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Exposure: Fluoride

Fluoridation of Drinking Water

by Marlena Bludzien

Water fluoridation is a practice with growing opposition but yet little change in action throughout the country. The United States continues to artificially add fluoride to more than 70 percent of public water supplies even though 97 percent of developed countries do not participate in such a practice. Furthermore, some countries such as China, even take measures to reduce the levels of naturally occurring fluoride in their drinking water due to the negative effects it has on the health of the population.

Fluoride is a compound of fluorine with another element or group classified by the Food and Drug Administration as a drug “used to prevent or mitigate disease.” Fluoride is often found in tooth paste and dental hygiene products at it protects against tooth decay. The compound was first discovered in select drinking water reservoirs by dentists in the early 20 century when local patients had decreased levels of tooth decay than nearby areas. Within a few decades, Grand Rapid, Michigan became the first town in the world to artificially fluoridate their drinking water as a form of medical treatment, although administered without any requirement of informed consent. One of the first problems with water fluoridation is that everyone is exposed, even though certain groups of people, such as children, elderly, the sick etc., are more susceptible to its dangers. Moreover, since there is no way on measuring the amount of water each person drinks, it is impossible to control the amounts of fluoride individuals ingest. This has become an increasingly large problem as now there are more sources of fluoride than in the beginning of the water fluoridation program in 1962. Such sources, besides fluoridated dental products, include drinks made with treated water, tea, certain deboned meats, and some foods with pesticide residues. With all of these different sources of fluoride we now are exposed to, there is no longer a need for such water fluoridation, and many people especially children are being overexposed.

Much of the real problem with such a water treatment is that there are many studies suggesting serious potential side effects and yet very little evidence proving its safety credibility. Such negative health consequences of fluoride is the damage it may have on the human brain. In fact, The United States Environmental Protection Agency (EPA) has listed fluoride among the top 100 chemicals as having “substantial evidence of developmental neurotoxicity.” There have been over one hundred animal experiments conducted showing how the chemical compound is linked to brain damage and some even show morphological organ changes (brain and kidney) with increased levels of aluminum in the brain. Further problems associated with fluoride include damage to the outside layer of bone which is important in protecting against fractures. Some findings date back to studies conducted as early at 1945 such as the Newburgh-Kingston trial. People with kidney disease are at a higher risk of bone defects as the fluoride accumulates in the blood and bone at higher levels since the kidneys are not able to functionally excrete the chemical from the body. These high levels of fluoride increase the risk of developing skeletal fluorosis, a debilitating bone disease caused by high levels of fluoride exposure. Osteosarcoma, or bone cancer, is also an elevated risk among those exposed to fluoride as shown by numerous studies and reviews, such as those funded by the US government and the National Cancer Institute.

Water Fluoridation is an unnecessary practice that puts individuals in danger of numerous negative health effects. Not only does fluoridation raise concern over health problems but it also leads to environmental injustices among low income families who cannot afford to buy non-fluoridated. With such suggestions of strong potential hazards of fluoride treatment, more investigations and studies need to be conducted to provide robust evidence to end such a dangerous tradition.

One of the Easiest Ways

to Combat Tooth Decay

by Jason Zheng

In 1995 California passed the Assembly Bill 733, which is also known as the fluoridated drinking water act. This required water systems with 10,000 or more service connections to fluoridate their water supply. The bill (AB 733) was introduced by Assemblywoman Jackie Speier (D-Burlingame), is part of a national campaign by the US Public Health Service to introduce fluoridate water and reach the goal of 75% by 2000. The bill won approval on a vote of 42-13.

Water fluoridation prevents tooth decay, where the amounts recommended by the Division of Drink Water (DDW). The Metropolitan Water District of Southern California (MWD) began supplying fluoride in their systems in November 2007, and the San Francisco Public Utilities Commission (SFPUC) started since the 1950s.

The amount of fluoride recommended is 0.8 milligrams per liter (mg/L), which is the amount that tis deemed optimum for preventing tooth decay. The amount is below the limit set by the DDW and as well the US Environmental Agency (maximum of 4 mg/L). Water fluoridation is endorsed by many health institutes, such as the Centers for Disease Control and Prevention (CDC), American Medical Association (AMA), and the American Dental Associations (ADA). The CDC estimated in 2016 that over 74% of the US population on community water systems (CWS) are receiving fluoridated water. The fluoridation of water does not alter the taste, odor and appearance of water consumed. The CDC considers water fluoridation to be the most cost-effective method in preventing tooth decay.

Fluoride is also present in toothpaste and rinses, which is an alternative way for some people to get their fluoride needs, but the exact amount is not listed on the labels. The debate for water fluoridation goes further. At least seven cities or town across the country debate the issues of halting water fluoridation. Consumption of fluoride at higher level can lead to various thyroid problems, painful bone disease, dental fluorosis, or browning and pitting of teeth in young children. Is estimated that 10-15% of the young population who receive the recommended dosage of fluoride suffer from a degree of fluorosis. Children under the age of nine should not consume water fluoride levels exceeding 2 mg/L.

Communities can receive their way from different sources, such as East San Jose, a traditionally low-income community, tend to have the worst health outcomes. Practicing proper water fluoridation methods can also benefit those who do not have dental insurance nor the amount of money to visit a dentist. People should be allowed to be given the freedom to choose whether they want their water treated with fluoride. However, if national health care coverage can be available for all people, regardless of income, there may be a possibility of eliminating and/or decreasing fluoridation.

https://www.dentalproductsreport.com/view/5-countries-with-the-worst-oral-healthhttps://www.who.int/news-room/fact-sheets/detail/oral-healthhttps://www.mouthhealthy.org/en/az-topics/f/fluoride#:~:text=Fluoride%20is%20often%20called%20nature's,attacks%20that%20cause%20tooth%20decay.https://www.americashealthrankings.org/explore/annual/measure/water_fluoridation/state/ALLhttps://www.americashealthrankings.org/explore/annual/measure/water_fluoridation/state/ALLThe effects of lack of access to fluoride in drinking water

By Marianne Makhlouf


Fluoridated water exists in approximately 73.0% of the U.S. population which was reported in 2018 by Centers for Disease Control and Prevention (CDC). Individuals without access to fluoridated water are prone to dental caries. Dental caries, which are also known to the public as cavities, are permanently damaged areas in the hard surface of the teeth that develop into small openings. A study conducted by the United Health Foundation revealed that children who live in low-income areas(1) were less likely to live in communities with access to fluoridated water. The lack of access to fluoridated water can increase children's susceptibility to dental caries.


Although there are many other ways to access fluoride through toothpaste, and mouthwash, the most cost effective for those facing poverty is through tap water. Those who are impoverished, without access to clean drinking water are more susceptible to poor oral hygiene. Clean drinking water is essential to an individual's health span. Furthermore, contaminated drinking water can affect a person's health beyond oral health. There's a great deal of controversy on fluoridated water, and how it may be unhealthy for an individual. Although, it is proven that fluoride aids in the remineralization of fragile tooth enamel (2); which can further revert the process of tooth decay.


Tooth decay is classified as the most persistent health condition, which affects roughly 3.5 billion people (3). Many individuals with poor oral hygiene leave their health untreated due to the expenses that come with dental care; which leads to weakened, and exposed enamel. The Philippines is known to have the worst oral hygiene in the entire world. The Philippines College of Dentistry revealed to the public that 90% of resident's experience tooth decay (4). The Philippines is also known for having no fluoridation in the drinking water except for a few areas (5). Which reveals how many dental caries could be prevented with the presence of fluoridated water. Furthermore, for those who are impoverished, and can’t afford fluoride products, we should revert to more cost-effective options like drinking tap water which contains elements of fluoride.


(1)  https://www.americashealthrankings.org/explore/annual/measure/water_fluoridation/state/ALL

(2) https://www.mouthhealthy.org/en/az-topics/f/fluoride#:~:text=Fluoride%20is%20often%20called%20nature's,attacks%20that%20cause%20tooth%20decay.

(3) https://www.who.int/news-room/fact-sheets/detail/oral-health 

(4) https://www.dentalproductsreport.com/view/5-countries-with-the-worst-oral-health

(5) https://www.ppdsi.org.ph/policies-and-guidelines/policy-use-fluoride 

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