Moderate Concern

Fluoride in Drinking Water

Fluoride is added to water for dental health but causes tooth discoloration and other effects at high levels. Controversial topic with debate over benefits vs risks.

What is Fluoride?

Fluoride is a mineral that occurs naturally in some water sources. Since 1945, many US communities have added fluoride to water supplies to prevent tooth decay - a practice called water fluoridation. About 73% of Americans on public water systems receive fluoridated water.

Two Sources: (1) Natural deposits in rock and soil, (2) Intentional addition by water utilities for dental health. Some areas have naturally high fluoride requiring removal.

Health Effects

Benefits (At Low Levels)

  • • Prevents tooth decay
  • • Strengthens tooth enamel
  • • Reduces cavities by 25%
  • • Especially beneficial for children

Risks (At High Levels)

  • • Dental fluorosis (tooth discoloration)
  • • Skeletal fluorosis (bone damage)
  • • Thyroid dysfunction
  • • Reduced IQ (controversial, high exposures)
  • • Bone fractures

The Debate: Public health agencies support fluoridation as safe and effective. Critics argue risks outweigh benefits, especially for bottle-fed infants.

EPA Limits & Recommendations

EPA Maximum Contaminant Level
4.0 mg/L

Enforceable limit to prevent skeletal fluorosis

EPA Secondary Standard (Cosmetic)
2.0 mg/L

To prevent dental fluorosis (tooth discoloration)

CDC Optimal Level (For Fluoridation)
0.7 mg/L

Recommended for dental benefits with minimal fluorosis risk

Where Fluoride is Found

  • Fluoridated systems: 73% of US public water systems add fluoride
  • Natural deposits: Parts of Texas, Southwest, Midwest have naturally high fluoride
  • Industrial discharge: Aluminum, fertilizer manufacturing

Check your water utility's Consumer Confidence Report to see if your water is fluoridated and at what level.

How to Remove Fluoride

Effective Methods

1. Reverse Osmosis - 85-92% removal

Most practical home option

2. Activated Alumina - 80-90% removal

Specialized media for fluoride. Point-of-use filters available.

3. Distillation - 95%+ removal

Very effective but slow

What Does NOT Work

  • • Standard carbon filters (Brita-style) do NOT remove fluoride
  • • Boiling water concentrates fluoride
  • • Freezing does not remove fluoride
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