{"id":79327,"date":"2024-12-13T12:14:16","date_gmt":"2024-12-13T19:14:16","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=79327"},"modified":"2024-12-13T12:14:16","modified_gmt":"2024-12-13T19:14:16","slug":"the-truth-about-fluoride-in-water-a-public-health-story-with-colorado-roots","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/the-truth-about-fluoride-in-water-a-public-health-story-with-colorado-roots\/","title":{"rendered":"The truth about fluoride in water: A public health success story with Colorado roots"},"content":{"rendered":"
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\"What
Fluoride in water has dramatically reduced cavities and tooth decay for children. It has also helped adults keep more of their teeth. Photo: Getty Images.<\/figcaption><\/figure>\n

Fluoride is a naturally occurring mineral, and local communities across the U.S. decide whether to add fluoride to water supplies in order to reduce cavities.<\/p>\n

The history of fluoride in water has a fascinating Colorado connection. Back in 1901, a young dental school graduate named Frederick McKay moved to Colorado Springs and while launching his dental practice, noticed brown stains on the teeth of children in Colorado Springs. McKay worked for years to understand the cause of the staining and decades later, he and other dentists and researchers confirmed that the staining was linked to naturally-occurring fluoride in Colorado Springs\u2019 water. They also found naturally-occurring fluoride in other communities around the country. (Learn how McKay<\/a> and others figured out that fluoride in water was decreasing cavities and improving dental health.)<\/p>\n

While high levels of natural fluoride in water caused brown stains, dentists also learned that fluoride strengthened the protective coating on teeth and prevented tooth decay. That’s what led public health experts to start adding safe amounts of fluoride to water supplies. The first community to do so was Grand Rapids, Michigan in 1945. The results were stunning. After 10 years, dentists found that the rate of cavities in children in Grand Rapids dropped by 60%.<\/p>\n

As fluoridated water has reemerged as a hotly-debated health topic, we consulted with a dental expert to answer frequently asked questions about fluoride and public health.<\/p>\n

Dr. Bruce Dye<\/a> is a professor at the University of Colorado School of Dental Medicine<\/a> on the Anschutz Medical Campus<\/a>. He is also chair of the Department of Community Dentistry and Population Health and is a co-author of the seminal U.S. study: \u201cOral Health in America.<\/a>\u201d<\/p>\n

Dye also previously worked at National Institute of Dental and Craniofacial Research<\/a> at the National Institutes of Health<\/a>.<\/p>\n

What is fluoride?<\/strong><\/h2>\n

\u201cFluoride is a mineral that exists naturally in various concentrations in different places in the country and around the world,\u201d Dye said.<\/p>\n

\u201cFluoride is in rock and soil and there can be a lot of fluoride in water because it\u2019s attracted to water,\u201d he said.<\/p>\n

Can there be too much or too little natural fluoride in water?<\/strong><\/h2>\n

Yes, there can be too much. That\u2019s what happened in Colorado Springs and in some other communities when dentists like Frederick McKay noticed some brown discoloration on people\u2019s teeth more than a century ago.<\/p>\n

\u201cThe natural levels in some places could be much higher than we would recommend, for instance, to prevent dental caries,\u201d Dye said.<\/p>\n

Some water managers dilute the amount of naturally-occurring fluoride in municipal water supplies. In other areas where there is very little naturally-occurring fluoride in water supplies, utility managers add small amounts of fluoride to water to help prevent tooth decay.<\/p>\n

What are dental caries?<\/strong><\/h2>\n

Dental caries or tooth decay is a disease process that causes tooth enamel to weaken, creating damage, tooth infection and potential pain. Dentists and public health experts more commonly use the phrase dental caries rather than talking about cavities.<\/p>\n

Does Colorado Springs add fluoride to its water now?<\/strong><\/h2>\n

No. Colorado Springs water managers dilute the amount of fluoride in the city\u2019s water since naturally-occurring fluoride is plentiful in the Pikes Peak region. If you live in the area, you can check out an interactive map<\/a> to see how much fluoride is in your water.<\/p>\n

Do other <\/strong>communities in Colorado and around the U.S <\/strong>add fluoride to water?<\/strong><\/h2>\n

Local community leaders decide whether to add fluoride to water. You can look up information about communities that add fluoride<\/a> to their water through the U.S. Centers for Disease Control and Prevention (CDC).<\/p>\n

About 63% of people in the U.S. live in communities with fluoridated water<\/a> supplies.\u00a0<\/strong><\/p>\n

Who decides whether to add fluoride to water supplies, and who determines safe levels?\u00a0<\/strong><\/h2>\n

No arm of the federal government requires communities to add fluoride to water.<\/p>\n

\u201cIn the United States, the decision to add fluoride to a public water system is made by local communities. The federal government and the CDC don\u2019t make that decision,\u201d Dye said.<\/p>\n

\u201cThe FDA (U.S. Food and Drug Administration) doesn\u2019t regulate adding fluoride to water,\u201d Dye said. \u201cNone of the regulatory agencies within the HHS (U.S. Department of Health and Human Services) mandate fluoride.<\/p>\n

\u201cSo adding fluoride to water systems is voluntary, and communities, through their elected officials, make the decision about whether to add fluoride or not,\u201d he said.<\/p>\n

An entity called the U.S. Public Health Service has determined safe levels of fluoride in water.<\/p>\n

What is the recommended level of fluoride in water?<\/strong><\/h2>\n

Experts at the U.S. Public Health Service recommend a level<\/a> of .7 milligrams per liter of fluoride in drinking water.<\/p>\n

\u201cThe primary reason for this current recommended level is that there\u2019s a recognition that people are also being exposed to fluoride in other ways. For example, we have widespread fluoride in toothpaste.<\/p>\n

\u201cSo, we want to maximize the benefit for cavity prevention while minimizing dental fluorosis,\u201d Dye said.<\/p>\n

Fluorosis is when tooth enamel takes up too much fluoride, like an overexposure to fluoride.<\/p>\n

\u201cIt\u2019s mostly a cosmetic issue. In mild cases it can cause white spots or lines and in more moderate to severe cases it can cause yellowing or pitting of the teeth.\u201d<\/p>\n

Why do dentists and public health experts support adding fluoride in water?\u00a0<\/strong><\/h2>\n

\u201cThe evidence is very clear. Community fluoridation really helps children, especially those in underserved communities,\u201d Dye said.<\/p>\n

Fluoridated water is vital for kids who live in lower-income areas because many might not be getting regular dental care, be brushing their teeth every day with toothpaste that contains fluoride or be receiving fluoride varnishes that many children in higher-income areas receive during regular visits to the dentist.<\/p>\n

Public health experts with the CDC echo these recommendations, noting that fluoridated water is safe and highly cost effective<\/a> for the following reasons:<\/p>\n