This article was written as part of The Michigan Daily’s investigation to better understand the risks, advancements and future of water in Michigan and beyond. Read other stories from the project here.
In January, Robert F. Kennedy Jr., who was recently confirmed as President Donald Trump’s Secretary of Health and Human Services, claimed fluoride in water systems can cause arthritis, bone fractures, bone cancers, IQ loss, neurodevelopmental disorders and thyroid disease, prompting pushback from the scientific community. While too much fluoride ingestion can be linked to health problems, the mineral has long been used to increase dental health.
Fluoride is a mineral that naturally occurs in water, soil and certain foods and is known to help prevent oral cavities. According to the National Institute of Health, the natural concentration of fluoride in water in some areas is high enough to improve oral hygiene. In places where this is not the case, municipalities add fluoride to their public water system in a process known as fluoridation. The US Center for Disease Control and Prevention recommends a target fluoride level of 0.7 ppm.
According to the CDC, if drinking water is fluoridated at the recommended level, it can reduce dental cavities by about 25% in both children and adults. In an email to The Michigan Daily, Livia Tenuta, associate professor of dentistry, wrote water fluoridation is an effective step in good oral hygiene.
“Fluoride works by maintaining and restoring our teeth’s minerals because it can easily combine with the calcium and phosphate from our teeth,” Tenuta wrote. “Therefore, fluoride not only helps prevent new cavities but also reduces the rate of progression of existing caries lesions.”
Municipalities have jurisdiction over water fluoridation, but must abide by Environmental Protection Agency standards. The EPA mandates that, if a municipality’s water supply contains less than 0.7 parts per million of fluoride, they can elect to fluoridate their water. However, at four parts per million, fluoride levels can lead to health concerns and action should be taken to remove fluoride from the water system.
Sam Page, a public relations representative at Michigan Medicine, wrote in a recent article that scientists are working to decipher the correct amount of fluoride that effectively prevents cavities while also not causing fluorosis, a condition that occurs when teeth enamel is exposed to too much fluoride and has the potential to cause tooth discoloration.
In an interview with The Daily, dentistry professor Margherita Fontana defined fluorosis as a potential health issue in tooth development.
“If you ingest a lot of fluoride for a long period of time, you can affect that development,” Fontana said. “But this is a side effect, and again, you’re balancing the risk of fluorosis with the risk of cavities, which is a huge, huge problem if you end up having cavities.”
Fontana said due to the natural effects of fluoride concentration, when fluoride is present in a water supply at a concentration of two or higher parts per billion, municipalities are required by the EPA to notify citizens.
“If they have two or higher (parts per billion), they have to let the people in the town or in the city know about that,” Fontana said. “That is just to be clear that this community water fluidization programs are just adjusting fluoride to this ideal level in cities where it’s too low, where the local people just have to vote to add this element.”
The Undergraduate Student National Dental Association is a pre-dental organization that promotes community service and outreach specifically with a focus on minorities. In an email to The Daily, USNDA President Faith Lee wrote that fluoride is known to have widespread health benefits and can help bridge the gap created by health disparities between communities.
“Fluoridation safely and inexpensively benefits both children and adults by effectively preventing tooth decay, regardless of socioeconomic status or access to care,” Lee wrote.
In 2007, The Michigan Department of Health and Human Services launched Varnished!, a program that will supply free fluoride varnish to medical providers to use on young children. The data collected from this program will be utilized by MDHHS to continue improving fluoride concentration conditions across the state.
Information and data collection on the subject continues to expand. Fontana said that international data, including from Australia, points to the benefits of fluoride and that the scientific community does not support Kennedy’s claims about fluoride and the brain.
“Everyone benefits the same way, adult or young child,” Fontana said. “Australia and New Zealand (and) many other countries that have really, really good data have not shown this (connection between fluoride and the brain) at all, and in fact, this report also says there’s no biological mechanism how fluoride will affect the brain and affect IQ.”
Daily Staff Reporter Anjali Budhram can be reached at abudhram@umich.edu
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