By Patrick Crow
The U.S. Public Health Service (PHS) has recommended fluoride in drinking water be limited to 0.7 mg/L, nearly half the maximum of the 0.7 to 1.2 mg/L range that was recommended in 1962.
The addition of fluoride to drinking water is known to prevent tooth decay but is contentious in many communities. PHS said nearly 75% of Americans served by public water systems receive fluoridated water.
The recommendation (not a regulation) was long expected. Department of Health and Human Services agencies and the Environmental Protection Agency first proposed the 0.7 mg/L standard in January 2011.
The Centers for Disease Control and Prevention (CDC), which was also involved in the regulatory process, has received 19,000 public comments on the recommendation in the past four years. About 700 of those were "unique" comments and the rest were duplicates. CDC said it reviewed all the remarks but found no reasons to revise its findings.
U.S. Deputy Surgeon General Boris D. Lushniak explained that the standard was reduced because Americans have access to more sources of fluoride, such as in toothpaste and mouth rinses, than they did when fluoridation was first introduced.
"As a result, there has been an increase in fluorosis, which, in most cases, manifests as barely visible lacy white marking or spots on the tooth enamel," he said. "The new recommended level will maintain the protective decay prevention benefits of water fluoridation and reduce the occurrence of dental fluorosis."
Lushniak said there still is a need for fluoridation. "Community water fluoridation continues to reduce tooth decay in children and adults beyond that provided by using only toothpaste and other fluoride-containing products." He added that fluoridation has helped reduce the prevalence of cavities in teenagers from more than 90% to about 60%.
Opponents say that there is medical evidence that fluoride overexposure may increase the risks for thyroid problems, attention deficit hyperactivity disorder, and other health issues.
Fluoride Action Network said 97% of the population of Western Europe drinks water without fluoride. "It makes far more sense for those people who want to use fluoride to brush it on their teeth and spit it out. That way you apply fluoride to the only tissue in the body that stands to benefit and don't expose every other tissue in the body," it said.
Dr. Maxine Feinberg, president of the American Dental Association, said, "Water fluoridation is effective and safe. It has now been 70 years since Grand Rapids, Mich., became the first U.S. city to begin adding fluoride to its water system. Since then, decades of studies and the experience of tens of millions of people have affirmed that water fluoridation helps prevent cavities in both children and adults. Today's [HHS] announcement is based on solid science."
The Association of Metropolitan Water Agencies (AMWA) noted that a reduction in fluoride chemical usage could mean significant cost savings for many drinking water utilities.
It said although the 0.7 mg/L standard has been anticipated since 2011 many water utilities have delayed reducing their fluoride levels until the recommendation was finalized.AMWA also said some utilities are awaiting CDC's revision of its 1995 "Engineering and Administrative Recommendations for Water Fluoridation," which will provide operational guidance for the 0.7 mg/L standard. Those recommendations are awaiting final administrative reviews prior to publication.
About the Author: Patrick Crow covered the U.S. Congress and federal agencies for 21 years as a reporter for industry magazines. He has reported on water issues for the past 15 years. Crow is now an Austin, Texas-based freelance writer.
