Fluoride Myth vs. Facts

Image of Kitchen Sink Faucet

“Fluoride: Myth vs. Fact” is an ongoing effort to educate the oral health community and general public about the science behind community water fluoridation. New items appear periodically in the WDA Journal and here on WDA.org.

 Look for Fluoride Friday posts on WDA Facebook and Twitter pages to learn more about community water fluoridation.

Myth: Removing fluoride from a community’s water system saves money.

Fact: Research shows community water fluoridation offers perhaps the greatest return-on-investment of any public health strategy. The reduction alone in the cost of filling and extracting diseased teeth and time lost from work to get care more than makes up for the cost of fluoridation.

A study conducted by the Centers for Disease Control and Prevention found it costs 50 cents per person per year to fluoride water in larger communities with more than 20,000 residents. For most cities, every $1 invested in this preventive measure yields approximately $38 in dental treatment costs.

Source: ilikemyteeth.com and CDC

Myth: We don’t need fluoride in drinking water, because it is in toothpaste.

Fact: Research conducted since fluoride toothpaste became widely used shows fluoridated water continues to protect everyone’s teeth from decay.

The Centers for Disease Control and Prevention reviewed this question in January 2011. After looking at all the ways we might get fluoride (including fluoride toothpaste), the CDC recommended communities fluoridate water at 0.7 parts per million. Any less than that puts the health of our teeth at risk.

Toothpaste alone is insufficient, which is why dentists and pediatricians often prescribe fluoride tablets to children living in non-fluoridated areas.

Fluoridation offers an easy, inexpensive preventive strategy that everyone can benefit from by simply turning on their water faucet.

Myth: Studies show that fluoride is linked to lower IQ scores in children.

Fact: Recent studies conducted in China, Mexico and India have raised questions about the potential effects of high levels of fluoride on intelligence and behavior.

However, these studies were poorly designed, gathered unreliable data and were
not peer-reviewed by independent scientists.

Foreign studies cited involved fluoride levels that were at least double or triple the level used to fluoridate drinking water in the U.S. It is irresponsible to claim these studies have any real meaning for our situation in the U.S.

Researchers who evaluated these studies also pointed out that the lower IQs could be traced to other factors, such as arsenic exposure, the burning of high-fluoride coal inside homes and the eating of contaminated grain.

Source: fluoridescience.org and ilikemyteeth.org.

Myth: “Fluoride in our drinking water is unnatural.”

Fact: Fluoride is already present in most water sources, even the oceans. Water fluoridation is simply the adjustment of fluoride that occurs naturally to a recommended level for preventing tooth decay.

Myth: Fluoride causes cancer.

Fact: According to generally accepted scientific knowledge, there is no association between cancer rates in humans and optimal levels of fluoride in drinking water.

Since community water fluoridation was introduced in 1945, more than 50 epidemiologic studies in different populations and at different times have failed to demonstrate a link between fluoridation and the risk of cancer.

A 2011 study in the Journal of Dental Research found no significant association between bone fluoride levels and osteosarcoma, a rare, primary malignant bone tumor that is more prevalent in males.

The case-control study was led by the Harvard University School of Dental Medicine and approved by the National Cancer Institute.

Fluoride concentration was measured in samples of normal bone that were adjacent to a person’s tumor. Because fluoride naturally accumulates in bone, this method provides a more accurate measure of cumulative fluoride exposure than relying on the memory of study participants or municipal water treatment records.

Source: The American Dental Association Fluoride Facts and National Cancer Institute

Question: European countries have rejected fluoridation, so why should we fluoridate water?

Answer: Europe has used a variety of programs to provide fluoride’s benefits to the public. Water fluoridation is one of these programs.

Fluoridated water reaches 12 million Europeans, mostly residents of Great Britain, Ireland and Spain. Fluoridated milk programs reach millions of additional Europeans, mostly in Eastern Europe.

Salt fluoridation is the most widely used approach in Europe. In fact, at least 70 million Europeans consume fluoridated salt, and this method of fluoridation reaches most of the population in Germany and Switzerland. These two countries have among the lowest rates of tooth decay in all of Europe.

Technical challenges are a major reason why fluoridated water isn’t widespread in Europe. In France and Switzerland, for example, water fluoridation is logistically difficult because of the terrain and because there are tens of thousands of separate sources for drinking water. This is why Western Europe relies more on salt fluoridation, fluoride rinse programs and other means to get fluoride to the public.

Source: The American Dental Association Fluoride Facts and ILikeMyTeeth.org

Myth: Fluoridated water isn’t safe for babies and young children.

Fact: The American Dental Association concludes it is safe to use fluoridated water to mix infant formula and encourages parents to discuss any questions they may have with their dentists and pediatricians.

Although using fluoridated water to prepare infant formula might increase the chance that a child develops dental fluorosis, nearly all instances of fluorosis are a mild, cosmetic condition.

Fluorosis nearly always appears as very faint, white streaks on teeth. The effect is usually so subtle that only a dentist would notice it during an examination. Mild fluorosis does not cause pain, nor does it affect the function or health of the teeth.

A 2010 study examined the issue of fluorosis and infant formula, and reached the conclusion that no general recommendations on avoiding use of fluoridated water in reconstituting infant formula are warranted.

The researchers examined the condition’s impact on children and concluded the effect of mild fluorosis was not adverse.

Infant formula fluoride intake recommendations

Members of the 2011 ADA expert panel encourages clinicians to follow the American Academy of Pediatrics guidelines for advising parents and caregivers of infants who consume powdered or liquid concentrate infant formula as the main source of nutrition:

Suggest the continued use of powdered or liquid concentrate infant formulas reconstituted with optimally fluoridated drinking water, while being cognizant of the potential risk of enamel fluorosis development.

When the potential risk of fluorosis development is a concern, suggest ready-to-feed formula or powdered or liquid concentrate formula reconstituted with water that is either fluoride-free or has low concentrations of fluoride.

Source: The American Dental Association Fluoride Facts and ILikeMyTeeth.org

Myth: Adding fluoride is like forcing people to take medicine.

Fact: Fluoride is not a medication. It is a mineral, and when present at the right level, fluoride in drinking water has two beneficial effects: preventing tooth decay and contributing to healthy bones.

U.S. court decisions have rejected the argument that fluoride is a medication that should not be allowed in water. The American Journal of Public Health summarized one of these rulings, noting fluoride is not a medication, but rather a nutrient found naturally in some areas but deficient in others.

There are several examples of how everyday products are fortified to enhance the health of Americans, such as iodine added to salt, folic acid added to breads and cereals and Vitamin D added to milk.

Numerous scientific studies and reviews have recognized fluoride as an important nutrient for strong healthy teeth.

Source: The American Dental Association Fluoride Facts and ILikeMyTeeth.org