoridated water.
If you live in a locale that doesn’t fluoridate the water or if you drink only bottled, distilled, or certain kinds of filtered water, let your dentist know so they can discuss cavity prevention.
There are several areas that previously fluoridated their water supply and later banned the process. Calgary, Alberta, Canada, banned it in 2011. Within five years, cavities increased twofold among elementary children, and antibiotic use skyrocketed eightfold. Juneau, Alaska, ceased community water fluoridation in 2007, and the odds of someone age 18 or younger receiving treatment for tooth decay were approximately 25 percent greater after 2007. There were economic costs as well: After 2007, the average cost of decay-related treatment for children in Juneau was nearly 50 percent higher than it was when water fluoridation was in place.
The bottom line is that the fluoridation of water is a safe and effective public health intervention for protecting dental health. Dental disease increases when fluoride is removed from the water supply. Lower-income families will suffer a greater financial burden from treating advanced gum disease and debilitating tooth decay resulting from the removal of fluoridation from our water supplies.
