“Once I drink the water, I feel it immediately. I go from being a wilted plant to one that has been rejuvenated by the rain.” —Cameron Diaz
The process of adding fluoride into water is called water fluoridation. Around 1945, the United States became the first country to start fluoridating public water systems. It concluded this would reduce dental caries (tooth decay). The process continues today, although it is surrounded by controversy.
So what exactly is fluoride? Fluoride (F-) is a monatomic anion of the chemical element Flourine (F). In other words, Fluoride is comprised of a single Fluorine atom that has more electrons than protons, giving it a negative charge. It is naturally present in drinking water, generally in small doses (i.e., 0.01-0.3 ppm), although it sometimes occurs in high enough concentrations to cause significant adverse health effects.[i]
Fluoride, at least in the United States, is typically added in one of three forms: Sodium Flouride (NaF), Fluorosilicic acid (H2 Si F6), and Sodium Fluorosilicate (Na2 Si F6). Typically, these sources of Fluoride come from phosphate rock. Companies as diverse as cosmetics manufacturers and producers of industrial fertilizer need other materials from phosphate rock (e.g., phosphates for the production of phosphate fertilizers), and when they process phosphate rock for these purposes, Fluoride results as a byproduct.[ii] By consuming fluoridated water, low levels of fluoride develop in our saliva, reducing the rate at which the enamel of our teeth decays, and even increasing the rate at which it remineralizes during the early stages of cavity formation.[iii]
It costs the U.S. government approximately $1.02 per person to fluoridate the country’s public water supplies.[iv] Of course, in some areas, fluoride naturally occurs in greater quantities than in others, and some sources might not need any additional Fluoride at all. In New York State, the recommended target concentration of fluoride in water is 1 mg/L, and the NY State Department of Health ensures—under the supervision of the EPA—that concentration levels are maintained between 0.8 mg/L and 1.2 mg/L. Moreover, according to the Safe Drinking Water Act (SDWA), Fluoride added to the water supplies must be tested—“Fluoride that is added to drinking water is subject to a system of standards, testing, and are certified by the American Water Works Association (AWWA) and the National Sanitation Foundation/American National Standards Institute (NSF/ANSI). Both of these entities are nonprofit, nongovernmental organizations.”[v]
Although water fluoridation is common in many countries across the world, there are many reasons why some countries have decided against this practice. Israel, for instance, banned the practice in 2014, citing concerns about the inability to control how much fluoride is consumed by individuals: “One major open question is what constitutes a safe dose of fluoride. Supporters say the small amount put into water is safe, but opponents of the process point out that once the chemical is put into water, its dose cannot be easily controlled or monitored since people drink widely varying amounts of water and have different body weights and ability to process the mineral.”[vi]
In addition, many opponents of water fluoridation question its ethicality. By fluoridating public drinking water, individuals are exposed to fluoride whether they like it or not, essentially taking the decision away from individual members of the public and putting it in the hands of state and federal governments. They argue that, regardless of whether or not water fluoridation is beneficial, everyone should have the right to choose what chemicals they put into their bodies.
A third concern raised by many is that water fluoridation no longer makes sense in the developed world where topical applications of fluoride are readily available. We no longer need to force the public to ingest Fluoride when we have fluoridated toothpaste, Fluoride treatments at dental offices, and even fluoridated salts. These are products that consumers can choose to purchase or avoid, effectively giving them control over their exposure to Fluoride.
For those of us living in places where such products and advanced dental treatment is readily available, it doesn’t make sense to needlessly consume Fluoride in our water. If we’re truly worried about dental carries, we should pay attention to our diets and forego the sugars and acids that erode our tooth enamel to begin with; and if we still want to reap the potential anti-carry benefits of Fluoride, we can control our exposure to this potentially harmful element through the use of topical applications, rather than drinking fluoridated water. That’s why I have chosen to use a Fluoride reduction or removal water filtration system at home and in the shower. Fluoride is just one of the multitude of elements in the water beyond Hydrogen and Oxygen.
[i] “Fluoride in Drinking-water: Background document for development of WHO Guidelines for Drinking-water Quality.” World Health Organization, 2004, p. 2.
[ii] Reeves, Thomas G. et al. Water Fluoridation: A Manual for Engineers and Technicians. Atlanta: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, 1991.
[iii] Ibid.
[iv] Centers for Disease Control and Prevention.Recommendations for using fluoride to prevent and control dental caries in the United States. MMWR Recomm Rep. 2001;50(RR-14):1–42.
[v] “Fluoridation in New York State: Addressing Safety Concerns.” NYS DoH. <https://www.health.ny.gov/prevention/dental/fluoridation/safety.htm>
[vi] Main, Douglas. “Israel Has Officially Banned Fluoridation of its Drinking Water.” Newsweek 8/29/14 <http://www.newsweek.com/israel-has-officially-banned-fluoridation-its-drinking-water-267411>