Compiled by Michael F. Dolan, PhD

European Food Safety Authority Says 1.5 Milligrams of Fluoride Per Liter Limit is Not Protective

By including fluoride exposure from food and dental products, The European Union’s (EU) agency that analyzes risks associated with the food chain has concluded in a recent report that the World Health Organization’s recommended maximum level of fluoride in drinking water, 1.5 milligrams (mg) per liter, does not protect all people from its toxic effects.

“The risk assessment suggests that the current legal limit for drinking water (1.5mg/L) in the EU is not sufficiently protective,” conclude the authors.

“Based on the outcome of this assessment, a re-evaluation of the current legal limit of fluoride in drinking water seems warranted,” they concluded.

In their lengthy report, co-authored by more than 30 experts, adopted May 14, and published in the EFSA Journal, the European Food Safety Authority (EFSA) explained they were asked to conduct a new risk assessment because of recent findings that prenatal and early life exposure to fluoride has a neurotoxic effect on children’s developing brains.

“In the context of recent studies suggesting a relationship between intake of fluoride from drinking water with less than 1.5 mg fluoride/L and neurotoxicity in children, EFSA was mandated by the European Commission to carry out a consumer risk assessment for fluoride in food and drinking water, taking into account all relevant hazard information and all sources of oral exposure. The Scientific Committee considers that dental care products and fortified foods are major relevant sources and they were included in the assessment,” wrote the EFSA.“

For adults the safe level of intake is exceeded at levels of exposure associated with high contributions from all the following sources combined in descending order: drinking water, food, fluoridated discretionary salt and dental care products. Such exceedances in the subgroup of pregnant women would indicate increased risk of adverse effects on fetal neurodevelopment.

“Because the RP [reference point] derived for CNS effects (1.5 mg fluoride/L) and the RP for dental fluorosis (1.4 mg/L) are respectively equal or nearly equal to fluoride concentration corresponding to the current legal limit for drinking water, aggregate intake under the ‘legal limit 1’ scenario will lead to exceedances of the HBGVs [Health Based Guidance Value]. As a result, the current legal limit for fluoride in drinking water is not considered sufficiently protective,” they write.

The authors noted that they prioritized studying fluoride’s effects on the Central Nervous System (CNS) and thyroid and bone fractures rather than skeletal fluorosis because “it was concluded that skeletal fluorosis likely occurs at higher exposures compared to exposures resulting in bone fractures.” For many years and continuing today, advocates of water fluoridation have maintained that skeletal fluorosis is the only adverse effect from fluoride.

In what has to be considered a firm rebuff of fluoridation advocates, particularly dentists and pediatricians who disparage recent research that has uncovered fluoride’s neurotoxicity as “junk science” or “pseudo-science,” the EFSA authors write of the neurotoxicity research, “The available prospective studies examining associations with CNS development were judged to be relevant and reliable.”

Similarly, the EFSA authors note regarding recent cross section studies of fluoride’s neurotoxicity, “A large majority of those studies reported associations between fluoride concentrations in drinking water and lower IQ in children. The relative consistency of these findings observed across different populations increases the confidence in their findings.”

Reflecting the miniscule concentrations of fluoride in drinking water involved in this discussion, the authors express “reasonable confidence in the evidence from both human and animal studies suggesting that an association with neurodevelopmental outcomes may occur at relatively high fluoride exposures, i.e. above 1.5 mg/L in drinking water,” but they find the evidence for an association at lower concentrations “inconclusive.” Yet they go on to report, “it is important to note that the concentration in drinking water where adverse effects begin to occur is subject to uncertainty.”

Source: https://doi.org/10.2903/j.efsa.2025.9478

Low Fluoride Concentrations Alter Types and Distribution of Immune Cells

Concerned that the immune system plays an important role in many of the adverse health effects caused by chronic exposure to low levels of fluoride in drinking water, but aware the effects of fluoride on immune cells are poorly understood, scientists at Harbin Medical University conducted studies in humans and rats, and found that “long-term low-dose fluoride exposure impairs adaptive immunity by disrupting CD4+ T-cell distribution and function,” warning, “This persistent immune imbalance warrants attention for its long-term health implications.”

As occurred with our understanding of lead poisoning, in which certain levels of exposure were said to be safe, but were later found to be hazardous, the international safe maximum standard of fluoride in drinking water of 1.5 milligrams per liter has failed to protect people from many effects of chronic, low concentration fluoride exposure.

The Harbin authors write, “[E]merging evidence indicates that systemic damage can occur even when water fluoride levels meet the World Health Organization (WHO)-recommended limit of <1.5 mg/L. Low-fluoride exposure [humans: <1.5 mg/L, rats: <20.9 mg/L sodium fluoride (NaF), mice: <30.2 mg/L NaF, cells: <3.9 uM NaF] similarly induces skeletal tissue damage, such as dental fluorosis. It also adversely affects multiple systems, including cardiovascular, nervous, hepatic/renal, reproductive, thyroid, and immune functions.”

Regarding the immune system the authors note, “During the aforementioned tissue damage processes, the immune system plays a crucial role. As the core defense system of the human body, the immune system undertakes important functions such as immune surveillance, defense, and regulation. T cells, as critical immune cells, recognize and eliminate pathogens and aberrant cells while regulating other immune components through cytokine secretion, thereby orchestrating immune system modulation. Epidemiological and animal studies consistently show reduced CD3+/CD4+/CD8+T cell counts and altered CD4+/CD8+ratios in both endemic fluorosis populations (drinking water fluoride: 0.89–2.66 mg/L) and animal models with elevated urinary fluoride, confirming fluoride’s immunotoxicity.”

The authors also note, “Given the insidious nature of low-fluoride exposure-induced body injury, identifying more sensitive immune parameters is critical for elucidating fluorosis mechanisms and advancing early diagnosis.”

Source: https://doi.org/10.1016/j.envres.2025.122482

German Study Finds Children Overdosing on Fluoride

An analysis by scientists at the Fraunhofer Institute for Toxicology and Experimental Medicine in Hannover, Germany has found that adding up expected fluoride consumption from all sources reveals that young children in Europe, in the worst-case situation, are consuming more fluoride than recommended and even more than the considered upper tolerable limit.

Under the European Food Safety Authority guidelines, children younger than 3 years have a recommended fluoride intake of 0.7 milligrams per day (mg/d), but are actually consuming up to 2.05 mg/d. This amount even exceeds the upper tolerable limit for that age group of 1.5 mg/d.

The authors attribute most of this fluoride consumption as coming from the ingestion of fluoridated toothpaste, 80 percent of which these kids swallow.

Children between 3 and 6 years, consuming up to 2.23 mg/d, are also exceeding their recommended fluoride intake of 1.1 mg/d, but don’t exceed their tolerable upper limit of 2.5 mg/d. While the youngest children’s intake is based only on toothpaste, fish and drinking water, for the 3-6 years group consumption from mouthwash and salt is also included. Children at this age are thought to ingest only about a third of their toothpaste.

Since most European countries do not practice water fluoridation, the level of fluoride in drinking water found there is generally not more than 0.3 mg/liter, according to the authors.

Writing in the Journal of Applied Toxicology July 9th, the authors note that fluoride-related health problems are considered scarce in Europe, so the topic has not been studied very much, and they needed to use reports from other countries in their analysis.

They conclude, “Reassessing existing studies can deliver important information about possible health effects through chronic exposure to low fluoride levels.”

Source: https://doi.org/10.1002/jat.4865

Water Fluoridation Doesn’t Reduce Incidence of Emergency Department Visits

Researchers from Yale University and Nuvance Health in Poughkeepsie, NY, after examining the National Emergency Department Sample and the Centers for Disease Control and Prevention’s State Fluoridation Report, have concluded that water fluoridation does not reduce the number of atraumatic dental visits to hospital emergency departments.

“Our results indicate that there is no clear correlation between water fluoridation and number of visits to the emergency department with atraumatic dental complaints. These findings suggest that… further investigation is needed to understand the multifactorial influences on community dental health outcomes,” write Jenna LaColla and Melissa Nelson-Perron in the July issue of the Western Journal of Emergency Medicine.

The authors used data from large geographic regions in the USA, for example, reporting that the Northeast, that is 57.48 percent fluoridated, had an average incidence of 158.81 atraumatic dental visits per 100,000 from 2016 to 2019 while the Midwest, that is 90.5 percent fluoridated, experienced 186.40 atraumatic dental visits per 100,000 during the same period.

Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC12342427/

Utilities Company to End Fluoridation in Los Angeles County Systems

An Ontario, Canada-based utilities company has announced that it will end water fluoridation in systems it runs in six southern California cities this fall.

Liberty Utilities of Oakville, Ontario, with US headquarters in Salem, NH, posted a notice on its website August 8 announcing the end of fluoridation in systems that it owns or operates in six Los Angeles County cities: Compton, Los Angeles, Lynwood, Bellflower, Norwalk and Artesia.

The announcement was not accompanied by any further public comment from the company, nor has it appeared to generate any press coverage.

The US Centers for Disease Control and Prevention’s (CDC) My Water’s Fluoride on-line database website lists the Liberty Utilities-Compton system that supplies over 22,000 residents of that city of over 96,000, but that website is of limited value as it often lists the source of water as “mixed”. According to that site Lynwood receives its water from a specific water system of the City of Los Angeles that serves over 3 million residents. When the service area populations are combined, it is estimated at around 400,000 residents who will now have fluoride-free drinking water.

The City of Norwalk’s website lists Liberty Utilities as one of three water systems that serve the city. A service map on the city’s website shows a patchwork of areas served by Liberty Utilities.

Neither Bellflower nor Artesia appear to have municipal systems from an examination of their city websites. My Water’s Fluoride lists a Bellflower Municipal Water System that is non-fluoridated.

In posting its August 8 notice Liberty Utilities did not indicate why it was ending fluoridation in these systems, suggesting people with health concerns about the de-fluoridation consult their physicians.

Prof. Ashley Malin, formerly of the University of Southern California in Los Angeles, now at the University of Florida, published a report in JAMA Network Open in 2024 on prenatal exposure to fluoride in Los Angeles that found such exposure to the toxin was associated with neurobehavioral problems in the children.

According to its announcement, Liberty Utilities will end fluoridation in these systems on October 24.

Source: https://california.libertyutilities.com/uploads/Fluoride%20Letter_Updated_8-8-25.pdf

Communities Ending Fluoridation Since FAN’s Fluoridation Court Ruling: https://fluoridealert.org/content/communities-that-have-ended-fluoridation-since-the-fluoride-lawsuit-ruling/

Young Rainbow Trout Harmed by Environmentally Relevant Fluoride Exposure

Rainbow trout embryos exposed to fluoride at environmentally relevant concentrations experience reduced growth, skeletal malformations and perturbations of the thyroid hormone system, according to a new report from scientists at several European universities posted as a preprint on the internet.

Making it clear that “Fluorine is not an essential element,” they note “Endocrine disrupting chemicals (EDCs) are attracting growing interest due to their effects on humans and on the environment. Among suspected EDCs, sodium fluoride (NaF) is a widespread pollutant in aquatic ecosystems, particularly as a result of fluoridation of drinking water,” write the authors.

They review reports of fluoride’s adverse effects on numerous fish species, including the rainbow trout (Oncorhynchus mykiss) which is used as a model organism, and note, “Aquatic environments are a sink for EDCs, and aquatic organisms, especially if exposure occurs during early life stages, are particularly at risk.”

They found that at the higher levels of fluoride contamination (27.5 and 51.5 mg/L) the trout larvae were significantly shorter.

The authors note, “In the literature, exposure to environmental stressors leading to reduced growth is often linked with increased metabolic demands. These increases in energy demand are compensatory responses to an environmental stressor, e.g. implementation of detoxification, cell damage repair, and the renewal of damaged cells. This can result in a reduction in available energy for growth, ultimately leading to development delays and/or growth impairments.”

They found fluoride affected the fishes’ heart rates, reporting, “In the present study, trout larvae exposed to 1.5, 5 and 27.5 mg/L suffered from tachycardia [fast rate of heart beats] following fluoride exposure” while fluoride exposure reportedly caused reduced heart rates in other fish.

While the fluoride did not affect thyroid hormone levels, the toxin alters

the transcription of key genes involved in the thyroid endocrine system in a dose-dependent manner, and appeared to increase thyroid activity. The authors suggested the juvenile fish may not have yet started producing their own hormones, as they still contained the yolk sac derived from the mother.

The authors conclude, “Sodium fluoride is commonly used in industrial processes, for water fluoridation, and in dental care products. Anthropogenic sources, in addition to natural ones, can lead to fluoride release in the environment. Aquatic organisms are therefore particularly at risk. Moreover, due to the evolutionary conservation of endocrine systems across animal taxa, similar effects on the thyroid hormone system might be expected in other vertebrates than rainbow trout, including humans, which contributes to growing health concerns about sodium fluoride.”

Source: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5380475

•• Michael Dolan can be contacted at <mdolan.ecsn@outlook.com>