120 l © 2025 American Dental Association
Fluoridation Facts
200. US Enviornmental Protection Agency. Six-year review 3 of drinking water standards. 2016. Accessed March 20, 2025.
https://www.epa.gov/dwsixyearreview/six-year-review-3-drinking-water-standards
201. US Environmental Protection Agency. Federal Register: National Primary Drinking Water Regulations Announcement of the Results of EPA’s
Review of Existing Drinking Water Standards and Request for Public Comment and/or Information on Related Issues. National archives: 2017.
https://www.federalregister.gov/documents/2017/01/11/2016-31262/national-primary-drinking-water-regulations-announcement-of-
the-results-of-epas-review-of-existing. Accessed May 13, 2025.
202. US Environmental Protection Agency. Six-year review 4 of drinking water standards. 2024. Accessed March 20, 2025.
https://www.epa.gov/dwsixyearreview/six-year-review-4-drinking-water-standards.
203. US Environmental Protection Agency. Questions and answers on fluoride. 2011. Accessed March 20, 2025. https://19january2021snapshot.
epa.gov/sites/static/files/2015-10/documents/2011_fluoride_questionsanswers.pdf.
204. Environmental Protection Agency. Final rule: national primary and secondary drinking water regulations fluoride. Federal Register 1986.
205. Jackson RD, Brizendine EJ, Kelly SA, et al. The fluoride content of foods and beverages from negligibly and optimally fluoridated communities.
Community Dent Oral Epidemiol. 2002 30(5):382–391.
206. US Department of Agriculture. USDA national fluoride database of selected beverages and foods, release 2. Beltsville, Maryland:
Beltsville human nutrition research center nutrient data laboratory 2005. Accessed March 20, 2025.
https://www.ars.usda.gov/ARSUserFiles/80400525/data/fluoride/f02.pdf.
207. US Environmental Protection Agency. Fluoride: exposure and relative source contribution analysis. Health and ecological criteria division,
Office of water 2010. Accessed March 20, 2025. https://nepis.epa.gov/Exe/ZyPURL.cgi?Dockey=P100N49K.txt.
208. Whitford GM. The metabolism and toxicity of fluoride. Monogr Oral Sci. 1996 16(Rev 2):1–153.
209. Slade GD, Davies MJ, Spencer AJ, Stewart JF. Associations between exposure to fluoridated drinking water and dental caries experience
among children in two Australian states. J Public Health Dent. 1995 55(4):218–228.
210. Franzman MR, Levy SM, Warren JJ, Broffitt B. Fluoride dentifrice ingestion and fluorosis of the permanent incisors. J Am Dent Assoc.
2006 137(5):645–652.
211. Buzalaf MAR, Levy SM. Fluoride intake of children: considerations for dental caries and dental fluorosis. Monogr Oral Sci. 2011 22:1–19.
212. Levy SM. Review of fluoride exposures and ingestion. Community Dent Oral Epidemiol. 1994 22(3):173–180.
213. Barnhart WE, Hiller LK, Leonard GJ, Michaels SE. Dentifrice usage and ingestion among four age groups. J Dent Res. 1974 53(6):1317–1322.
214. Ericsson Y, Forsman B. Fluoride retained from mouthrinses and dentifrices in preschool children. Caries Res. 1969 3(3):290–299.
215. Ekstrand J, Ehrnebo M. Absorption of fluoride from fluoride dentifrices. Caries Res. 1980 14(2):96–102.
216. Levy SM. A review of fluoride intake from fluoride dentifrice. ASDC J Dent Child. 1993 60(2):115–124.
217. Levy SM, Kiritsy MC, Warren JJ. Sources of fluoride intake in children. J Public Health Dent. 1995 55(1):39–52.
218. American Dental Association Council on Scientific Affairs. Fluoride toothpaste use for young children. J Am Dent Assoc. 2014 145(2):190–191.
219. Sa Roriz Fonteles C, Zero DT, Moss ME, Fu J. Fluoride concentrations in enamel and dentin of primary teeth after pre- and postnatal fluoride
exposure. Caries Res. 2005 39(6):505–508.
220. Leverett DH, Adair SM, Vaughan BW, Proskin HM, Moss ME. Randomized clinical trial of the effect of prenatal fluoride supplements in
preventing dental caries. Caries Res. 1997 31(3):174–179.
221. Buzalaf MAR, Whitford GM. Fluoride metabolism. Monogr Oral Sci. 2011 22:20–36.
222. Newbrun E. Fluorides and dental caries: contemporary concepts for practitioners and students. 3rd ed. Charles C. Thomas Publisher.
Springfield, Illinois 1986.
223. McDonagh MS, Whiting PF, Wilson PM, et al. Systematic review of water fluoridation. BMJ. 2000 321(7265):855–859.
224. Levy SM, Eichenberger-Gilmore J, Warren JJ, et al. Associations of fluoride intake with children’s bone measures at age 11.
Community Dent Oral Epidemiol. 2009 37(5):416–426.
225. Levy SM, Eichenberger-Gilmore JM, Warren JJ, et al. Associations of fluoride intake with children’s cortical bone mineral and strength
measures at age 11. J Public Health Dent. 2018 78(4):352–359.
226. Levy SM, Warren JJ, Phipps K, et al. Effects of life-long fluoride intake on bone measures of adolescents: a prospective cohort study.
J Dent Res. 2014 93(4):353–359.
227. Oweis RR, Levy SM, Eichenberger-Gilmore JM, et al. Fluoride intake and cortical and trabecular bone characteristics in adolescents at age 17:
a prospective cohort study. Community Dent Oral Epidemiol. 2018 46(6):527–534.
228. Saha PK, Oweis RR, Zhang X, et al. Effects of fluoride intake on cortical and trabecular bone microstructure at early adulthood using multi-row
detector computed tomography (MDCT). Bone. 2021 146:115882.
229. Bhatia GK, Levy SM, Warren JJ, et al. Associations between longitudinal fluoride intakes from birth to age 23 and multi-row detector
computed tomography bone densitometry outcomes at age 23. J Public Health Dent. 2024 84(4):428–438.
230. Levy S, Pendleton C, Guha I, et al. Longitudinal fluoride intake not associated with age 23 tibial bone strength from finite element analyses
(Abstract 140). 70th ORCA Congress 2023.
231. Nasman P, Ekstrand J, Granath F, Ekbom A, Fored CM. Estimated drinking water fluoride exposure and risk of hip fracture: a cohort study.
J Dent Res. 2013 92(11):1029–1034.
232. Sowers M, Whitford GM, Clark MK, Jannausch ML. Elevated serum fluoride concentrations in women are not related to fractures and bone
mineral density. J Nutr. 2005 135(9):2247–2252.
233. Li Y, Liang C, Slemenda CW, et al. Effect of long-term exposure to fluoride in drinking water on risks of bone fractures. J Bone Miner Res.
2001 16(5):932–939.
Fluoridation Facts
200. US Enviornmental Protection Agency. Six-year review 3 of drinking water standards. 2016. Accessed March 20, 2025.
https://www.epa.gov/dwsixyearreview/six-year-review-3-drinking-water-standards
201. US Environmental Protection Agency. Federal Register: National Primary Drinking Water Regulations Announcement of the Results of EPA’s
Review of Existing Drinking Water Standards and Request for Public Comment and/or Information on Related Issues. National archives: 2017.
https://www.federalregister.gov/documents/2017/01/11/2016-31262/national-primary-drinking-water-regulations-announcement-of-
the-results-of-epas-review-of-existing. Accessed May 13, 2025.
202. US Environmental Protection Agency. Six-year review 4 of drinking water standards. 2024. Accessed March 20, 2025.
https://www.epa.gov/dwsixyearreview/six-year-review-4-drinking-water-standards.
203. US Environmental Protection Agency. Questions and answers on fluoride. 2011. Accessed March 20, 2025. https://19january2021snapshot.
epa.gov/sites/static/files/2015-10/documents/2011_fluoride_questionsanswers.pdf.
204. Environmental Protection Agency. Final rule: national primary and secondary drinking water regulations fluoride. Federal Register 1986.
205. Jackson RD, Brizendine EJ, Kelly SA, et al. The fluoride content of foods and beverages from negligibly and optimally fluoridated communities.
Community Dent Oral Epidemiol. 2002 30(5):382–391.
206. US Department of Agriculture. USDA national fluoride database of selected beverages and foods, release 2. Beltsville, Maryland:
Beltsville human nutrition research center nutrient data laboratory 2005. Accessed March 20, 2025.
https://www.ars.usda.gov/ARSUserFiles/80400525/data/fluoride/f02.pdf.
207. US Environmental Protection Agency. Fluoride: exposure and relative source contribution analysis. Health and ecological criteria division,
Office of water 2010. Accessed March 20, 2025. https://nepis.epa.gov/Exe/ZyPURL.cgi?Dockey=P100N49K.txt.
208. Whitford GM. The metabolism and toxicity of fluoride. Monogr Oral Sci. 1996 16(Rev 2):1–153.
209. Slade GD, Davies MJ, Spencer AJ, Stewart JF. Associations between exposure to fluoridated drinking water and dental caries experience
among children in two Australian states. J Public Health Dent. 1995 55(4):218–228.
210. Franzman MR, Levy SM, Warren JJ, Broffitt B. Fluoride dentifrice ingestion and fluorosis of the permanent incisors. J Am Dent Assoc.
2006 137(5):645–652.
211. Buzalaf MAR, Levy SM. Fluoride intake of children: considerations for dental caries and dental fluorosis. Monogr Oral Sci. 2011 22:1–19.
212. Levy SM. Review of fluoride exposures and ingestion. Community Dent Oral Epidemiol. 1994 22(3):173–180.
213. Barnhart WE, Hiller LK, Leonard GJ, Michaels SE. Dentifrice usage and ingestion among four age groups. J Dent Res. 1974 53(6):1317–1322.
214. Ericsson Y, Forsman B. Fluoride retained from mouthrinses and dentifrices in preschool children. Caries Res. 1969 3(3):290–299.
215. Ekstrand J, Ehrnebo M. Absorption of fluoride from fluoride dentifrices. Caries Res. 1980 14(2):96–102.
216. Levy SM. A review of fluoride intake from fluoride dentifrice. ASDC J Dent Child. 1993 60(2):115–124.
217. Levy SM, Kiritsy MC, Warren JJ. Sources of fluoride intake in children. J Public Health Dent. 1995 55(1):39–52.
218. American Dental Association Council on Scientific Affairs. Fluoride toothpaste use for young children. J Am Dent Assoc. 2014 145(2):190–191.
219. Sa Roriz Fonteles C, Zero DT, Moss ME, Fu J. Fluoride concentrations in enamel and dentin of primary teeth after pre- and postnatal fluoride
exposure. Caries Res. 2005 39(6):505–508.
220. Leverett DH, Adair SM, Vaughan BW, Proskin HM, Moss ME. Randomized clinical trial of the effect of prenatal fluoride supplements in
preventing dental caries. Caries Res. 1997 31(3):174–179.
221. Buzalaf MAR, Whitford GM. Fluoride metabolism. Monogr Oral Sci. 2011 22:20–36.
222. Newbrun E. Fluorides and dental caries: contemporary concepts for practitioners and students. 3rd ed. Charles C. Thomas Publisher.
Springfield, Illinois 1986.
223. McDonagh MS, Whiting PF, Wilson PM, et al. Systematic review of water fluoridation. BMJ. 2000 321(7265):855–859.
224. Levy SM, Eichenberger-Gilmore J, Warren JJ, et al. Associations of fluoride intake with children’s bone measures at age 11.
Community Dent Oral Epidemiol. 2009 37(5):416–426.
225. Levy SM, Eichenberger-Gilmore JM, Warren JJ, et al. Associations of fluoride intake with children’s cortical bone mineral and strength
measures at age 11. J Public Health Dent. 2018 78(4):352–359.
226. Levy SM, Warren JJ, Phipps K, et al. Effects of life-long fluoride intake on bone measures of adolescents: a prospective cohort study.
J Dent Res. 2014 93(4):353–359.
227. Oweis RR, Levy SM, Eichenberger-Gilmore JM, et al. Fluoride intake and cortical and trabecular bone characteristics in adolescents at age 17:
a prospective cohort study. Community Dent Oral Epidemiol. 2018 46(6):527–534.
228. Saha PK, Oweis RR, Zhang X, et al. Effects of fluoride intake on cortical and trabecular bone microstructure at early adulthood using multi-row
detector computed tomography (MDCT). Bone. 2021 146:115882.
229. Bhatia GK, Levy SM, Warren JJ, et al. Associations between longitudinal fluoride intakes from birth to age 23 and multi-row detector
computed tomography bone densitometry outcomes at age 23. J Public Health Dent. 2024 84(4):428–438.
230. Levy S, Pendleton C, Guha I, et al. Longitudinal fluoride intake not associated with age 23 tibial bone strength from finite element analyses
(Abstract 140). 70th ORCA Congress 2023.
231. Nasman P, Ekstrand J, Granath F, Ekbom A, Fored CM. Estimated drinking water fluoride exposure and risk of hip fracture: a cohort study.
J Dent Res. 2013 92(11):1029–1034.
232. Sowers M, Whitford GM, Clark MK, Jannausch ML. Elevated serum fluoride concentrations in women are not related to fractures and bone
mineral density. J Nutr. 2005 135(9):2247–2252.
233. Li Y, Liang C, Slemenda CW, et al. Effect of long-term exposure to fluoride in drinking water on risks of bone fractures. J Bone Miner Res.
2001 16(5):932–939.
