About 71% of the Earth’s surface is covered in water, but the majority of this water is not suitable for drinking. It is estimated that less than 0.3% is consumable by humans. This makes potable water an extremely valuable asset, where 2.1 billion people lack access to water that is safe to drink. Much of the potable water that is accessible is usually supplemented with fluoride or has naturally accumulated fluoride from the environment, but is this water safe to drink?
Since the 1940s, fluoridation, the process of adding fluoride to public drinking water, has been a common practice in the United States. This practice began as a result of studies showing that it helped reduce the formation of cavities. Currently, about 74.4% of the U.S. population has fluoridated public water, but there has been much debate on whether or not fluoridation is harmful to humans.
Depending on location, the levels of fluoride in public water vary. In 2015, the recommended level of fluoride in water by the U.S. Department of Health and Human Services was changed to 0.7 milligrams of fluoride per liter of water (mg/L), compared to the previous recommendation of 0.7 to 1.2 mg/L in 1962. These changes were brought about due to fluoride now being much more accessible than in previous decades. Fluoride can now be found in most dental products such as toothpastes and mouthwash.
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One of the major arguments against fluoridation is that some individuals may drink more water than others, which can lead to higher levels of exposure to fluoride. New studies have also shown that fluoride primarily works topically, where it only needs to be applied externally, such as when you brush your teeth with a fluoride-rich toothpaste and does not necessarily have to be consumed.
Due to the increased accessibility to fluoride-enriched products, studies by the Centers for Disease Control and Prevention (CDC) have also seen an increase in the prevalence of fluorosis, which is staining of the teeth ranging from white spots to yellow or dark brown pits resulting from exposure to fluoride over time in kids ages 12 to 15. The Environmental Protection Agency (EPA) recommends that fluoride levels should not exceed 2.0 mg/L, which is suggested to protect children against fluorosis.
Additional studies have also shown that extremely high levels of fluoride have been shown to cause neurotoxicity in adults, as well as negative repercussions on the neurological development in children. Although there might be other side effects resulting from high levels of fluoride exposure, more studies need to be conducted to further understand the impact of chronic exposure to fluoride, as well as if fluoridation is still necessary with accessibility to fluoride-enriched products.
Overall, the levels of fluoride added to public water are deemed safe by the CDC. It is considered one of the most cost-effective ways of delivering fluoride to people of all backgrounds, which has resulted in the reduction of tooth decay in adults and children.
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