What Are the Pros and Cons of Fluoride in Drinking Water? 

Fluoride was originally added to public drinking water in the 1950s as a way to reduce dental cavities or tooth decay. There are some natural water supplies that contain fluoride, and public utilities will test to determine if removal or addition is warranted. 

The American Dental Association, Centers for Disease Control and others supported this effort then and still do today. The Environmental Protection Agency established a maximum contaminant level (MCL) of 4 mg/l or ppm and most utilities will add fluoride at 0.5 – 1.5 mg/l. 

In the years since initiation of fluoridation, there have been numerous studies which have investigated the potential health impacts associated with fluoride. Several studies have shown a link of ingested fluoride with an increase of dental and skeletal fluorosis (staining or pitting of teeth in children, or bone weakness), cognitive impairment, hypothyroidism, enzyme and electrolyte derangement, and uterine cancer. However, the American Cancer Society recently has stated that research has not shown a link of fluoride and cancer. 

Concentrations of fluoride in these studies varied, but some show a link to health effects at levels of 1-2 mg/l, well below the EPA MCL. The Department of Health and Human Service has recommended an optimal level of 0.7 milligrams per liter is set to promote public health benefits of fluoride for preventing tooth decay while minimizing the chance for dental fluorosis and other health issues. 

Currently the EPA is reviewing the new risk assessment of fluoride to determine whether to revise the drinking water standard. 

Given the increasing concern over potential health impacts with fluoridated water, there are efforts by various groups to lobby for utilities to stop adding fluoride to drinking water. One argument used is that since the use of fluoridated toothpaste and other topical products, which have been shown to be more effective than a water source, fluoridation is no longer warranted, especially given the potential harm to certain individuals or populations. In recent years, over 75 cities have stopped adding fluoride to their drinking water supply. Further the U.S. Public Health Service has lowered its recommended level of fluoride in drinking water. 

If you are concerned about fluoride in your drinking water, check with your public water utility. An annual Consumer Confidence Report is available and will inform you of the amount of fluoride in the water supply. If you are using a private well, you can have your water tested. There are several filters that will remove fluoride including anion exchange, activated alumina, and the most common is reverse osmosis which can be installed under the sink to treat your drinking water. 

For more information on water quality and testing, check out our website.

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