The U.S. Department of Health and Human Services is proposing a change to the recommendation for the optimal fluoride level in drinking water to prevent tooth decay. The new recommendation, 0.7 milligrams of fluoride per liter of water, replaces the previous recommended range of 0.7 to 1.2 milligrams per liter. There are several reasons for this change, including that Americans have access to more sources of fluoride than they did when water fluoridation was first introduced in the United States. The new guidance will update and replace original recommendations provided in 1962 by the U.S. Public Health Service.
This fact sheet provides information on community water fluoridation, as well as current federal activities to update guidance and regulations on community water fluoridation.
- What is fluoride?
- Why is fluoride added to water and toothpaste?
- How does fluoride work to prevent tooth decay?
- What is community water fluoridation?
- Why is the Department of Health and Human Services (HHS) developing new recommendations for community water fluoridation?
- How is HHS developing new recommendations?
- How were the recommended levels previously set for fluoride in drinking water?
Fluoride in drinking water and toothpaste more generally:
- How does fluoride get into tap water?
- Does my public water system add fluoride to the water?
- Why is EPA’s drinking water standard (referred to as the MCL or MCLG) different than HHS’ recommended optimal fluoridation level for community drinking water systems?
- What is dental fluorosis?
- Since the optimal level of 0.7 milligrams per liter of fluoride is a “recommended” level (i.e., not a nationwide level or EPA enforceable level) in community drinking water systems, how do I know whether my community has or will reduce the level of fluoride in my drinking water? Does it have to?
- Why has exposure to fluoride increased?
- In addition to water, what are other specific sources of fluoride?
- Given that we get fluoride from other sources, is it still beneficial to fluoridate drinking water?
- Why does HHS think that .7 milligrams of fluoride per liter of water is appropriate?
Potential adverse health effects from exposure:
- What are the adverse health effects of excessive fluoride exposure?
- Are children or adults exposed to too much fluoride?
- Who is at risk for excessive fluoride exposure?
- What are the effects of excess levels of fluoride and why are they different for children and adults?
- Is my child getting an appropriate amount of fluoride from drinking water and tooth brushing?
- What are the drinking water standards for maximum levels of fluoride? What do you mean by an MCL, an MCLG, and a secondary standard for fluoride? What is the difference?
- Has the safety of fluoridation been evaluated?
What people can do:
- What should I do to limit my exposure to fluoride?
- Should my children stop brushing their teeth with fluoride toothpaste?
- Should I reduce the number of times I brush my teeth daily?
- Should I refuse fluoride treatments at the dentist?
- If I am drinking water with fluoride, why do I also need to brush with toothpaste that contains fluoride?
- If they both contain fluoride, how can they work differently?
- Does toothpaste contain too much fluoride to be recommended for children?
- Are there methods I can use to remove fluoride from my drinking water at home? For example, boiling or use of commercially available water filters and units?
- Is there fluoride in infant formula? Should I try to remove fluoride from infant formula?
- Is fluoride present in mouthwash and dental whitening products?
- Does bottled water contain fluoride?