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Is fluoridated water safe?

Here's the latest from RFK Jr.:

This probably seems like just more crankery from RFK, but it's not.......quite. The science around fluoride is currently in flux.

Some background: The EPA already places a limit on fluoride in drinking water of 4 mg per liter. The level recommended by HHS for tooth protection is well below that at 0.7 mg/l. The Safe Drinking Water Act requires EPA to review its standards every six years, and the most recent review was published three months ago. It recommended no changes.

However, a long-awaited report from the National Toxicology Program was finally released a couple of months ago, and it concluded that fluoride levels above 1.5 mg/l might be associated with IQ losses in children. It came to no conclusions about levels of 0.7 mg/l.

A federal judge took note of this last month and ordered the EPA to address it. The judge also took note of a separate small metastudy suggesting fetal IQ losses at low fluoride levels among pregnant mothers. This metastudy examined three primary studies. Two of them, from Canada and Mexico, showed an IQ loss of 2-3 points at a fluoride level of 0.7 mg/l. The third, from Denmark, showed nothing. Previous studies have also been equivocal about effects at low fluoride levels.

So things are in flux. There's good reason to think that fluoride levels above 1.5 mg/l are probably dangerous, but the research is more ambiguous about typical levels of 0.7 mg/l. In other words, RFK Jr. is being hyperbolic but, that said, things are not quite open and shut. There are legitimate reasons to think this is worth more research.

66 thoughts on “Is fluoridated water safe?

  1. Crissa

    Here we have a problem with meta studies - laces with water that high are also associated with rurak poverty. They're rare locations already. So...

    Did they use the same or different tools to rule for such?

    Anyhow, as with everything, the dose is the poison.

  2. kenalovell

    As always, the cranks will rant about the supposed horrible consequences of putting fluoride in the water without making any attempt to weigh them against the massive proven benefits.

    1. DButch

      I was one of many kids in Hawaii who got fluoridation treatments starting at about 6-7 years old - but these were direct fluoride treatment in pads clamped to my teeth! Tasted foul, and if the pads were clamped down too tight, they hurt as well.

      If there was any effect on my IQ, it sure didn't show up in any IQ tests or later aptitude tests from 7 on. And I got 1599 in my SAT score in late 1968 and my three add-on science, math, and English essay tests were all above 795 (got the records at home and my wife and I are doing "art and good eating" right now.

      I do think levels of fluorine compounds in drinking water need to be better analyzed - there are lot of unknowns in a LOT of things that have been shrugged off because they don't kill or badly impair people (enough to get people riled up), but that's a "hope and prayers" thing, not good scientific or medical judgement.

      1. D_Ohrk_E1

        I would imagine that there are far more influences on IQ than exposure levels to fluoride. Poverty, for one, is vastly more influential.

        It would be both hypercritical and hypocritical to want to eliminate fluoride from water but allow child poverty to persist.

      2. Coby Beck

        Fluoride treatments do not involve injesting, hopefully you did not swallow any of it! Topical treatments are quite different from fluoridated drinking water. I don't think it makes my top 50 list of things I think should be changed, but I am against it.

        The science is unclear about any realized benefits. There is no plausible mechanism for low concentration fluoride in drinking water changing tooth enamel. There is a lot of (mostly) equivocal evidence of potential harms. There are many other ways to improve dental health at a policy level.

        I am unaware of any other mainstream practice of mass/forced medication, which is what putting fluoride in the drinking water supply is.

        1. James B. Shearer

          "I am unaware of any other mainstream practice of mass/forced medication, which is what putting fluoride in the drinking water supply is."

          How about vitamin D in milk? Not to mention many vaccination requirements for children.

        2. lsanderson

          You are so correct! 'I am unaware of any other mainstream practice of mass/forced medication, which is what putting fluoride in the drinking water supply is.' Well, except for iodine in salt, enriched white flour, and vitamin D in milk...

          1. Elctrk

            The reason flour is "enriched" is that so much of the good stuff is removed in the milling process. If you give me $10, I'll "enrich" you by putting $3 in your wallet.

      3. Crissa

        Why would they taste bad? Fluoride doesn't taste bad.
        Why would they hurt? There's no reason for them to rub or pull your teeth.

        Like, I had them as a child, too - because my parents had weak enamel - but they came in an array of fruit flavors and were relaxing?

        1. DButch

          Whatever the flouride was in solution with was quite sour to my taste buds and the saturated pads had spring clamps that, if not adjusted right squeezed your gums.

          Fruit flavors were not even an option dreamed of in 1956 on rural Maui.

  3. dilbert dogbert

    Went a Googling because I have this memory of living in an area with naturally fluorinated water till I was 10 years old.
    "Of the approximately 10 million people with naturally fluoridated public water supplies in 1992, approximately 67% had fluoride concentrations ≤ 1.2 mg/L (CDC 1993; see Appendix B). Approximately 14% had fluoride concentrations between 1.3 and 1.9 mg/L and another 14% had between 2.0 and 3.9 mg/L; 2% (just over 200,000 persons) had natural fluoride concentrations equal to or exceeding 4.0 mg/L.2 Water supplies that exceeded 4.0 mg/L ranged as high as 11.2 mg/L in Colorado, 12.0 mg/L in Oklahoma, 13.0 mg/L in New Mexico, and 15.9 mg/L in Idaho (see Appendix B, Table B-3).3 States with the largest populations receiving water supplies with fluoride at ≥ 4.0 mg/L included Virginia (18,726 persons, up to 6.3 mg/L), Oklahoma (18,895 persons, up to 12.0 mg/L), Texas (36,863 persons, up to 8.8 mg/L), and South Carolina (105,618 persons, up to 5.9 mg/L).
    National Academies of Sciences, Engineering, and Medicine. 2006. Fluoride in Drinking Water: A Scientific Review of EPA's Standards. Washington, DC: The National Academies Press. https://doi.org/10.17226/11571."
    Seems there would be epidemiological data supporting the dangers of Fluoride.

    1. Joel

      Yes. Like discolored teeth. But there are plenty of epidemiological data supporting the benefits of fluoride, both natural and artificial, in preventing tooth decay. The dose makes the poison. We've known this for decades.

  4. bw

    Bingo. If there are 100,000 South Carolinians drinking water at almost 4x the supposedly unhealthy level, you'd think that those towns would have such a reputation as a community of blithering idiots that scientists would eventually start studying them closely.

    But instead, at least in South Carolina-adjusted terms, they seem to be more-or-less normal.

    1. bw

      Also, the highest levels in South Carolina (the data appears to be from a USGS report from the early 1980s) seem to be in the area of Myrtle Beach - either in the city itself or maybe in the surrounding towns. I confess that I know relatively little about SC despite having a parent who currently lives there, but I don't think I've ever heard people in Myrtle Beach or environs described as particularly stupid.

  5. Citizen99

    RFK Jr gives the game away by labeling fluoride as "industrial waste." This is a way of saying "I know you might want to check into my claim before believing it, so I'll insert some really scary words that will cause your emotions to overrule your intellect. Industrial waste! That MUST be bad!"

    1. shapeofsociety

      I don't doubt that some industrial waste contains fluoride... just as some industrial waste contains water, salt, calcium, and magnesium.

    2. zic

      This; it may well be a by-product, but waste?

      That's like saying the geothermal baths in Iceland are industrial waste because most are plumbed with water from electrical plants that needs to be cooled before it can be released into the environment.

  6. hollywood

    Growing up in what was then a small town in Texas (Arlington), our water was fluoridated. I never felt any ill effects. I didn't have any cavities until about age 23. Yet people circulated conspiracy theory pamphlets suggesting that the fluoride was a Commie plot. There were also pamphlets about daylight savings time. I survived both.

  7. Paavo42

    No reference to Dr. Strangelove, so I registered to post one; this was the first thought to occur to me when I read about Mr. Kennedy's statement on YLE (Finnish public broadcaster, akin to BBC) this morning.

      1. Paavo42

        Indeed: because Gen Ripper with this concern was obviously deranged it seemed strange to me share his view. Now, thanks to Kevin, I know that there might be a real concern with water fluorine levels.

  8. golack

    They lowered the amount of fluoride added to water, and have policies in place for some time to remove excess fluoride. This should be updated as new information becomes available. Fluoride is a trace element that your body needs--but too much is bad.

  9. jdubs

    The dose is always the key. Even things like H2O or sugar can be framed as dangerous and in-flux because new research on dosing is always occuring. Also, research, testing and analysis continues on almost every vaccine.

    Framing RFK as merely 'hyperbolic' is misleading and a does readers a disservice.

        1. OwnedByTwoCats

          I love that site! The joke still amuses me, what, 27 years after that middle-schooler's science/social studies project.

    1. Joel

      I agree that framing RFK as merely 'hyperbolic' is misleading and a does readers a disservice. The clown is batshit insane. He even admitted he has a brain parasite.

  10. D_Ohrk_E1

    TIL that tea has high levels of bioaccumulated fluoride, so tea made from young leaves, such as "white" tea, have lower levels of fluoride than older leaves.

    Type of tea -- fluoride levels (mg/liter)

    Oolong -- 0.6-1.0
    Pu-erh tea -- 0.9-1.6
    Green -- 1.2-1.7
    Black -- 1.0-1.9

    Bottom line: Don't let your kids drink lots of those cold brewed tea beverages if your water already has fluoride.

    See: https://lpi.oregonstate.edu/mic/food-beverages/tea

  11. D_Ohrk_E1

    OT: I'm sure by now, everyone's seen the excitement from Ann Selzer's poll for the Des Moines Register, right? Harris +3 in Iowa! IOW, most of the polling outfits are indeed "herding" and getting it completely wrong.

    I thought she might have a chance to repeat Biden's 2020 electoral map and now I'm convinced that she might even expand upon it.

  12. RadioTemotu

    This is anti-vaxx logic: because there is a vanishingly small chance of adverse outcome (according to thoroughly questionable studies or maybe study) all positive outcomes are irrelevant.

  13. KJK

    So when "Worm Brain Jr" becomes head of the CDC or HSS, besides women needing to travel to Canada to get mifepristone and misoprostol after Il Duce signs the national abortion ban, you will need to send you kids to Canada for the currently recommended vaccine regiment.

    See you in 2029.

  14. Special Newb

    Germany and the Netherlands don't flouridate their water. Then again Europeans think Americans all having perfect teeth is creepy.

    With things like flouride in toothpaste I don't think it will do much harm to stop flouride in place where it's higher than .7

  15. JohnH

    This is preposterous. He is most certainly not being "hyperbolic." He has not weighed massive evidence that flouride is a real and present danger but understated the point at which a lower dose becomes safe (or even necessary to healthy teeth). He is just being his insane anti-science, anti-vax self, making things up out of whole cloth.

    He's the proverbial blind pig, but lying about having found an acorn. And Trump is being his usual irresponsible self in turning to him or even promising to turn U.S. health care over to him. Hey, Kevin, centrism can take you only so far.

      1. JohnH

        No matter, and I'll defer to you. But I had always heard it as pig, and Web searches for both versions do get hits. Wiktionary gives mine as a synonym for the other, so secondary but in use.

  16. NotCynicalEnough

    I seriously doubt that fluoride at the levels introduced in public water supplies has any significant effect on IQ however given that pretty much every toothpaste has flouride now it seems to be an idea that has outlived its usefullness. might as well stop and save a few bucks. I'm pretty sure that watching Fox "news" on a regular basis does lower IQ though and I wish researchers would measure that. Anecdotally I would reckon it at 10 to 20 points.

    1. ColBatGuano

      "Two of them, from Canada and Mexico, showed an IQ loss of 2-3 points at a fluoride level of 0.7 mg/l."

      Yeah, 2-3 points is not a measurable response that can be controlled for. Basing public policy on results like this would be malpractice.

  17. Elctrk

    Flouride may or may not cause harm, but that's not the primary question. The primary question is whether the cost of adding fluoride to water is creates benefits that outweigh the costs, and can those benefits be obtained in a cheaper manner?

    It stands to reason that if there is a dental benefit to fluoride, a topical application would be of much greater efficacy that adding it to one's general diet. But that hypothesis is worthy of testing.

    1. Joel

      Topical application under supervision of a dental professional is way more expensive that putting fluoride in the water supply.

  18. azumbrunn

    Regardless of toxicity I have always considered fluoridating drinking water as a waste of fluoride. Drinking water is used for laundry, toilet flushing, showers, lawn watering etc. etc. The percentage of this water that ever hits the inside of a human mouth is so small as to make the whole idea ridiculous.

    Toothpaste on the other hand is almost perfectly targeted: Most of it sees the inside of a mouth, most of it is not being swallowed. And you will have a hard time finding a toothpaste with no fluoride. Let's save ourselves the trouble and stop the fluoride in the water. It was always a bad idea (especially as fluoridated toothpastes were already available at the time these measures were introduced).

    1. bmore

      assuming everyone can afford toothpaste. have you seen the price of toothpaste lately! I know, some people have well water. but most people have public water. ACA, medicare, and Medicaid do not require dental coverage (exception is Medicaid for under 21). People.can die from de tal problems. Lower the dosage, but keep flooded for now.

  19. frankwilhoit

    There may be legitimate reasons to repeat/continue basic research on fluoride, but those reasons do not detract from the fact that all this is is Trump playing old tapes from his childhood. Like the tape about Fred gloating over Operation Wëtback; like the tape about "Communism"; like the tape about Al, for God's sake, Capone.

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