Recently, there has been some renewed debate over the impact of fluoride in water, and we understand that this may contribute to some concerns on your part about its safety. At the same time, we want to be sure you have the full picture of the facts in order to challenge any misinformation. Below is a summary of a recent article by Dr. Mary Beth Giacona addressing this issue. Dr. Giacona holds degrees in both dentistry and public health, and she currently is a professor at Rutgers School of Dental Medicine.
The Benefits of Fluoridated Water:
Dr. Giacona says that according to The Centers for Disease Control and Prevention (CDC), water fluoridation is one of the ten greatest public health achievements of the twentieth century. The reason for this is that it is major deterrent to the most common childhood chronic disease—tooth decay.
Dr. Giacona analyzes several real-life scenarios that all show a significant decrease in tooth decay due to fluoridated water. For instance, Grand Rapids, Michigan was the world’s first city to fluoridate its water supply in 1945. Eventually, more and more cities worldwide did the same. Clinical studies from the mid-twentieth century showed a decrease in tooth decay of 60-70% percent as a result. The extent of the impact of fluoridated water eventually decreased due to the impact of fluoridated toothpaste, though recent studies still show fluoridated water prevents up to 20-40% of cavities.
The national average of Americans who drink fluoridated water is 76%. As of 2022, only 16% of New Jersey residents had fluoridated water. Despite the concern some have that fluoridated water might lead to health problems, New Jersey residents had higher cancer and autism rates than national averages, and the rates of untreated tooth decay in children was higher than the national average.
Two other real-life scenarios mentioned by Dr. Giacona involve Juneau, Alaska and Calgary, Canada. In 2007, Juneau stopped fluoridating its water supply, and by 2012, there was a significant increase in cavities in children living there. This led to increased treatment costs for children enrolled in Medicaid, particularly for those ages zero to five. The increase in costs for this group increased 73%. In addition, low-income children had significantly more cavities than their higher income peers.
Concerns about Fluoridated Water:
Dr. Giacona also mentions a few real-life scenarios that are sometimes used to raise concerns about the impact of fluoridated water. For instance, in the early 1900s, residents of Colorado Springs, Colorado developed brown spots and mottled areas on their teeth from a mysterious dental disease called “Colorado Brown Stain.” Now we know that this disease is called fluorosis, which occurs when developing teeth are exposed to excessive fluoride. Residents there were drinking water that had extremely high natural levels of fluoride. Interestingly, they also had very low rates of tooth decay.
A recent report published by the National Toxicology Program has also raised concerns by some that fluoridated water could lead to neurological difficulties. This report compiled data from studies conducted abroad, and in these areas, residents were drinking water with naturally occurring fluoride at levels far greater than what the United States contains in its water supplies.
The Solution to Concerns:
The solution to these concerns about fluoridated water is using the optimal amount of fluoride in water supplies, says Giacona. The World Health Organization (WHO) endorses water fluoridation and recommends adding no more than 1.5 parts per million (ppm) of fluoride. Some studies whose populations drank natural water with fluoride levels far exceeding these recommendations showed higher risks for cancer and neurological disease. At the same time, expert panels, including the CDC, categorize these studies as being low quality, says Giacona. The American Dental Association and U.S. Public Health Services recommend a maximum of 0.7 parts per million (ppm) of fluoride. This is the U.S. standard. In addition, Giacona explains that oral health experts in the U.S. continuously monitor and modify levels.
The impact of fluoridated water on decreased tooth decay, particularly childhood tooth decay, is clear. The key is using the optimal level of fluoride in water, and the good news is, the U.S. uses this optimal amount, and it is also regularly monitored. Fluoridated water is also a very cost-effective way to prevent tooth decay, costing only one dollar a person a year, says Giacona. We hope that this summary has done much to alleviate any concerns that you might have had about fluoridated water!
Reference:
M. Giacona. Fluoride in the water: An added benefit, not a harmful one. The Hill. 12/26/24. https://thehill.com/opinion/5056213-cdc-fluoride-tooth-decay/