The Debated Benefits and Risks of Fluoride in Drinking Water
- Published:
- Updated: January 2, 2025
Summary
Fluoride in drinking water has been utilized for decades to enhance oral health by reducing cavities and tooth decay. However, its inclusion remains contentious due to concerns about potential risks such as skeletal fluorosis, thyroid issues, dental fluorosis, and possible links to cancer. While evidence supports its benefits, opposition highlights these risks, necessitating careful consideration. Alternatives include water filtration systems, fluoride-free toothpaste, fluoride-rich foods, and fluoride-free bottled water. The future of fluoride in drinking water will likely depend on ongoing research and community preferences.
Fluoride is a mineral that’s been added to our water in many places on Earth for more than 70 years. By keeping cavities and tooth decay at bay, fluoride should be added to the water you drink. But despite its prevalence, adding fluoride to water is still one of the most debated, highly contested ways of treating drinking water, and many question its safety and efficacy.
What is Fluoride?
Fluoride is an element that is naturally present in soil, water and most foods. We know it for its beneficial effects on teeth, restoring the enamel of teeth and fighting cavities and tooth decay. The fluoride in water that can be added is sodium fluoride, fluorosilicic acid, or sodium flurosilicate. Adding fluoride to drinking water is also known as fluoridation, and it is usually done at the plant prior to distribution to households and businesses.
The Benefits of Fluoride in Drinking Water
Fluoride’s benefits in drinking water are known and well-documented, and the dental community takes this to heart. These are just some of the main benefits of fluoride in water:
Reduced cavities and tooth decay. Fluoride can easily be used to treat cavities and decay, and it’s added to drinking water to make teeth healthier. — Fluoridated communities have up to 25% less cavities and tooth decay than unfluoridated communities.
Better dental health for children and the underprivileged. Drinking water fluoridated with fluoride can promote good dental health in children and people living in poverty, who might not have regular dental care or fluoridated foods. Those populations tend to be the ones with the most cavities and tooth decay, which is why drinking water with fluoride can be especially valuable.
Cost-effective oral health solution. Fluoride can be added to your water and is an economical way to maintain good oral hygiene as it can be provided to a huge number of people at a very affordable price. Fluoridating the water at a lower cost is an alternative to the other forms of fluoride administration – fluoride toothpaste or fluoride tablets.
The Risks of Fluoride in Drinking Water
Fluoride in our water is good, we accept the positive effects of it, but not so good. Fluoride builds up in bones, and skeletal fluorosis (joint pain, stiffness and fracture risk) can result. The condition is uncommon in water supply areas where fluoride is low but can be more prevalent in fluoridated regions.
Fluoride will disrupt normal thyroid gland function resulting in various illnesses such as hypothyroidism and goiter. This association has only limited research evidence, but a connection between high fluoride in the water we drink and impaired thyroid function has been found.
The fluoride may also make teeth whiter or streaky with dental fluorosis, which is caused by the fluoride. The most common causes are the young children who get plenty of fluoride at an early age of tooth growth.
Researchers have even attributed fluoride to a cancer risk, but this association has not been shown conclusively yet, because the research is still limited. There are studies on the relationship between fluoride and cancer — some finding a positive correlation, others none. More research is needed before we know the full extent of the harms of fluoride in water.
The Evidence for and Against Fluoride in Drinking Water
We still debate the pros and cons of fluoridated water, and there’s a lot of evidence for and against it. To the first, there’s plenty of evidence to suggest fluoride reduces cavities and tooth decay, and supports improved oral health — especially among children and the poor. This fact is backed by many studies, and fluoridation of drinking water in communities worldwide.
Meanwhile, there’s also a wealth of evidence that fluoride is bad for you – skeletal fluorosis, thyroid disease, fluorosis in the teeth, and it can be associated with cancer risk. These worries tend to stem from research that has linked fluoride to these diseases, but there is very little evidence and a lot more work needed before we really know how dangerous fluoridated water can be.
What are the Alternatives to Fluoride in Drinking Water?
If you are concerned about the potential risks of fluoride in drinking water, there are several alternatives to consider, including:
- Using a water filtration system. A water filtration system can remove fluoride from your drinking water, providing a simple and effective solution for reducing your exposure to this mineral. These systems can range from simple activated carbon filters to more complex reverse osmosis systems, and can be a cost-effective way to ensure that your drinking water is free of fluoride.
- Drinking bottled water. Some brands of bottled water are specifically marketed as being fluoride-free, and can provide an alternative source of water for those concerned about the risks of fluoride. While bottled water can be more expensive than tap water, it may be a good option for those who are concerned about the safety of fluoride in drinking water.
- Using fluoride-free toothpaste. Fluoride-free toothpaste is available for those who are concerned about the risks of fluoride, and can be a simple and effective way to reduce exposure while still maintaining good oral health. By using fluoride-free toothpaste, you can reduce your exposure to fluoride, while still receiving the benefits of oral health products.
- Consuming fluoride-rich foods. Consuming fluoride-rich foods, such as fish, tea, and certain fruits and vegetables, can help to improve oral health and reduce the need for fluoride in drinking water. By incorporating fluoride-rich foods into your diet, you can improve your oral health and reduce your dependence on fluoridated water.
The Future of Fluoride in Drinking Water
There is no real future for fluoride in water and it’s going to be a very contentious and hotly contested topic. Individual communities might decide to keep fluoride in their water; others might decide not to add it or decrease the dose. Whether or not to fluoridate drinking water is usually an individual, local or state decision made on the basis of extensive analysis of evidence, as well as public values and opinions.
After all, whether to put fluoride in our water or not is a nuanced and individual choice, and should be made after thoughtful review of the evidence, and of beliefs and values.
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