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When the National Research Council recently announced that more than 200,000 Americans drink water containing too much fluoride, many people were confused. For years organizations such as the American Dental Association and the Delta Dental Plans Association promoted fluoride as a tool against tooth decay. Should people stop using toothpaste and mouthwash with fluoride? Should dentists stop giving patients fluoride rinses?
The answer on both counts is "no."
The research, conducted by the National Research Council for the Environmental Protection Agency (EPA) studied drinking water with naturally occurring fluoride levels at 4 milligrams of fluoride per liter (mg/L) or higher. That is about four times higher than the fluoride levels in water artificially fluoridated by municipalities.
The report did not study the effects of lower levels of fluoride. According to a statement by the Delta Dental Plans Association, "We believe it's important for the public to understand that the recent EPA report on fluoride in drinking water released on March 22, 2006, did not evaluate or question the safety of artificially fluoridated water, which falls well below the maximum allowable standards."
Optimally fluoridated water is 0.7 to 1.2 mg/L, according to U.S. Public Health Service guidelines. Municipalities that add fluoride to their water systems maintain these fluoride levels to promote oral health benefits.
While the optimal amount of fluoride helps prevent cavities, too much fluoride can lead to defects in the tooth enamel, called "enamel fluorosis." Enamel fluorosis is characterized by discoloration, enamel loss and pitting of the teeth. Enamel fluorosis can also be caused by taking more fluoride supplement than is prescribed, and swallowing fluoridated toothpaste rather than spitting it out. |
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