Filtering the facts: Is fluoridated water safe to drink?

In 1945, authorities in Grand Rapids, Michigan chose to increase the fluoride content of the area’s water supply to 1.0 ppm. It became the first city in the US to implement large-scale water fluoridation. Between this first instance and 2008, it’s believed over 72% of US citizens with access to public water have received fluoridated water in their primary water supplies.

There are compelling arguments both for and against the addition of fluoride to public drinking water. Some experts claim the compound is a safe and effective way to prevent tooth decay and improve dental health, while others suggest there may be a link between fluoridated water and serious health complications. Either way, the topic has sparked fierce debate for many years.

With one Harvard-backed study finding a link between fluoridated water and reduced IQ scores in children, and others suggesting a connection between water fluoridation and the development of bone cancer in young males, the public’s concerns are understandable. To help readers make some sense of this matter, it’s important to filter the facts. So, is fluoridated water safe and healthy for children and adults to drink?

What is fluoride?

Fluoride is a chemical compound that combines the element fluorine with another substance, usually a salt or metal. Common compounds like calcium fluoride are used in the manufacturing industry, though fluoridated water contains three compounds said to improve dental health:

• Sodium fluoride
• Sodium fluorosilicate
• Fluorosilicic acid

Fluorides are naturally occurring compounds, commonly found in soil, water and air samples around the world, but the levels of these substances are usually much lower than in fluoridated drinking water. Fluoride levels in rivers, lakes and surface waters typically equal 0.1-0.2 ppm.

Why is fluoride added to drinking water?

The addition of fluoride to drinking water has been proven to protect teeth from decay. Naturally occurring bacteria in the mouth produce acids when introduced to sugars. These acids can eat away at the minerals on the surface of the tooth, weakening the structure and causing cavities.

Fluorides are easily absorbed into the blood via the digestive tract when consumed, typically collecting in areas high in calcium such as the bones and the teeth. For this reason, the regular consumption of fluorides can help to prevent tooth decay by gradually strengthening the teeth. This is also why fluorides are often found in dental products like toothpastes and mouthwashes.

Is fluoridated drinking water regulated?

Since the 1960’s, the United States Public Health Service (PHS) has recommended that all public water supplies contain 0.7mg/L of fluoride to aid in the prevention of tooth decay. Though the addition of fluoride to drinking water is not required by law in every state.

As overexposure to fluoridated drinking water can contribute to a dangerous build up of fluoride in the bones (skeletal fluorosis), the US Environmental Protection Agency (EPA) has developed a national drinking water standard. This permits no more than 4 mg/L of fluoride to be present in any public drinking water systems.

In addition, a secondary standard has been developed by the EPA recommending no more than 2 mg/L to protect young children from overexposure to fluorides. For comparison, natural levels of fluorides in water sources like springs, rivers and lakes are often equal to about 0.1-0.2 mg/L.

Possible health effects of drinking fluoridated water

Though the consumption of fluoridated water is considered safe by many national authorities, overexposure to fluoridated water has been shown to increase the risk factor for several health conditions. Most of these conditions are of particular concern to children aged 8 and below.

Skeletal fluorosis

Skeletal fluorosis is a serious condition caused by exposure to high levels of fluoride over many years. It leads to weakened bones, joint pain and stiffness.  Skeletal fluorosis can also contribute to muscular impairments in younger patients as the thickening of the bones impacts development.

Kidney damage

Excess exposure to fluorides can contribute to kidney disease, as any build up of fluorides in the soft tissue can increase the risk of fluoride toxicity. Kidney damage has been recorded at fluoride levels as low as 1 ppm in animals, with skeletal fluorosis patients facing elevated risks.

Osteomalacia

Osteomalacia is a bone-softening disease proven to be caused by overexposure to fluorides. In the 1970’s, scientists discovered excess fluorides in water used for dialysis were causing severe osteomalacia in patients. Later studies conducted with animals have also shown similar results.

Cancer

Some studies suggest exposure to fluorides from a young age may increase the risk of subjects developing osteosarcoma, a rare bone cancer. Researchers think excess fluoride in the growth plates of developing bones may cause abnormal cell growth, eventually leading to cancer.

Neurodevelopment

Research has shown a link between fluoride and neurotoxicity in animals, with a study backed by the Harvard School of Public Health finding children in high-fluoride areas demonstrated significantly lower IQ scores than those who lived in areas with low levels of fluoridated water.

How to avoid drinking fluoridated water

At present, around 73% of the US population is served by water systems containing fluoridated water, with some states mandating the fluoridation of public water systems by law. This means any US citizens wishing to avoid drinking fluoridated water must consider alternative means.

Bottled water

The easiest way to avoid drinking fluoridated water is to switch to drinking only bottled waters. However, the FDA allows a maximum fluoride level of 2.4 mg/L even in products said to contain no added fluoride. Brands like JUST Water have been shown to contain natural fluoride levels as low as 0.2 mg/L, illustrating a simple way to get clean water delivered direct to your home.

Filtered water

Alternatively, fluoridated water can be filtered via reverse osmosis, deionization or through the use of activated alumina. However, these methods will only remove up to 90% of the fluoride in water. It’s also important to note that activated carbon filters are not able to remove fluoride.

Conclusion

Though many national authorities insist fluoridated water is safe to drink, studies have shown links between overexposure to fluoride and the onset of serious health conditions, especially in children and young adults. If citizens wish to avoid drinking fluoridated water, it’s advisable to switch to bottled waters containing natural fluoride levels or to invest in effective filter systems.