With election season around the corner, a health-related topic that is coming up is fluoridated water. A community in Maine is considering re-adding fluoride to the water this November, as is the town of Wilkes-Barre, PA and Flagler County, FL. On the opposing side, a community in Washington State is considering removing fluoride from their water supply. Internationally, Queensland, AU, and Calgary, AB are also discussing a fluoridated water ban. We spoke to Dr. Stephen Hill of Richardson, TX for a dentist’s opinion about this debate.

What is fluoride, and what does it do?

Fluoride is an ionic compound which is derived from fluorine, which is found in many different kinds of rocks. The fluorine used in drinking water supplies is most commonly derived from the phosphorite rock- about 95% of fluoride is phosphorite-based. When applied directly to teeth (whether by toothpaste, your dentist or through your drinking water) fluoride binds to the tooth’s enamel and replaces the hydroxyl molecule, strengthening the teeth and making them more resistant to bacteria and acid.

What do the opponents say?

Opponents of fluoridated water don’t necessarily disagree that fluoride is good for your teeth. After all, there have been scores of studies proving it is. However, some studies have shown that while fluoride is beneficial topically, it has not been shown to have any benefit once ingested. Furthermore, too much fluoride has been shown to have some damaging side effects, such as brittle bones and problems with the endocrine and neurological systems. But this is very rare, and usually, is caused by excessive amounts of fluoride- not the extremely small 0.3ppm or less added to most water supplies. Still, more opponents are saying is that fluoridating water is unethical- it is essentially treating a populace without their consent.

What does a dentist say?

According to Hill, "Fluoridated water is safe, and fluoride poisoning is rare. But if you’d like to limit your fluoride intake, the first step is looking at your whole diet- not just your drinking water." Hill suggests that if your water is fluoridated and you’d like to limit your intake, you can look to eliminate fluoride elsewhere because fluoride is often added to foods and drinks. Says Hill "If you look at the foods with the highest levels of fluoride, canned fruits and vegetables are at the top of that list. Switching to frozen or fresh is an easy way to reduce your fluoride ingestion and still reap the health benefits of fruits and vegetables." Some more common sources of added fluoride include carbonated drinks, fruit juices, alcoholic beverages like beer and wine, and "enriched" cereals. Says Hill "The first three items on that list, you should already be limiting your intake. Soda, sugary fruit juices, and highly acidic drinks like wine are notoriously bad for your teeth."

As for consent, it is a matter of public record if your city or county fluoridates their public water supply. These records are easy enough to track down online or by calling your local water department. While you may not be able to choose whether or not the water that comes out of your faucet is fluoridated, knowing is half the battle. If your city does fluoridate and you do not want to ingest fluoridated water, there are still options. Bottled water is probably the easiest way to avoid fluoridated water, but you can also install a filter to your water supply that will remove the fluoride at home. Be aware, however, that not all filters can remove fluoride. The three types of filters that do filter fluoride are reverse osmosis filters, deionizers, or active alumina filters. However, Hill cautions against investing in a filter without first doing your homework. Says Hill "Before you rush out and buy an expensive filter, speak with your dentist first. At very least we can help come up with a treatment plan that will help make up for the lack of fluoridated water and still keep your teeth protected."

Ultimately, says Hill, "Fluoridated water is still recommended by the ADA, EPA, AMA and the CDC. If the risk of fluoride poison were as high as opponents would like you to believe, these groups would be the first ones telling municipalities to stop adding it."