Water fluoridation – a problem or a way to healthy teeth?

Fluoryzacja wody

On January 31, a San Francisco court, presided over by Judge Edward Chen, reopened a case brought by the U.S. Food and Water Watch (in the Fluoride Action Network) against the Environmental Protection Agency (EPA). The primary complaint is fluoridation of drinking water.

History of water fluoridation and its impact on consumers’ teeth

Fluoride supplementation of drinking water has been used in the United States since 1945. It was then introduced by the Grand Rapids city government. The spectacular decline in the number of tooth cavities in school-age children led other cities in the state of Michigan to follow this path after five years. Subsequently, more water mains were incorporated, and now almost 73 percent of the water mains are being built. U.S. residents using water supplied by public services take such enriched tap water. According to the Centers for Disease Control and Prevention(CDC), widespread water fluoridation is one of the top ten medical advances of the 20th century. And it has resulted in a decrease in the incidence of dental disease in children and adults by approx. 25%.

This is an averaged value. The percentage varies depending on local conditions. The first results indicated as much as 50-70 percent improvement, but this is less noticeable in some regions. In areas where the natural fluoride content of the water is high anyway, fluorosis, or enamel staining, can occur. As a rule, however, it has a mild form.

Water fluoridation in the world

One hundred percent water fluoridation has been achieved in Singapore and Hong Kong, for example. In many countries, it is carried out on a much smaller scale. In Europe, only in Ireland does it reach levels similar to the US. Water fluoridation is either not used at all, such as in Germany (where it took place mainly in the 1950s and 1960s, and now salt is fluoridated), or applies to a few percent of the water supplied. The problem of the element’s deficiency was solved somewhat differently – with the introduction of the element in the late 1960s. i 70. Last century enriched toothpaste with it. In some countries, fluoride is added to milk. Therefore, habits from one country may not be appropriate in another, and by importing toothpaste or salt, one may expose oneself to an excess or deficiency of fluoride.

In Poland, by 2022. The fluoride limit value for drinking water quality was used in determining the ecological status of waters. In 2019 and 2020, an annual average value higher than 1.5 mg/L was found four times. Three cases are small rivers from the Upper Vistula basin – the Gostynia, Bobrek and Rakówka, and the fourth is the Swinka in the Leczna-Vlodawa Lake District.

American conspiracy theories and IQ

In the United States, the tradition of distrust of the federal government is quite alive. Sometimes these reach the form of conspiracy theories. This is also how water fluoridation is sometimes perceived. Some view imposed supplementation as a violation of freedom of choice, but as a rule, opposition to such activity is not so much on grounds of principle as based on suspicions of harming citizens. At first, there were claims that communist agents were behind the introduction of fluoridation. According to some extreme opinions, fluoride is one of the substances attributed with mind-controlling properties.

A lawsuit filed in 2017 does not involve mind control. Fluoride Action Network cites the Toxic Substances Control Act. Its claim is that fluoride in supplemented water reaches concentrations that are harmful to health, and that this is particularly true for water used to dissolve powdered milk for infants. The trial began in 2020, but has been suspended pending the publication of a National Toxicology Program report. Its findings indicate that there is moderate certainty that fluoride levels twice as high as those recommended by government agencies may be related to children’s lowered IQ.

Expert recommendations

EPA representatives argue that there is no evidence that the recommended value, i.e. 0.7 mg/L was dangerous. Experts compiling the National Toxicology Program initially indicated that water fluoridation could pose a risk to neurological development, but under criticism from scientists, they backed away from this thesis. The Fluoride Action Network disputes the researchers’ findings and accuses them of deliberately delaying the document’s publication. In his opinion, since the report failed to directly indicate safe levels of fluoride, its addition to water should be banned altogether.

Fluoride supplementation

No one disputes the fact that too much fluoride can be harmful. In some areas of India and China, the concentration of fluoride ions in water exceeds 10 mgl/l, and the assimilated dose reaches several grams per day, causing bone fluorosis. World Health Organization since 1984. reports that the content of fluoride in drinking water should not exceed 1.5 mg/L, with the proviso that its other sources should be taken into account. The limiting dose of fluoride, from water, food, oral care products, etc., is to be 6 mg per day.

At the same time, he notes that the mere presence of fluoride in water is beneficial to dental health, although he does not recommend a minimum value. The same value has been indicated by Polish drinking water quality regulations for several decades. The WHO has reviewed its guidelines several times and found no basis for changing them. The U.S. supplementation standard falls roughly in the middle of the range used worldwide of 0.5-1 mg/l. But it is also half the WHO recommendation, so commentators predict that water fluoridation will not be banned.

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