New Fluoride Recommendation

— January 2011

Is There a Middle Ground for Fluoridation of Drinking Water?

Public officials are quick to reassure us about the safety of our drinking water even when there may be potential pollutants, such as prescription drugs. This is not to disparage the job that public water suppliers do, and there needs to be a line drawn somewhere when it comes to dangerous contaminants. As American Dental Association President Dr. Raymond F. Gist has commented, “with science on their side … we have always looked to the federal health agencies to guide us on this and other public health matters.”

Following the January 2011 commitment by the Department of Health & Human Services and Centers for Disease Control and Prevention (HHS/CDC) to both maintain its recommendation to add fluoride to tap water, but push it down to the lowest level to prevent tooth decay. American Water Works Association (AWWA) executive director David LaFrance issued a tepid statement both commending government agencies for affirming the importance of community water fluoridation and for taking into account multiple sources of exposure.

This reaction from one of public water suppliers’ most credible voices underscores why people often have conflicts with regard to the safety of their tap water.

From people that I have spoken with, mixed messages regarding drinking water all too frequently confuse people about what to drink; may reduce consumption; or worse, because of the confusion, keep some people from drinking water altogether.

This blog is dedicated to the importance of drinking water over less healthy beverages. When it comes to the health of our teeth, the best advice is to cut out the junk food and high-sugar beverages that build up acid. This is especially important for children’s teeth. In areas with really bad dental health, it’s the diet and the acids and bacteria in the mouth causing the biggest problems; and a dose of fluoride in our tap water can help protect teeth.

I’ll cover many topics about contaminants in drinking water as well as the benefits of consuming water in the future, but this blog specifically deals with fluoride. Community water fluoridation has been labeled one of 10 great public health achievements of the 20th century by CDC. Over time, the occurrence of decay in at least one tooth among U.S. children was reduced from about 90 percent to 60 percent.

But times have changed since Grand Rapids, MI became the world’s first city to add fluoride to its water supply in 1950. And the problem now is that kids ages 12 through 15 increasingly experience a splotchy tooth condition.

Also, CDC says the problem has grown far more common since the 1980s. The unnerving update is that two in five teens in America show signs of what the medical community calls dental fluorosis (streaking, spotting or pitting of teeth), but what its harshest critics call “fluoride poisoning.”

HHS/CDC maintain that dental fluorosis in the U.S. mostly appears as, “barely visible lacy white markings or spots on the enamel.” And the government says that the severe form of dental fluorosis, staining and pitting on the tooth surface, is rare.

And while Youtube videos show that people sensitive to fluoride can be crippled with neurological problems, arthritic pain, and autoimmune responses, HHS assistant secretary for health, Dr. Howard Koh, thinks fluoridation’s effectiveness in preventing tooth decay is not limited to children, but extends throughout life, resulting in improved oral health.

Concerns remain, however, and on January 7, 2011, HHS/CDC recommended changing the fluoride standard in tap water to a single lower level to replace a range.

One of water fluoridation’s big advantages — that it benefits all residents of a community, “at home, work, school or play,” according to Health and Human Services’ Dr. Koh, is also problematic given new scientific data that recognizes that people now have access to more sources of fluoride, which prompted the AWWA reaction above.

Dr. Robert Barsley, a professor at Louisiana State University’s Health Sciences Center School of Dentistry told the LA Times that the main problem is the extra fluoride in toothpaste, mouthwash, etc. that people use. “And people want nice white teeth so they brush three times a day.”

The result is that it’s also hard to know how much is actually being consumed, especially because only two-thirds of Americans actually get added fluoride to their drinking water.

Summing it up, fluoride in tap water is a complex issue for many reasons. While government will maintain the practice, critics claim that science is on their side and that fluoridation should be banned.

Questions that I will tackle in future blogs include critics’ claims that fluoride used in tap water is hazardous to health; fluoride concerns for infants; fluoride and water filtration; fluoride in bottled water and well water; and topical vs systemic applications.

(1) [January 8, 2011,]

Photo: Dental Fluorosis

About Me

Jonathan Hall is a drinking water advocate. He blogs at and has worked as an independent strategy and social media content consultant.