Fluoride in Water: The Benefits and Risks of Fluoridation in Water

Fluoridation of public water contributes to dental and bone health for most Americans. Find out more about the pros and cons of fluoride in this article.

Darrell Smith
Fluoride in Water
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Did you know that from 1966 to 1970, the average 12-year-old kid had at least four decayed, missing, or filled teeth (DMFT)? Two decades later, children within this age range showed only an average of 1.3 problematic teeth.

Fluoride, according to scientists and medical experts, is to thank for this decrease. In fact, water fluoridation is one of the Centers for Disease Control & Prevention's (CDC) top 10 public health achievements of the 20th century.

What exactly is fluoride in the first place though? What difference does it make to our dental health, and most importantly, how safe is it?

We've rounded up the main pros and cons of fluoride in this post, so be sure to keep reading!

What Is Fluoride?

Fluoride is a derivative of the naturally-occurring element fluorine. When fluorine mixes with other minerals found in the earth, it creates fluoride.

What Does It Do?

Fluoride helps in the mineralization of human bones and teeth. In fact, 99% of the fluoride in the body is in hardened or calcified tissues. Fluoride helps fortify the hardness and strength of these tissues.

In addition, fluoride helps restore some of the body's demineralized areas. Early tooth decay, for instance, can cause the affected tooth to lose some of its minerals. Fluoride can help remineralize the tooth by "replacing" some of its lost minerals.

However, as impressive as fluoride's ability to counter existing tooth decay is, the primary benefit of fluoride is its ability to prevent tooth decay.

How Exactly Does It Prevent Dental Decay?

Did you know that the human mouth is home to at least 700 bacterial species? These bacteria feast on carbohydrates such as starches and sugars that remain on the teeth.

As these microorganisms digest the carbs, they produce acids. When these acids mix with your saliva and other food debris, they form plaque. Plaque is the sticky, translucent film that forms on unbrushed teeth.

Unremoved plaque is the leading cause of dental decay all over the world. The longer plaque stays on the teeth, the more time the bacteria and its acids have to bore holes into their surfaces. When this happens, the teeth lose their mineral content, starting with the enamel.

Fluoride helps fight tooth decay by making the teeth more resistant to acids. For instance, it has been shown to change the structure of developing enamel. In this way, it helps the teeth become less susceptible to dissolving due to acid attacks.

Fluoride can also help keep dental decay at bay by discouraging bacterial growth. It appears to do so by stopping or slowing bacterial enzyme activity. The fewer bacteria and acids in the mouth, the lower the risks for tooth cavities and other dental problems.

Where Can You Find This Element?

Natural water already contains trace amounts of fluoride. In most cases though, there's too little of it for consumers to enjoy the benefits.

Fluoridation helps bridge this gap.

Fluoridation is the process of adding fluoride to something such as drinking water. In fact, fluoridated water is the most common source of this important mineral. In the US, two-thirds of consumers have access to fluoridated public water.

Various studies estimate water fluoridation to reduce risks of tooth decay by 30% to 60%.

There are also fluoridated dental-care products such as toothpaste and mouthwashes. Many dentists also provide professional fluoride treatments like topical tooth varnishes. One study found that these products reduced tooth cavities by 43%.

Time To Drink Loads of Fluoridated Water? Not So Fast

As helpful as fluoride is in helping keep your teeth healthy, too much of it can also damage your pearly whites. One of the biggest disadvantages of excessive amounts of fluoride is that it can cause fluorosis. The two main types of fluorosis are dental and skeletal fluorosis.

Dental Fluorosis

This is a cosmetic dental condition that causes lacy white spots on the teeth that are visibly "whiter" or "lighter" in color than the rest of the teeth. There are, however, severe cases wherein the spots can be yellowish or dark brown in color.

Either way, dental fluorosis results from overexposure to fluoride. According to the latest CDC study, dental fluorosis affects about 23% of people aged six to 49 in the US. The majority of these individuals suffer from very mild fluorosis.

Note that children are more prone to developing fluorosis, especially those who are eight years old or younger. After all, it's during this time that the formation of their permanent teeth occurs.

Skeletal Fluorosis

This type of fluorosis affects the skeletal system (bones) and takes many years of ingesting high levels of fluoride to develop.

In its early stages, skeletal fluorosis can cause stiffness and pain in the joints. In more severe cases, the disease can alter the structure of the bones and calcify the ligaments.

In the US, this type of fluorosis is very rare. The latest available update on this is from a 2004 letter from the CDC that indicates there have only been five reported cases of skeletal fluorosis in the US.

Still, it's best to avoid long-term overexposure to fluoride just in case.

How Can Overexposure To Fluoride Occur?

Using too many fluoridated dental products is the most common cause of fluorosis. Children are at a higher risk because many of them like the taste of fluoridated toothpaste and mouth rinses, so they swallow these products rather than spit them out.

In adults, fluorosis can occur due to excessive intake of fluoride supplements when they already drink fluoridated water. The same goes for drinking a lot of fluoride-fortified beverages with fluoridated water. People with fluoride varnish on their teeth are also at a higher risk of dental fluorosis.

How Fluoridated Is Your Water?

It's important to understand that fluoridated water is safe and potable. However, for fluoridated water to be safe for consumption, it should only contain 0.7 milligrams/liter of fluoride.

Luckily, nearly all public and community water suppliers in the US abide by this standard and make sure that the water's fluoride content remains at this level. You can call your water provider or check their website to see a local water-quality report called the Consumer Confidence Report.

If you rely on a private well, though, remember that the water won't be fluoridated unless you add it. To find out what minerals and contaminants are in your water, you should conduct regular water quality tests.

What If There's Too Much Fluoride In the Water?

What can you do if the test results show that your water supply has excessively high levels of fluoride? If you get your water from a public system, call them to file a report. They should look into the possible culprits behind the water's elevated fluoride levels.

If you have a well or private source of water, it's best to install a water filter. Note that only a few types of water filtration systems can remove excess fluoride though. Two of the most common are reverse osmosis (RO) systems and de-ionizers (ion-exchangers).

Both types of filtration systems can remove as much as 90% of fluoride in water. Studies have even confirmed that RO systems have a fluoride removal efficiency of up to 98%.

Keep the Pros and Cons of Fluoride Well-Balanced

Like everything else in life, too little or too much fluoride can make or break your dental and skeletal health. That's why it's important to keep in mind all the pros and cons of fluoride and to know how much of it's in your water. This way, you can avoid overexposure, or in the case of too little fluoride, do what you can to get more of it.

Looking to invest in a whole-house filter? Then make sure you check out our in-depth guide on how to choose the best home filtration system!

In this post: pros and cons of fluoride, fluoride in water, fluoridation of water

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