United States Cuts Optimal Fluoride Level in Drinking Water

Megan Brooks

April 28, 2015

The United States has lowered the recommended level of fluoride in community drinking water, the US Department of Health and Human Services (HHS) announced April 27.

The final recommendation from the US Public Health Service for a single fluoride level of 0.7 mg/L of water replaces the previous recommended range of 0.7 to 1.2 mg/L issued in 1962.

"The change was recommended because Americans now have access to more sources of fluoride, such as toothpaste and mouth rinses, than they did when water fluoridation was first introduced in the United States," the HHS explained in a news release.

"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. The new recommended level will maintain the protective decay prevention benefits of water fluoridation and reduce the occurrence of dental fluorosis," the HHS said.

"While additional sources of fluoride are more widely used than they were in 1962, the need for community water fluoridation still continues," US Deputy Surgeon General Rear Admiral Boris D. Lushniak, MD, MPH, noted in the release.

Experts Applaud New Recommendation

In a statement, the American Dental Association applauds the new recommendation on optimal fluoride in community water systems, saying the new level "results from years of scientifically rigorous analysis of the amount of fluoride people receive from all sources."

"Water fluoridation is effective and safe," said American Dental Association President Maxine Feinberg, DDS. "It has now been 70 years since Grand Rapids, Michigan became the first US 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 announcement is based on solid science."

Joan Gluch, RDH, PhD, interim director, Division of Community Oral Health, Penn Dental Medicine, Philadelphia, Pennsylvania, told Medscape Medical News that HHS "made the right decision to accept the [Public Health Service] recommendation to set a single level of 0.7 mg of fluoride per liter in drinking water, rather than the previous range of 0.7 to 1.2 mg.

"This recommendation continues the 70-year tradition in the United States to maintain the decay prevention benefits of community water fluoridation in a safe and effective manner," Dr Gluch said.

The US Centers for Disease Control and Prevention lists community water fluoridation as one of 10 great public health achievements of the 20th century.

The US Public Health Service recommendation was published online April 27 and in the July/August issue of Public Health Reports.

Public Health Rep. Published online April 27, 2015. Full text

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