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Many toothpaste brands include fluoride, but surprisingly, some juices also contain this mineral.
iStockphoto/ThinkstockDuring the early 1900s, scientists determined that adding up to 1.0 parts per million (ppm) of fluoride to drinking water effectively reduced tooth decay while limiting side effects like dental fluorosis, which causes enamel discoloration and pitting. In 1945, Grand Rapids, Michigan, became the first city globally to fluoridate its water supply and study the impact on dental health. After 11 years of observing local schoolchildren, the National Institute for Dental Research reported a decline in tooth decay rates by over 60% [source: NIDCR]. Over the following decades, fluoridation became widespread across the U.S., though it remains optional in some areas.
Critics of water fluoridation argue that it exposes Americans to potential health risks and resembles government-enforced medication. They highlight that prolonged excessive fluoride intake may lead to higher risks of bone fractures and pain. Additionally, children under 8 exposed to fluoride are more prone to dental fluorosis [source: CDC]. However, fluoridation has undeniably reduced tooth decay rates, and the CDC recognizes it as one of the top 10 public health achievements of the 20th century [source: CDC].
Given the widespread endorsement of fluoride by organizations like the Environmental Protection Agency (EPA) and the American Dental Association, it’s no wonder that fluoride has been incorporated into various consumer products beyond drinking water. Nowadays, fluoride is present in items such as toothpaste, mouthwash, juices, sodas, dietary supplements, and even some pesticides. With so many sources of fluoride in our daily lives, it’s crucial to determine the safe limits of fluoride intake. Learn more about fluoride on the next page.
How Much Fluoride Is Too Much: Things to Consider
Children face the highest risk from overexposure to fluoride.
John Moore/News/Getty ImagesIn January 2011, the Department of Health and Human Services (HHS) and the EPA proposed lowering the recommended fluoride level from 0.7–1.2 milligrams per liter (mg/L) to 0.7 mg/L [source: HHS]. This adjustment was based on new scientific findings, including rising cases of dental fluorosis in children, and the increased presence of fluoride in various products. Let’s explore these and other factors that influence how much fluoride might be considered excessive:
- Children 8 Years and Younger: In the U.S., the primary health concern related to excessive fluoride is dental fluorosis, which causes enamel staining and pitting. Children are particularly vulnerable because fluorosis only impacts developing teeth. Consequently, the CDC advises restricting fluoride-containing products and using alternative water sources for children under 8 if public water exceeds 2 mg/L of fluoride [source: CDC].
- Naturally Occurring Fluoride: The EPA's maximum contaminant level goal (MCLG) for fluoride is set at 4 mg/L. In regions like the Rocky Mountains, natural fluoride levels can surpass this limit, requiring water authorities to remove excess fluoride from public drinking supplies. You can check your water's fluoride concentration at this site.
- Products Containing Fluoride: According to the CDC, up to 75% of fluoride intake comes from drinking water and processed beverages such as juices and sodas [source: CDC]. Since fluoride is also present in foods, dental products, and pesticides, it’s easy to exceed recommended levels, especially if toothpaste is accidentally swallowed.
In moderate amounts (0.7 to 1.2 mg/L), fluoride effectively prevents tooth decay. However, excessive levels (ranging from over 1.5 mg/L, as per the World Health Organization, to more than 4 mg/L according to the EPA) can lead to dental fluorosis, bone deposits, and severe conditions like skeletal fluorosis [source: WHO]. In the U.S., where fluoride levels are regulated and should not exceed the EPA MCLG of 4 mg/L, mild dental fluorosis remains the primary health concern.
Since dental fluorosis only affects children whose permanent teeth are still developing, parents of kids aged 8 and younger should be cautious about limiting their fluoride intake. Additionally, individuals in areas with high natural fluoride levels should monitor their consumption of fluoride-containing products.
Discover more fluoride facts on the next page.
