Table of Contents

Fluoridation Facts, 2025 E-book

• American Dental Association Executive Summary ix9
• Introduction 111
• Section 1: Effectiveness and Benefits 919
• • Question 1: What is fluoride? 919
  • Question 2: How does fluoride help prevent tooth decay? 919
  • Question 3: What is water fluoridation? 1121
  • Question 4: How much fluoride is in your water? 1222
  • Question 5: What additives are used to fluoridate water supplies in the United States? 1323
  • Question 6: Is there a difference in effectiveness between naturally occurring fluoridated water (at optimal fluoride levels) and water that has fluoride added to reach the optimal level? 1424
  • Question 7: Is water fluoridation effective in helping to prevent tooth decay? 1525
  • Question 8: With other sources of fluoride now available, is water fluoridation still an effective method for preventing tooth decay? 1828
  • Question 9: What happens if water fluoridation is discontinued? 1929
  • Question 10: Is tooth decay still a serious problem in the United States? 2333
  • Question 11: Do adults benefit from fluoridation? 2434
  • Question 12: Are dietary fluoride supplements effective in helping to prevent tooth decay? 2737
  • Question 13: The ADA Dietary Fluoride Supplement Schedule from 2010 contains the word “none” in specific boxes. Does this mean the ADA does not recommend fluoride for children? 2939
  • Question 14: What are salt and milk fluoridation and where are they used? 3040
  • Question 15: Can the consistent use of bottled water result in individuals missing the benefits of optimally fluoridated water? 3343
  • Question 16: Do home water treatment systems such as water filters, reverse osmosis, and water softeners remove fluoride from drinking water? 3545
• Section 2: Safety 3646
• • Question 17: Does fluoride in the water supply, at the levels recommended for the prevention of tooth decay, adversely affect human health? 3646
  • Question 18: Are additional studies being conducted to determine the effects of fluorides on humans? 3747
  • Question 19: Why did the USPHS issue a report in 2015 recommending 0.7 mg/L as the optimal level for fluoride in drinking water for all temperature zones in the United States? 3949
  • Question 20: What is the recommendation for the maximum level of naturally occurring fluoride in drinking water contained in the 2016 EPA6-Year Review 3? 4050
  • Question 21: What is the Secondary Maximum Contaminant Level (SMCL) for naturally occurring fluoride in drinking water established by the EPA? 4353
  • Question 22: Does the total intake of fluoride from air, water, food, and beverages in the community in the United States with drinking water fluoridated at the recommended level pose significant health risks? 4454
  • Question 23: How much fluoride is recommended to maximize the tooth decay prevention benefits of fluoride? 4656
  • Question 24: Is there a need for prenatal dietary fluoride supplementation? 4858
  • Question 25: When fluoride is ingested, where does it go? 4959
  • Question 26: Will drinking water that is fluoridated at the recommended level adversely affect bone health? 4959
  • Question 27: What is dental fluorosis or enamel fluorosis? 5262
  • Question 28: Is it safe to use fluoridated water to reconstitute infant formula? 5565
  • Question 29: What can be done to reduce the occurrence of dental fluorosis in the United States? 5666
  • Question 30: Why is there a warning label on a tube of fluoride toothpaste? 5868
  • Question 31: Is fluoride, as provided by community water fluoridation, a toxic substance? 5969
  • Question 32: Does drinking water fluoridated at the recommended levels cause or accelerate the growth of cancer? 6171
  • Question 33: Does fluoridated water cause osteosarcoma? 6272
  • Question 34: Does fluoride, as provided by community water fluoridation, inhibit the activity of enzymes in humans? 6373
  • Question 35: Does the ingestion of fluoridated water at recommended levels adversely affect the thyroid gland or its function? 6474
  • Question 36: Does fluoride affect the function of the pineal gland? 6676
  • Question 37: Does fluoride, at the levels found in drinking water that is fluoridated to the recommended levels, alter immune function or produce an allergic reaction (hypersensitivity)? 6676
  • Question 38: Is fluoride, as provided by community water fluoridation, a genetic hazard? 6777
  • Question 39: Does fluoride at the levels found in water fluoridation affect human reproduction, fertility, or birth rates? 6878
  • Question 40: For women, does drinking water fluoridated at the recommended level create a risk for their children to be born with Down syndrome? 6979
  • Question 41: Does ingestion of water fluoridated at recommended levels have an adverse effect on neurodevelopment or intelligence (IQ) or behavioral disorders in children? 7080
  • Question 42: Does drinking fluoridated water increase the level of lead in the blood or cause lead poisoning in children? 7484
  • Question 43: Does drinking water fluoridated at recommended levels cause Alzheimer’s disease? 7585
  • Question 44: Does drinking water fluoridated at recommended levels cause or contribute to heart disease? 7686
  • Question 45: Is the consumption of water fluoridated at recommended levels harmful to the kidneys? 7787
  • Question 46: What are some of the erroneous health claims made against water fluoridation? 7989
• Section 3: Fluoridation Practice 8191
• • Question 47: Who regulates drinking water additives in United States? 8191
  • Question 48: What standards have been established to ensure the safety of fluoride additives used in community water fluoridation in the United States? 8292
  • Question 49: Does fluoridating the community water supply raise concerns about lead, arsenic, and other toxic contaminants to the water supply? 8494
  • Question 50: Have fluoride additives been tested for safety? 8494
  • Question 51: What is the source of the additives used to fluoridate water supplies in the United States? 8595
  • Question 52: Does the process of water fluoridation present unusual safety concerns for water systems and water facility operators? 8696
  • Question 53: Does fluoridation present difficult engineering problems? 8797
  • Question 54: Does fluoride at levels used in fluoridation corrode water pipes? 8898
  • Question 55: Does fluoride at levels used in water fluoridation corrode glass, concrete, or other surfaces in water plants? 8999
  • Question 56: Does fluoridated water harm the environment? 8999
• Section 4: Public Policy 90100
• • Question 57: What is public health? 90100
  • Question 58: Is water fluoridation a valuable public health measure? 91101
  • Question 59: Does water fluoridation reduce disparities and improve health equity in dental health? 94104
  • Question 60: Along with the ADA, who supports community water fluoridation? 95105
  • Question 61: Has the legality of water fluoridation been upheld by the courts? 97107
  • Question 62: Why does opposition to community water fluoridation continue? 99109
  • Question 63: What are the tactics fluoridation opponents use to provoke opposition to water fluoridation? 101111
  • Question 64: Where can valid, evidence-based information about water fluoridation be found on the Internet? 104114
  • Question 65: Why does the public sometimes vote against community water fluoridation when it is put to a public vote? 105115
  • Question 66: Is community water fluoridation accepted by other countries? 107117
  • Question 67: Is community water fluoridation banned in Europe? 108118
• Section 5: Cost 109119
• • Question 68: Is water fluoridation a cost-effective and cost-saving method of preventing tooth decay? 109119
  • Question 69: Why fluoridate an entire water system when the vast majority of the water is not used for drinking? 113123
• References 114124