Fluoride is back in the news after entering the US.health tsarRobert F. Kennedy Jr requested his removal from drinking water.
At the same time, the Australian Medical Association (Queensland) recently urged local councils to restore fluoride in water supplies, amid rising cases of oral disease.
So what is fluoride and why is it so controversial?
What is fluoride?
Fluorine is a natural substance it is found in rocks (for example, the mineral fluorite) as well as in water sources, soils and plants.
THE Australian drinking water guidelines recommend three compounds for water fluoridation: sodium fluoride, sodium fluorosilicate and fluorosilicic acid.
Typically, one of these compounds is added – under carefully monitored conditions – during the treatment of drinking water before it is sent to the tap.
Is it good for our teeth?
Fluoride helps prevent tooth decay by making tooth enamel stronger acid resistant from bacteria in your mouth.
The addition of small amounts of fluoride to drinking water to prevent tooth decay began in the United States in 1945. This arose from health officials in a Colorado town who noticed that residents had stained but remarkably healthy teeth.
This was traced to the high levels of naturally occurring fluoride in the local water. Research later confirmed while Excess fluoride can cause cosmetic discolorationlower concentrations still prevent caries without harmful side effects.
In Australia, fluoride was first added to water Beaconsfield, Tasmania in 1953.
Today, about 90% of Australians have access to fluoridated water at levels in between 0.6 to 1.1 mg/L. This is estimated to have reduced caries in Australia by 26–44%.
This depends on where you live, as there are different policies in different states and territories. For example, about 28% of Queenslanders they do not have fluoridated water.
What are people worried about?
There has always been opposition to fluoridation. This includes the argument It is “government overreach” since we cannot easily opt out of drinking tap water.
A 2019 study also claimed that fluoride affected children’s IQ. But this work was done was heavily criticized and detailed study of 2024 serious weaknesses in the design of the study.
Multiple reviews of high quality studies from many different countries including US and Australiathey found no evidence of damage.
One study followed people over 30 yearstested their IQ at various ages and found no relationship between fluoride levels and IQ scores.
Looking at what is safe
It makes sense to want to know what’s in our drinking water and make sure it’s safe. But discussions of toxicity are meaningless without context.
Too much fluoride intake can have harmful effects, such as weakened bones (skeletal fluorosis). But the key word is “excessive”.
Anything may be toxic in humans if the dose is too high, even water itself. The amount of fluoride needed to cause harm is far greater than what you get from drinking water.
In Australia, the The National Health and Medical Research Council recommends states and territories fluoridate their drinking water supplies in a range of 0.6 to 1.1 mg/L.
Recently, authorities decided to deliver bottled water for children under 12 and pregnant women to two remote communities in the Northern Territory with high natural levels of fluoride (1.7 to 1.9 mg/L). This measure was taken as a precautionary measure in response to community concerns, not because harmful effects were recorded.
Lessons from places that removed fluoride
The dangers of adding fluoride to water are extremely low. However, several recent cases demonstrate the very real health risks of not fluoridating water.
The Canadian city of Calgary removed fluoride from its drinking water in 2011. Seven to eight years later, dental cavities in children were significantly higher in Calgary compared to nearby Edmontonwhich did not remove the fluoride.
In 2015, Buffalo, New York removed fluoride from its water supply. Dental problems increased the parents so much they sued the city for harming their children.
Israel is another interesting case. His introduction nationwide water fluoridation in 2002 significantly reduced children’s dental problems. This trend was reversed in 2014 when fluoridation was discontinued – despite the government introducing free dental care for children in 2010.
Equity issue
Evidence continues to show that fluoride is not only safe but has significant oral health benefits.
Some of the benefits of fluoride can be achieved through fluoride toothpaste or fluoride treatments at the dentist.
But dentistry is not included in Medicare. fluoridated water (or table salt, as used in many European countries) remains one of the fairest ways to ensure that these benefits are not just for those who can afford it.
This article is republished from The Conversation. Written by: Oliver AH Jones, RMIT University
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Oliver AH Jones receives funding from the Australian Research Council (ARC), various water utilities and the Environmental Protection Agency (EPA) Victoria for research on environmental pollution. He is also deputy director of the RMIT University Water: Effective Technologies and Tools (WETT) research centre.
