On April 27, 2015, the U.S. Department of Health and Human Services released the final Public Health Service (PHS) recommendation for the optimal fluoride level in drinking water to prevent tooth decay. (The photo accompanying this post shows caries tooth decay in a small child.)
The new recommendation is for a single level of 0.7 milligrams of fluoride per liter of drinking water. It updates and replaces the previous recommended range (0.7 to 1.2 milligrams per liter) issued in 1962.
The fluoride recommendation was revised as too many cases of fluorosis were being detected in U.S. teens (link to CDC fluorosis fact page). In keeping with the U.S. PHS recommendation, the FDA also recommended that bottled water manufacturers do not add fluoride to bottled water at concentrations greater than a maximum final concentration of 0.7 mg/L. (Link to U.S. FDA site).
Fluoride Use to Prevent Tooth Decay
Fluoride is an inorganic anion of fluorine. Typically, fluoride-containing compounds, such as sodium fluoride or sodium monofluorophosphate are used in preventing tooth decay, they are also used for water fluoridation and in many products like toothpaste. In the past sodium fluoride was used to fluoridate water; hexafluorosilicic acid (H2SiF6) and its salt sodium hexafluorosilicate (Na2SiF6) are more commonly used additives, especially in the United States. In many countries, the fluoridation of water is used to systematically prevent tooth decay on the population.
Fluoridated water has fluoride at a level that is effective for preventing cavities; this can occur naturally or by adding fluoride. According to the Center of Disease Control, the health benefits of fluoride include:
- Fewer cavities and less severe cavities.
- Less need for fillings and tooth extractions.
- Less pain and suffering associated with tooth decay.
Implementation of Community Water Fluoridation in the U.S.
In the U.S., community water fluoridation was implemented in 1945 to improve the overall dental health of its citizens and the city of Grand Rapids in the state of Michigan became the first city in the world to fluoridate its drinking water. The Grand Rapids water fluoridation study was originally sponsored by the U.S. Surgeon General, but was taken over by the NIDR shortly after the Institute’s inception in 1948, and is told in a fascinating story, titled, The Story of Fluoridation.
Like what you are learning?
Is Too Much Fluoride Bad for You?
This brings us to the vital question: if fluoride is so beneficial in preventing tooth decay and making our smiles prettier then why all the debates and going back and forth by regulatory agencies?
The American Dental Association website states: “More than 70 years of scientific research has consistently shown that an optimal level of fluoride in community water is safe and effective in preventing tooth decay by at least 25% in both children and adults” and the Centers for Disease Control and Prevention has named community water fluoridation as one of 10 great public health achievements of the 20th century.
It turns out that there are several dangers associated with having too much fluoride intake. One of the side effects of having too much fluoride consumption is fluorosis which results in the discoloration of tooth enamel, surface irregularities, and pits and erosion of teeth. Fluorosis affects nearly one in every four Americans ages 6 to 49. Another concern is that those individuals that do have fluorosis are more prone to tooth decay.
More serious concerns include fluoride being an endocrine disruptor and prenatal and postnatal exposure to fluoride possibly having a role in ADHD among young and adolescents (link to study abstracts). If we have fluoride in our water, toothpaste and mouth wash….could we be getting too much fluoride in our bodies?
Chromatography Applications for the Testing of Fluoride in Water
Whichever side of the debate you are on, both sides would agree that testing of fluoride in drinking and bottle water is a necessity to protect consumers. We have many ion chromatography solutions for the quick and easy testing of fluoride as well as other ions in bottled and drinking water (the raw ingredient for most beverages).
Check out the following downloadable application notes on the testing of fluoride in water:
- Determination of Trace Concentrations of Oxyhalides and Bromide in Municipal and Bottled Waters Using a Hydroxide-Selective Column with a Reagent-Free Ion Chromatography System
- Determination of Trace Concentrations of Chlorite, Bromate, and Chlorate in Bottled Natural Mineral Waters
Where are you on this debate on the addition of fluoride to drinking water? Would like to hear your thoughts on this issue.