Dental Tribune America

US to lower fluoride in drinking water after 50 years

By Dental Tribune International
April 28, 2015

WASHINGTON, USA: U.S. health authorities have updated their guidelines for fluoride in drinking water and now recommend an optimal fluoride concentration of 0.7 mg/L. As Americans today have greater access to fluoride in the form of toothpaste and mouthrinse and owing to the increasing incidence of fluorosis due to excess fluoride, the Department of Health and Human Services sought to replace its recommendations that were issued in 1962.

Since the early 1960s, the practice of adding fluoride to public drinking water systems has grown steadily in the U.S. Nearly all water fluoridation systems in the U.S. have used fluoride concentrations ranging from 0.8 to 1.2 mg/L. With the recent update, however, this will be reduced by 0.1–0.5 mg/L, and fluoride intake from drinking water alone will decline by approximately 25 percent. The total fluoride intake will be reduced by about 14 percent.

According to the department's report issued on April 27, the new optimal concentration of 0.7 mg/L was chosen to maintain caries prevention benefits, but reduce the risk of dental fluorosis.
Although a number of studies have found that community water fluoridation has led to a significant decline in the prevalence and severity of tooth decay, data from the 1999–2004 National Health and Nutrition Examination Survey and the 1986–1987 National Survey of Oral Health in U.S. School Children indicate that over 20 percent of people aged 6–49 have some form of dental fluorosis.

Today, nearly 75 percent of Americans who are served by public water systems receive fluoridated water. In 2012, the Centers for Disease Control and Prevention estimated that approximately 200 million people in the U.S. were served by 12,341 community water systems that added fluoride to water or purchased water with added fluoride from other systems.

Artificial fluoridation of drinking water remains controversial as a public health measure, as it has been suggested that excess fluoride may have adverse health effects. For instance, it has been associated with neurodevelopmental delays in children and with the development of attention deficit hyperactivity disorder only recently.

In contrast to fluoridation policy in the U.S., many western European countries, including Austria, Belgium, Finland, Germany and Sweden, do not fluoridate their water supply. Other European countries, such as Ireland and the UK, currently add fluoride to drinking water at levels ranging from 0.2 to 1.2 mg/L.

The full report, titled "U.S. Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the Prevention of Dental Caries," can be accessed at

Click here to learn more about fluoride.

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