Federal health officials Monday changed the recommended amount of fluoride in drinking water for the first time since 1962, cutting by almost half the maximum amount of fluoride that should be added to drinking supplies.
The Department of Health and Human Services recommended 0.7 milligrams of fluoride per liter of water instead of the long-standing range of 0.7 to 1.2 milligrams.
"The change is recommended because now Americans have access to more sources of fluoride, such as toothpaste and mouth rinses, than they did when fluoridation was first introduced in the United States," Dr. Boris Lushniak, the deputy surgeon general, told reporters during a conference call.
As a result, many Americans are getting too much fluoride, which is causing a big increase in a condition known as fluorosis that causes very faint white marks on people's teeth.
"The new recommended level will maintain the protective decay prevention benefits of water fluoridation and reduce the occurrence of dental fluorosis," Lushniak says.
But opponents of fluoridation and even some scientists maintain the new standard doesn't go nearly far enough. They say there's evidence that overexposure to fluoride might increase the risk for other health issues, including possibly thyroid problems, attention deficit hyperactivity disorder and even lower IQs.
"Due to the importance of having the best possible brains in the future, I think that that would suggest that we be careful about the amount of fluoride that we deliver to the population in drinking water," says Dr. Philippe Grandjean at the Harvard T.H. Chan School of Public Health.
Because fluoride is so readily available, critics argue people should be able to decide for themselves whether to use fluoride and how they get it.
"In our view it's high time for the United States to start following the approach taken by most of the Western world and stop fluoridating its water," says Michael Connett of the group Fluoride Action Network.
"It makes far more sense for those people who want to use fluoride to brush it on their teeth, spit it out and that way you apply fluoride to the only tissue in the body that stands to benefit," he says. "And you don't expose every other tissue in the body."
But the decision was welcomed by groups such as the American Dental Association. Federal health officials dismiss concerns that fluoride might cause other health problems.
"The only documented risk of water fluoridation is fluorosis, and it is primarily a cosmetic risk," says Barbara Gooch, a dentist at the Centers for Disease Control and Prevention. "Fluorosis in the milder form is not a health risk."
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Transcript
ROBERT SIEGEL, HOST:
It's something most of us consume every day, but rarely think about - the fluoride in our drinking water. The Department of Health and Human Services now says the maximum amount of fluoride in water supplies should be cut almost in half. It is the first change in that recommendation since 1962. NPR's Rob Stein has the story.
JOEL STEIN: Water fluoridation is one of the big bogeyman of modern life. Take this clip from the Cold War classic movie, "Dr. Strangelove."
(SOUNDBITE OF FILM, "DR. STRANGELOVE OR: HOW I LEARNED TO STOP WORRYING AND LOVE THE BOMB")
STERLING HAYDEN: (As Jack D. Ripper) Do you realize that fluoridation is the most monstrously conceived and dangerous communist plot we have ever had to face?
(SOUNDBITE OF GUNFIRE)
STEIN: The idea that water fluoridation is a communist plot eventually faded, and the success of water fluoridation in protecting people's teeth has been called one of history's great public health victories. But the debate about water fluoridation has hardly evaporated. Here's Michael Connett. He's with an anti-fluoride group called the Fluoride Action Network.
MICHAEL CONNETT: There's many concerns with fluoride's systemic effects on health. And in our view, it's high time for the United States to start following the approach taken by most of the Western world and stop fluoridating its water.
STEIN: For the last few years, federal health officials have been taking a look at this, and today, the deputy surgeon general, Boris Lushniak, announced a new standard. The maximum amount of fluoride that should be allowed in the water should be cut almost in half.
BORIS LUSHNIAK: Now, why did we make this change?
STEIN: Well, not really because of most of the stuff critics like Connett are worried about.
LUSHNIAK: The change is recommended because now Americans have access to more sources of fluoride, such as toothpaste and mouth rinses, than they did when water fluoridation was first introduced in the United States.
STEIN: As a result, many Americans are getting too much fluoride, which is causing a big increase in a condition known as fluorosis, which usually causes very faint, white splotches on people's teeth.
LUSHNIAK: The new recommended level will maintain the protective decay-prevention benefits of water fluoridation and reduce the occurrence of dental fluorosis.
STEIN: But skeptics maintain the new standard doesn't go nearly far enough. They say there's evidence that fluoride might increase the risk for all kinds of other health problems. Philippe Grandjean at the Harvard School of Public Health says it could even hurt babies' brains.
PHILIPPE GRANDJEAN: Due to the importance of having the best possible brains in the future, I think that that would suggest that we be careful about the amount of fluoride that we deliver to the population in drinking water.
STEIN: So he agrees with critics that people should be able to decide for themselves whether to use fluoride and how they get it - again, Michael Connett.
CONNETT: It makes far more sense for those people who want to use fluoride to brush it on their teeth, spit it out, and that way you apply fluoride to the only tissue in the body that stands to benefit. And you don't expose every other tissue in the body.
STEIN: But federal health officials dismiss concerns that fluoride might cause other health problems. Barbara Gooch is at the Centers for Disease Control and Prevention.
BARBARA GOOCH: The only documented risk of water fluoridation is fluorosis, and it is primarily a cosmetic risk. Fluorosis in the milder form is not a health risk.
STEIN: But it's clear that the debate over water fluoridation is far from over. Rob Stein, NPR News. Transcript provided by NPR, Copyright NPR.
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