ATLANTA (AP) - In a remarkable turnabout, federal health
officials say many Americans are getting too much fluoride, and
it's causing splotches on children's teeth and perhaps other, more
The U.S. Department of Health and Human Services announced plans Friday to lower the recommended level of fluoride in drinking water for the first time in nearly 50 years, based on a fresh review of
The announcement is likely to renew the battle over
fluoridation, even though the addition of fluoride to drinking
water is considered one of the greatest public health successes of
the 20th century. The U.S. prevalence of decay in at least one
tooth among teens has declined from about 90 percent to 60 percent.
The government first began urging municipal water systems to add
fluoride in the early 1950s. Since then, it has been put in
toothpaste and mouthwash. It is also in a lot of bottled water and
in soda. Some kids even take fluoride supplements. Now, young
children may be getting too much.
"Like anything else, you can have too much of a good thing,"
said Dr. Howard Pollick, a professor at the University of
California, San Francisco's dental school and spokesman for the
American Dental Association.
One reason behind the change: About 2 out of 5 adolescents have
tooth streaking or spottiness because of too much fluoride, a
government study found recently. In extreme cases, teeth can be
pitted by the mineral - though many cases are so mild only dentists
notice it. The problem is generally considered cosmetic and not a
reason for serious concern.
The splotchy tooth condition, fluorosis, is unexpectedly common
in youngsters ages 12 through 15 and appears to have grown more
common since the 1980s, according to the Centers for Disease
Control and Prevention.
But there are also growing worries about more serious dangers
The Environmental Protection Agency released two new reviews of
research on fluoride Friday. One of the studies found that
prolonged, high intake of fluoride can increase the risk of brittle
bones, fractures and crippling bone abnormalities.
Critics of fluoridated water seized on the proposed change
Friday to renew their attacks on it - a battle that dates back to
at least the Cold War 1950s, when it was denounced by some as a
step toward Communism. Many activists nowadays don't think fluoride
is essential, and they praised the government's new steps.
"Anybody who was anti-fluoride was considered crazy," said
Deborah Catrow, who successfully fought a ballot proposal in 2005
that would have added fluoride to drinking water in Springfield,
Ohio. "It's amazing that people have been so convinced that this
is an OK thing to do."
Dental and medical groups applauded the announcement.
"This change is necessary because Americans have access to more
sources of fluoride than they did when water fluoridation was first
introduced," Dr. O. Marion Burton, president of the American
Academy of Pediatrics, said in a statement.
The fluoridated water standard since 1962 has been a range of
0.7 parts per million for warmer climates where people used to
drink more water to 1.2 parts per million in cooler regions. The
new proposal from HHS would set the recommended level at just 0.7.
Meanwhile, the EPA said it is reviewing whether to lower the
maximum allowable level of fluoride in drinking water from the
current 4 parts per million.
"EPA's new analysis will help us make sure that people benefit
from tooth decay prevention while at the same time avoiding the
unwanted health effects from too much fluoride," said Peter Silva,
an EPA assistant administrator.
Fluoride is a mineral that exists in water and soil. About 70
years ago, scientists discovered that people whose supplies
naturally had more fluoride also had fewer cavities.
In 1945, Grand Rapids, Mich., became the world's first city to
add fluoride to its drinking water. Six years later a study found a
dramatic decline in tooth decay among children there, and the
surgeon general endorsed water fluoridation.
And in 1955, Procter & Gamble Co. marketed the first fluoride
toothpaste, Crest, with the slogan "Look, Mom, no cavities!"
But that same year, The New York Times called fluoridation of
public water one of the country's "fiercest controversies." The
story said some opponents called the campaign for fluoridation
"the work of Communists who want to soften the brains of the
The battles continue for a variety of reasons today.
In New York, the village of Cobleskill outside Albany stopped
adding fluoride to its drinking water in 2007 after the longtime
water superintendent became convinced the additive was contributing
to his knee problems. Two years later, the village reversed the
move after dentists and doctors complained.
According to a recent CDC report, nearly 23 percent of children
ages 12 to 15 had fluorosis in a study done in 1986-87. That rose
to 41 percent in a study that covered 1999 through 2004.
"The report of discoloration has been going up over the
years," said Dr. Robert Barsley, a professor at the LSU Health
Sciences Center School of Dentistry. "It is not the water that's
causing this by any means. It's the extra fluoride products -
toothpaste, mouthwash - that people are using. And people want nice
white teeth so they brush three times a day."
Susan Jeansonne, oral health program manager for Louisiana
Department of Health and Hospitals, said one reason for the problem
is children swallowing fluoride toothpaste or eating it.
Toothpaste labels have long recommended that parents supervise
children under 6 when they are brushing their teeth; give them only
a pea-size amount; and make sure they spit it out. Toddlers under 2
shouldn't use toothpaste with fluoride.
In 2006, the National Academy of Sciences released a report
recommending that the EPA lower its maximum allowable level of
fluoride in drinking water. The report warned severe fluorosis
could occur at 2 parts per million. Also, a majority of the
report's authors said a lifetime of drinking water with fluoride at
4 parts per million or higher could raise the risk of broken bones.
In addition, in 2005, the heads of 11 EPA unions, including ones
representing the agency's scientists, pleaded with the EPA to
reduce the permissible level of fluoride in water to zero, citing
research suggesting it can cause cancer.
In Europe, fluoride is rarely added to water supplies. In
Britain, only about 10 percent of the population has fluoridated
water. It has been a controversial issue there, with critics
arguing people shouldn't be forced to have "medical treatment"
forced on them.
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