In this series, "America, the Fluoridated," we explore the contentious findings surrounding fluoridation of the U.S. public water supply and answer the question of whether water fluoridation poses a risk and what we should do about it.
Previously: Fluoridation of the U.S. public water supply has been a polarizing topic both academically and politically since its start in the 1940s. Debate over its benefits and health risks has raged on as the science has continued to unfold. While some studies indicate water fluoridation can reduce cavities, others link it to side effects, including cognitive issues in children.Water fluoridation is controversial for more than its potential adverse events on people; there are also concerns about how the fluoride used in water is produced.
Not all fluoride is created equal. Naturally occurring fluoride, such as calcium fluoride (CaF2), is released into the soil as weathered crustal rock and minerals dissolve. The fluoride is then picked up by any source of water and some plants, including those we eat.
Naturally occurring calcium fluoride has the potential to cause health problems with prolonged intake or overconsumption. There are regions in the world where high amounts of calcium fluoride cause major health issues.
The article warns that more than 60 million people are possibly at risk of calcium fluoride contamination in India.
The fluoride additives in our public water system aren't the naturally occurring calcium fluoride (CaF2), however.
- Fluorosilicic acid (H2SiF6; also referred to as hydro fluorosilicate, FSA, or HFS), the form used by most water systems in the United States
- Sodium fluorosilicate (Na2SiF6)
- Sodium fluoride (NaF)
Synthetic Chemicals Added to WaterWhat are these synthetic chemicals that are added to our public drinking water?
Fluorosilicic AcidGeneral Description: “A colorless fuming liquid with a penetrating pungent odor. Corrosive to metals and tissue. Both the fumes and very short contact with the liquid can cause severe and painful burns. Used in water fluoridation, in hardening cement and ceramics, as a wood preservative.”
This chemical requires the hazard label “corrosive,” and workers handling it are required to wear protective clothing, rubber gloves, and safety glasses.
Sodium FluorosilicateGeneral Description: “A fine, white, odorless, powdered solid. Toxic by ingestion, inhalation, and skin absorption. Used as a rodenticide.”
Sodium FluorideGeneral Description: “A colorless crystalline solid or white powder, or the solid dissolved in a liquid. It is soluble in water. It is noncombustible. It is corrosive to aluminum. It is used as an insecticide. It is also used to fluorinate water supplies, as a wood preservative, in cleaning compounds, manufacture of glass, and for many other uses.”
In January 2011 the Department of Health and Human Services (HHS) update and replace the 1962 U.S. Public Health Service Drinking Water Standards recommendations for fluoride concentrations in drinking water to 0.7 mg/L.
Prior to this, the recommended range set in 1962 was 0.7 to 1.2 milligrams per liter. But large sections of the population were suffering from dental fluorosis. A 2018 study published in Preventative Nutrition and Food Science said that between 1999 and 2004, the prevalence of dental fluorosis was 41 percent in American adolescents aged 12 to 15 years.
After a review of new information regarding the high prevalence of dental fluorosis and the relationships between fluoride exposure, bone fractures, and skeletal fluorosis that began in September 2010 by a panel of scientists from across the U.S. government brought together by the Department of Health and Human Services, the recommendation was downgraded to the lowest end of the previous recommended range to minimize fluoride toxicity.
The CDC notes that this recommendation isn't an enforceable federal regulation. Fluoridation is not required by EPA as it's prohibited by the Safe Drinking Water Act from requiring the addition of any substance to drinking water for preventive health care purposes.
The CDC provides recommendations about the optimal levels of fluoride in drinking water in order to prevent tooth decay. Individual jurisdictions make their own decisions on whether to fluoridate their community’s water supplies, and some states mandate fluoridation for communities of a specific size.
CDC Argues Artificial Is the Same as NaturalThe CDC argues that because studies show that naturally occurring calcium fluoride and synthetic chemical additives have the “same fluoride ion” present, there is no difference in the health effects of fluoride depending on its source or chemical compound.
Are There Benefits?According to the CDC, drinking fluoridated water “bathes” the teeth in fluoride-enhanced saliva, thus helping to protect and build surfaces by affecting the activity of cavity-causing bacteria. They say this is a cost-effective way of reaching poorer families who may not have a balanced diet, access to a dentist, or the regular habit of brushing with fluoride toothpaste.
Critics question whether swallowing treated water allows fluoride into our bones and blood where it may be harmful to other parts of the body. They say that we must consider that if fluoride can kill enzymes in tooth bacteria, it could potentially have a damaging effect on other vital enzymes.
He warns that we need basic research to make sure that fluoridation doesn't cause adverse health risks.
In the next article:In 1945, the first real-world experiment commenced in Grand Rapids, Michigan, making it the first city in the world to fluoridate its drinking water.
By June 1950, the Surgeon General declared that any community wishing to fluoridate its water supply should be “strongly encouraged” to proceed, as noted in the CDC timeline.