Fluoridation Update

Several communities in the United States have stopped adding fluoride to their water systems.  Recently Pinellas County in Florida elected to stop adding fluoride to its public water supply although they just started the program 7 years ago.  Two hundred other communities have also stopped fluoridating in the past four years.  They are motivated by the economic downturn and by concern about the benefits of fluoride.

The US Public Health Service and the Centers for Disease Control and Prevention maintain that it is a mistake to end public water fluoridation.  The Federal government recommends water fluoridation, a practice which began in the 1940’s.  About 72% of the American population drinks fluoridated water.

Although fluoride has been demonstrated to decrease tooth decay, large amounts can lead to dental fluorosis, or brown spots on the teeth.  In 2011 The federal Department of Health and Human Services recommended reducing the amount of fluoride added to the water supply to 0.7 milligrams per liter of water.  The old standard ranged from 0.7 to 1.2 milligrams per liter.

Did you know that Suffolk County water is not fluoridated? Many times people do not realize this.

The U.S. Department of Health and Human Services (HHS) and the U.S. Environmental Protection Agency (EPA) announced this week that the recommended level of fluoride in drinking water be set at the lowest end of the current optimal range to prevent tooth decay.  The EPA is also reviewing the maximum amount of fluoride allowed in drinking water.

The new guidelines will reduce the possibility of children ingesting too much fluoride, while maintaining fluoride’s benefit in preventing dental decay.  The HHS proposed recommendation of 0.7 milligrams of fluoride per liter of water replaces the current recommended range of 0.7 to 1.2 milligrams. The new recommendation is a result of recent EPA and HHS scientific studies seeking to balance fluoride’s benefit in preventing cavities while limiting any undesirable health effects. The EPA will also determine whether to lower the maximum amount of fluoride allowed in drinking water.

Dental fluorosis may occur with excess fluoride intake while teeth are developing.      Dental fluorosis in the United States is mostly in the mild form: lacy white spots on the outside of the teeth. The severe form of dental fluorosis, including staining and pitting of the enamel, is rare in the United States.

Today we have access to more sources of fluoride than were available when water fluoridation was first introduced in the 1940s. In addition to fluoridated water, we may receive fluoride from dental products (toothpaste and mouth rinses), fluoride supplements, and fluoride applied in the dental office.

For the full report of the new recommendations see: http://www.hhs.gov/news/press/2011pres/01/pre_pub_frn_fluoride.html

A recent study published in the July 2009 issue of the Journal of the American Dental Association concludes that infants who consume infant formula have a higher risk of developing enamel fluorosis in their permanent teeth. Mild fluorosis can appear as white spots on the teeth while more severe fluorosis appears as discoloration or pitting of the teeth. Fluorosis is caused by ingesting higher than the recommended levels of fluoride.

The fluoride in infant formula may come from the industrial processes used in preparation of the formula or by the fluoride levels in the water used to reconstitute the liquid or powder formula. Breast milk has a fluoride concentration of about .02 parts per million (ppm) but fluoride concentration in formula can range from .03 to .34 ppm. Most public health organizations recommend breast-feeding, if possible, as the healthier choice for a variety of reasons.

For more information about children visit children’s dentistry.