A: Yes, it remains a concern. Although dental health has improved for many Americans, tooth decay remains the most common chronic childhood disease—five times more prevalent than asthma. Tooth decay causes problems that often last long into adulthood, affecting kids’ schooling and their ability to get jobs as adults.

A: Yes, high levels of natural fluoride in the water can cause fluorosis. “Dental fluorosis is caused by a disruption in enamel formation which occurs during tooth development in early childhood related to a higher than optimal intake of fluoride. …  After tooth enamel is completely formed, dental fluorosis cannot develop even if excessive fluoride is ingested” (ADA, “2018 Fluoridation Facts,” p. 50). 

Fluorosis Facts: A Resource for Parents and Caregivers 

A: “Reverse osmosis systems remove fluoride from household drinking water as well as the protective effects that fluoridated water has on oral health. Water softeners use an ion exchange resin that replaces calcium ion within hard water with a sodium ion that results in softer water. So, water softeners do not affect fluoride levels. “

– Angela Kennedy, PE, Former Texas Department of State Health Services, Water Fluoridation Project, Engineer

Home water filtration systems, like Pur or Brita, remove contaminants but do not advertise they remove fluoride or its protective benefits from water. 

A: Most bottle water does not contain fluoride. There are many health and dental care providers that may recommend children under the age of twelve drink bottled water with fluoride. “When bottled water without fluoride is substituted for fluoridated tap water, the advantage of regular, small amounts of healing fluoride is lost and children and adults will be more prone to cavity activity on the surfaces of their teeth,” Burton Edelstein, D.D.S., M.P.H. If you use bottled water, insure it has fluoride by checking the label.

A: No, an allergic reaction is an antigen/antibody reaction. The antigen(cause) MUST be a protein. Fluoride is not a protein and therefore cannot be the cause of an allergic reaction. If fluoride is combined with a flavoring or a preservative, they are proteins and can cause an allergic reaction. Fluoride in CWF cannot cause an allergic reaction. When a patient has a reaction to fluoride treatment in a dental office, it is a reaction to the flavoring or preservative which are antigens. It is not due to fluoride.

A: The FDA is just one of several regulatory agencies that ensure public safety.  The FDA’s authority is limited to products sold to the public and fluoride has been approved for use in toothpastes, mouth rinses and even bottled water. The FDA has no role in approving drinking water additives  pursuant to their agreement with the EPA in the early 1980’s.  Additives are covered by state regulations.  It should be noted that the FDA does not have the authority to approve many of the products we use every day.  For more information on what the FDA regulates, visit https://www.fda.gov/AboutFDA/Transparency/Basics/ucm194879.htm.

The Safe Drinking Water Act (SDWA) of 1974 confers the authority for ensuring the safety of public drinking water to the Environmental Protection Agency (EPA).  The EPA is responsible for setting drinking water standards and has the authority to regulate the addition of fluoride to the public drinking water (American Fluoridation Society).

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