Many Americans are unaware of the fact that most public water supplies carry an increased level of fluoride. Every person should feel informed about what they are consuming and the health benefits and risks associated with it. While drinking water fluoridation is proven to be safe, the issue has been a source of much controversy over the years. Even today, when fluoride is added to drinking water supplies across the globe, misinformation and confusion over just what fluoride is and does remains widespread.

In this brief article, we’ll give you a rundown of the basics of fluoride. We’ll take a look at both the pros and cons, and let you decide for yourself if you feel fluoridation is a good thing or not. If you decide you want to rid yourself of it, we’ll also direct you towards a few ways to remove fluoride from your water.

Fluoride in Drinking Water: The Pros and Cons

Chemically speaking, fluoride is an anion of the element fluorine. Being an anion means the atom has more electrons than protons, giving the ion a net negative charge. It is found in minerals like fluorite and water in trace amounts, and it has a naturally bitter taste. Because fluoride can prevent tooth decay, you probably know it as an ingredient in your toothpaste and other personal products associated with oral hygiene.

Especially in countries with diets high in sugar, dental decay has posed a huge public health problem. Because of its properties that prevent oral decay, some governments have added fluoride in controlled amounts to public water supplies to improve the public’s dental health. The level of fluoride for the optimum prevention of tooth decay is 0.7 ppm or 0.7 milligrams of water per liter.

The practice originated in 1945 in the United States when the city of Grand Rapids Michigan, raised the levels of fluoride in its water supply, and most other cities followed suit. Today, three-quarters of U.S. cities have fluoridated water, and the World Health Organization has lauded the positive effects of water fluoridation on public health and recommended its implementation where possible.

The Fluoridation Controversy

Despite the positive press from the World Health Organization, water fluoridation certainly has had its critics, today as well as decades ago. The debate over fluoride in drinking water originated in the 1940s and ‘50s when conspiracy theorists during the Cold War believed water fluoridation was a government attempt to socialize medicine. More extreme theories included the idea that water fluoridation was a communist plot to deplete the brain power of Americans by putting toxic substances in their drinking water.

Today, the controversy has evolved past communist plots. Critics are more likely to cite the unclear efficacy of water fluoridation in preventing tooth decay as a complaint, or they feel that forcing a medical program onto the population via drinking water is a violation of the public’s rights.

Some critics have more morbidly asserted a connection between fluoride in drinking water and a higher risk of cancer. However, every major health organization in the United States has countered this allegation, promising safe and effective benefits to all those who are exposed to fluoridated water.

The Benefits of Fluoride in Water

Fluoride is naturally present in water and safe to consume.

Because trace amounts of fluoride are already found in ocean water and groundwater, adjusting fluoride amounts to a healthier level is no cause for alarm. Much like some salts are fortified with iodine and some milk with Vitamin D, fluoridated water helps the drinker reap the health benefits of this anion.

Let’s take a look at some of the benefits of having fluoride in our drinking water.

Fluoridation strengthens and protects children’s and adults’ teeth.

Studies suggest that there are considerable benefits to living in a town with fluoridated water over a town without fluoridated water, even when both communities are using fluoridated toothpaste. Water with fluoride in it prevents decay in children’s teeth and protects adults’ teeth from further decay. This prevention suggests that topical application, or direct application to the teeth, is not the only way to secure fluoride’s oral health benefits.

Fluoridation reduces unnecessary dental treatment costs.

Studies suggest that low-income children living in areas without fluoridated water will require more dental treatments than those living in areas with fluoridated water. This water saves healthcare programs a lot of money that can be allocated elsewhere. And big government programs won’t be the only ones saving money; the average lifetime cost per person to raise fluoride levels in water costs less than one dental filling!

Fluoridation reduces the disparity in oral health across income groups.

A fluoridated water supply means everybody has better teeth, not just certain groups. A 2010 study reported that “the benefits of [Community Water Fluoridation] may be larger than previously believed and that CWF has a lasting improvement in racial/ethnic and economic disparities in oral health.”

The Cons of Fluoride in Water

Poor oral health remains a significant problem among children and adults in the United States.

Despite the endorsement of water fluoridation by American health organizations, the implementation of water fluoridation has been unable to completely reverse the epidemic of poor dental health among American children and adults. Significant proportions of American children still suffer from one or more cavities before age five, and the level of tooth decay only worsens with age.

While not strictly the fault of fluoride, the fact that it has not proven a miraculous cure has fueled the fires of many fluoridation critics. Because it is very difficult to evaluate the efficacy of fluoride on a personal level, skeptics often point to poor oral health statistics as an indictment of the practice of water fluoridation. Yet, despite these claims, leading health and water management experts are certain the situation is better with fluoride than without it.

Levels of fluoride above the recommended amount can cause serious health effects.

As with any substance, too much fluoride is not healthy. In early childhood, when teeth are developing, an excess of exposure to fluoride can result in a condition called enamel fluorosis. Enamel fluorosis is characterized by a discoloration of the permanent teeth.

Before six years of age, children are likely to swallow toothpaste when brushing; this can be avoided by supervising them during tooth brushing. Young children also should avoid taking a daily fluoride supplement if they already have a significant source of fluoride elsewhere.

Because young children need less fluoride than adults and older children, you should be especially careful about infant formula. If the water used to hydrate infant formula is fluoridated, the infant may be ingesting unhealthy levels. If you are concerned this may be an issue, a low-fluoride or fluoride-free water should be used to reconstitute baby formula.

How to Remove Fluoride from Water

If for the reasons listed above, you wish to ensure there are low levels of fluoride in your drinking water, simply purchasing a water filter can do the trick. However, make sure you are purchasing a filter that will remove the fluoride. Because fluoride is a tricky-to-remove chemical element, filters which rely on mechanical filtration unfortunately won’t do the trick. Reverse osmosis, deionizers and activated alumina filters should remove up to 90% of the fluoride in your water.

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Drinking water expert Phil McNamara gives us a primer on what fluoride is and what it's doing in our drinking water.