What you need to know about fluoride in drinking water

() – President-elect Donald Trump tapped Robert F. Kennedy Jr. as secretary of Health and Human Services and promised to let him “go big on health,” making health care a priority on his second term agenda.

Although we don’t know what his policies will be, one of the things Kennedy has signaled is that he will study water fluoridation throughout the United States. He will not be able to take any action until he is appointed and confirmed by the Senate in 2025. But on the social network fluoride from public systems. “Fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, loss of IQ, neurodevelopmental disorders and thyroid diseases,” he said.

Fluoride is a natural mineral that is present in trace amounts in soil, plants, water and food, and at optimal levels helps prevent cavities by keeping teeth strong. Countries take varying approaches to ensuring children receive fluoride, with some adding it to water, like the United States, and others adding fluoride to milk or salt to maintain recommended levels. Other countries opt for varnishes and mouthwashes provided in schools.

Community water fluoridation was introduced in the United States in 1945 to help improve oral health in a cost-effective and equitable way. The US Centers for Disease Control and Prevention (CDC) considered drinking water fluoridation one of the 10 most important health interventions of the 20th century in this country, along with vaccination, family planning and safety in the workplace.

According to CDC figures, in 2022 72% of the US population receives fluoridated drinking water. This figure varies by state, from 8.5% of Hawaii’s population to 100% of Washington’s population.

Water fluoridation is not mandatory, and although there is a recommended concentration of fluoride in drinking water (0.7 milligrams per liter) by the CDC, that level is not a mandatory standard. The decision to fluoridate water is made at the local level and depends on the amount of fluoride naturally present.

There are 36,767 water supply systems in 36 states with public information available on the CDC website, a small portion of the estimated number of drinking water supply systems in the US. In 2023, just over a third ( 37%) of the water systems included in the data are fluoridated.

It also varies by state. In Kentucky, 93.8% of these declared water systems are fluoridated, and on the low end, only 3.7% of declared water systems in Alaska are fluoridated.

There is also a wide variety in the levels of fluoride found in these water systems. Not all of the 36 states that report fluoride access report concentration levels, limiting opportunities for comprehensive analysis. Among them, 24 states report fluoride levels in 1,774 public water systems.

About 53% of these water systems have a fluoride concentration within recommended levels: between 0.7 and 1.2 mg per liter. Just under half of them (47%) have a fluoride concentration below the level recommended by the CDC.

Of publicly available data on fluoride levels from water systems, two water systems, both located in South Carolina, reported fluoride concentration levels above WHO guidelines. The WHO states that long-term exposure to fluoride levels above 1.5 milligrams per liter (mg/L) in drinking water can cause health problems.

Fluoride has long been known to help strengthen teeth and bones; That’s why it has been added to food and tap water for many decades. The CDC believes that community fluoridation is responsible for a 25% reduction in cavities in children. Cavities can cause pain and tenderness, which can affect speech and eating. They can also cause tooth loss or an infection that can spread through the body, causing serious illness or death.

But at certain concentration levels, fluoride can cause harm. The World Health Organization states that although fluoride reduces the incidence of dental caries, it has negative effects at higher levels, such as “causing dental and skeletal enamel fluorosis after prolonged exposure to high concentrations.” Skeletal fluorosis is a serious disease that causes bone weakness and joint stiffness and pain.

Numerous studies have shown that fluoridated water can help prevent cavities and improve oral health. A 2010 study in Nevada found that living in a community with fluoridated drinking water was associated with a lower incidence of decayed or missing teeth. In 2011, the Canadian city of Calgary removed fluoride from its water due to skepticism about its benefits and to reduce costs. A later study comparing children in the city with those in Edmonton, where the water was still fluoridated, found that over three years, Calgary children had more cavities in their baby teeth. This suggests that fluoridated water, without other interventions, was an important source of fluoride for that community.

However, other studies have found that improvements in oral hygiene awareness and dental practices in general have diminished the benefits of fluoridated water. A recent report concluded that water fluoridation does help prevent cavities, but not as much as originally thought; The authors postulate that recent improvements in cavity prevention are due to the popularity of fluoride in toothpastes and mouthwashes.

International data also corroborate this. Around the world, tooth decay has decreased since the 1970s, even in countries where fluoride is not added to water.

Some of the countries where water is not fluoridated take a different approach to oral health, opting for other fluoride-based interventions.

In the United Kingdom, for example, Manchester and Blackpool have programs to provide fluoridated milk to local schoolchildren. In the rest of the country, it is estimated that 10% of the population has access to fluoridated water, either naturally or through local fluoridation programs.

In Iceland, the water is not fluoridated, but there are fluoride flushing programs in schools across the country. School children receive fluoride rinses twice a month.

Japan started a similar fluoride mouthwash program in schools in 1970, which has since spread to daycare centers across the country. Research has shown that these fluoride mouthwash programs are most effective in reducing cavities when started at younger ages.

In Italy, the Society of Pediatric Dentistry recommends a series of interventions for children, such as brushing their teeth twice a day with fluoridated toothpaste and reducing consumption of sugary foods and drinks. Fluoride tablets, varnishes, gels or sealants are recommended for high-risk people depending on their age.

However, excessive exposure to fluoride can have adverse effects. A study, published in May of this year, found that greater exposure to fluoride during pregnancy was associated with an increase in neurobehavioral problems. And in August, a federal review of existing research found that higher estimated fluoride exposure (above the WHO guideline of 1.5 mg/L) was associated with lower IQ in children. These levels are rarely found in the United States.

Water fluoridation “is considered especially beneficial for disadvantaged communities and families who are unable or culturally unwilling to access dental hygiene and dental services,” John Fawell, a water researcher and professor, told in an email. Visitor to Cranfield University.

Fawell, who has advised the World Health Organization on water quality standards, added: “Fluoride at concentrations lower than those that cause dental fluorosis has been associated with a small reduction in IQ in children in some studies. epidemiological”.

“However, in the absence of a clear mechanism, it remains a not necessarily causal association.”