These days, there are many reasons to be cautious about safe drinking water. From PFOA and lead to atrazine and perchlorate, toxins and heavy metals in water systems harm the environment and our health.
To make us healthier, municipal utilities added yet another chemical to our drinking water: fluoride. But is it safe, especially for kids? And can it make us healthier? Let us pull out some facts to find out.
In early 2014, the Lancet Neurology published an article which claimed that fluoride—added to public water supply and contained in most toothpaste—may affect brain development in children. This article attracted a lot of attention, as well as controversy.
As it turned out, the information presented in the article was simply a reiteration of the findings of a previously published systematic review, which also caused a stir on the internet. That review was primarily based on older data gathered in China, where there were some rural areas with high concentrations of naturally-occurring fluoride in public drinking water. Such a study could not establish cause-and-effect; it could only present an association.
Due to the origin of the data, it was not clear whether it was really fluoride that led to the neurodevelopmental problems of children, or other factors such as other chemicals in water supply and poor nutrition.
On the contrary, there is a mounting number of well-designed studies that demonstrate how fluoride improves dental health in both kids and adults. That is why a low concentration of fluoride is added to the public water supply of many communities since 1940s.
Some websites also claim that fluoride can cause cancer, but there is still no strong scientific evidence to prove this claim. Some anti-fluoride groups cited some research showing a link between fluoride overexposure and osteosarcoma, which is a form of bone cancer. But those researches were either from animal data or were poorly designed. Scientific and medical organizations including the American Academy of Pediatrics, the National Institutes of Health, the American Council of Science & Health, and the National Academy of Sciences all have concluded that there is no firm basis for the allegation that fluoride causes cancer. This is based on large population-based studies and a comprehensive literature review.
Over the past 7 decades, fluoride has been shown to decrease tooth decay in both children and adults. It relieves discomfort and saves money for American families and healthcare systems. In fact, drinking water fluoridation was one of the 10 greatest public health achievements of 20th century, as listed by the Center for Disease Control & Prevention.
However, there has also been some controversy when it comes to fluoridating drinking water, with the primary concern being dental enamel fluorosis. The most vulnerable to this issue are newborn babies. In the US, about a quarter of newborns drink formula since birth, and two-thirds of 3-month-olds (about 2.7 million) drink certain amount of formula. And that amount becomes even higher as they gain more months.
Liquid and powder concentrate formulas have become popular with caregivers and parents due to their cost-effectiveness and convenience. But the overexposure to fluoride can result in dental fluorosis, characterized by the formation of spots, white lines, pitting or staining on teeth. It may also weaken teeth as they may develop in the gums. The number of babies affected by dental fluorosis seems to increase over time. Some scientists say that too much fluoride may also impair neurodevelopment and other bones, as well as the brain and nervous system.
In 2015, the US Department of Health & Human Services lowered its recommended fluoride use, from 1.2 mg. fluoride per one liter of water to 0.7 mg. per liter (max). The reduced amount is aimed at balancing the benefits of fluoride to teeth against the risk of developing dental fluorosis.
Due to these recent findings, we advise parents to take necessary steps to regulate the amount of fluoride they give their babies. Ask your water provider to check if your tap water has added fluoride and if your water system follows HHS recommendations. Note that some water companies haven’t reduced the fluoride amount in the drinking water they let run in the water systems.
If your baby shows symptoms of dental fluorosis or if you’re worried about your family drinking too much fluoride, do not hesitate to talk to a pediatrician or your dentist. As your baby begins to consume solid foods (and thus his formula intake is reduced), his exposure to fluoride may go down but his risk of developing fluorosis remains until his teeth have completely developed, which will happen around the age of eight.
Let your kids use non-fluoridated toothpaste until they can rinse properly and spit out the toothpaste (this usually happens at age 2 or 3). Once they can be relied upon in doing that, they may use fluoride toothpaste to strengthen their teeth with lower risk of overexposure. Be sure to buy a child-specific brand with slightly lower concentration of fluoride and supervise his tooth-brushing to make sure he does not swallow the toothpaste.