Frequently Asked Questions

What is fluoride?

Fluoride is an inorganic monatomic anion of the element fluorine. It’s created when salts from the element fluoride combine with minerals in soil and rocks. It can be found naturally, usually in trace amounts, in soil and water.

Fluoride-containing compounds, such as sodium monofluorophosphate and sodium fluoride are used in topical fluoride dental products. Hydrofluorosilicic acid and sodium fluorosilicate are used for water fluoridation.

Fluoride in water is regulated by the Environmental Protection Agency (EPA) as a contaminant.

Do we need fluoride?

No. It is now well established that fluoride is not an essential nutrient. This means that no human disease – including tooth decay – will result from a “deficiency” of fluoride. Fluoridating water supplies is therefore different than adding iodine to salt. Unlike fluoride, iodine is an essential nutrient (the body needs iodine to ensure the proper functioning of the thyroid gland). No such necessity exists for fluoride.

Does fluoride occur naturally in water?

Throughout North America and the world, most fresh ground and surface water naturally contains very low “trace” levels of fluoride, with an average concentration of less than 0.1 ppm. This is 7 to 10 times lower than the levels added by water department personnel in fluoridated communities, typically fluctuating between 0.7 to 1.0 ppm depending on daily water usage. This increase is neither a small adjustment nor typical of the naturally occurring levels found in most water sources.

While the vast majority of ground water naturally only has trace levels of fluoride, high levels can be naturally occurring. Naturally occurring fluoride in water results from the erosion of fluoride-rich rocks and soil by surface and groundwater. Fluoride can also be found in water as the result of pollution from coal-burning facilities and from the production of various products such as steel, glass, aluminum, ceramics, and semiconductors. As a general rule, the only fresh water with high levels of fluoride (other than waters polluted by fluoride-emitting industries) is water derived from deep wells.

Rather than being beneficial to teeth, high levels of naturally occurring fluorides have wreaked havoc on the health of people living in contaminated regions around the world, causing serious health ailments including disfiguring tooth damage, bone disease, ulcers, reduced IQ, thyroid disease, and infertility. Because of this, international organizations like UNICEF assist developing nations in finding ways of removing fluoride from the water.

What is water fluoridation and why is it done?

Water fluoridation is the practice of using the public’s drinking water as a delivery system to increase the amount of fluoride residents ingest on a daily basis. This is done by adding industrial waste by-products known as “silicofluorides” (i.e., hydrofluorosilicic acid and sodium fluorosilicate) to public water systems during the treatment process in either liquid or powder form to artificially elevate the fluoride content to 0.7 ppm (parts per million). Fluoridating water is intended as a medical treatment to prevent tooth decay (a non-water borne disease).

What makes fluoride different from other water treatment chemicals?

Silicofluorides are the only chemicals or water treatment process not intended to improve the safety or potability of drinking water. Unlike chlorine and coagulants that are added to purify and clarify the water, silicofluorides offer no such benefits.

Fluoride is the only chemical added to treat people who consume the water, rather than the water itself. Fluoridating water supplies can thus fairly be described as a form of mass medication, which is why most European countries have rejected the practice.

Where does the fluoride added to water come from?

The main chemicals used to fluoridate drinking water are known as “silicofluorides” (i.e., hydrofluorosilicic acid and sodium fluorosilicate). Silicofluorides are not pharmaceutical-grade fluoride products; they are unprocessed industrial by-products of the phosphate fertilizer industry. Since these silicofluorides undergo no purification procedures, batch samples and certificates of analysis that accompany shipments of fluoridation additives reveal that they’re often contaminated with elevated levels harmful toxins, including lead, aluminum, and arsenic — moreso than any other water treatment chemical. In addition, recent research suggests that the addition of silicofluorides to water is a risk factor for elevated lead exposure due to the extreme acidity of silicofluorides. They can increase corrosion of the water infrastructure, resulting in the leaching of heavy metals from pipes and fixtures into the water that residents rely on for drinking, cooking, and bottle-feeding their infants. Moreover, the caustic nature of fluoridation chemicals requires the introduction of an additional treatment chemical to the drinking water to inhibit corrosion, called orthophosphates.

What countries fluoridate their water?

Most developed nations in the world have rejected fluoridation, including 97% of western Europe. The United States, which fluoridates more than 70% of its water supplies, is an exception to this rule. According to the British Fluoridation Society, there are more people drinking artificially fluoridated water in the United States than all other countries combined.

Does fluoridated water reduce tooth decay?

If water fluoridation has a benefit, it is a minimal one. Recent large-scale studies from the United States and the United Kingdom have found little practical or statistical difference in tooth decay rates among children living in fluoridated versus non-fluoridated areas. In addition, data complied by the World Health Organization (WHO) shows that tooth decay rates have declined just as rapidly in non-fluoridated western countries as they have in fluoridated western . Read more.

Does fluoride need to be swallowed in order to prevent tooth decay?

NO. Although fluoridation of water was initially approved on the premise that swallowing fluoride is the most effective way to strengthen teeth, most dental researchers now concede that fluoride’s primary benefit comes from direct topical contact with the teeth, not from ingestion. There is no need to swallow fluoride to prevent tooth decay, whether in water or tablet form.

It is hard to overstate the importance of this point to the fluoride debate, particularly when considering that fluoride’s risks come primarily from ingestion.

How do I avoid fluoride?

If you live in a community that fluoridates its water supply, there are several options to avoid drinking the fluoride that is added. Unfortunately, each of these options will cost money (unless you happen to have access to a free source of spring water). The options include:

Spring water: Most spring water contains very low levels of fluoride (generally less than 0.1 ppm). To see the fluoride levels in popular brands of water, click here.

Water filtration: Many water filters (e.g., Brita & Pur) use an “activated carbon” filter that does not remove fluoride. Water filters that do remove fluoride include reverse osmosis, deionizers that use ion-exchange resin, and activated alumina. To learn more, click here.

Water Distillation: Distilling water is an effective way of removing fluoride from water. Whereas a water filter is installed directly into the sink, a distillation unit is a separate device that can be stored on your countertop.

For tips on how to reduce your fluoride exposure see:

What are the risks of swallowing fluoride?

Fluoride has long been known to be a very toxic substance. This is why, like arsenic, fluoride has been used in pesticides and rodenticides (to kill rats, insects, etc). It is also why the Food and Drug Administration (FDA) now requires that all fluoride toothpaste sold in the U.S. carry a poison warning that instructs users to contact the poison control center if they swallow more than used for brushing.

Excessive fluoride exposure is well known to cause a painful bone disease (skeletal fluorosis), as well as a discoloration of the teeth known as dental fluorosis. Excessive fluoride exposure has also been linked to a range of other side effects, including neurotoxicity during fetal and infant brain development, arthritis, bone fragility, dental fluorosis, glucose intolerance, gastrointestinal distress, thyroid disease, and possibly cardiovascular disease and certain types of cancer.

While the lowest doses that cause some of these effects are not yet well defined, it is clear that certain subsets of the population are particularly vulnerable to fluoride’s toxicity. Populations that have heightened susceptibility to fluoride include infants, individuals with kidney disease, individuals with nutrient deficiencies (particularly calcium and iodine), and individuals with medical conditions that cause excessive thirst.

To see a complete list of FAN’s research on fluoride’s health effects, click here.

My child has dental fluorosis. What can we do to fix it?

The tooth discoloration that fluorosis causes can be reduced, and sometimes eliminated, through cosmetic treatment. Treatment options for fluorosis, however, will depend on the severity of the fluorosis. For more information on three common treatment options.

If our water does not contain fluoride, should we give our child fluoride supplements?

Fluoride supplements were developed on the incorrect assumptions that fluoride is a nutrient and is effective when swallowed. Modern research has found that, while fluoride supplements greatly increase the risk of dental fluorosis, they do little to reduce tooth decay. Most western countries have thus begun to phase out the use of fluoride supplements, and even the American Dental Association now only recommends them for children who are at particularly high risk of tooth decay. Read more.