US proposes cut in water fluoride level


The US Department of Health and Human Services and the US Environmental Protection Agency have proposed that the fluoride level in drinking water be reduced to prevent dental fluorosis, a form of tooth decay.

But there has been no mention of the other “more serious (non-dental) health concerns” about fluoride ingestion, noted the international campaign group Fluoride Action Network. The Network added that “the chemicals used to fluoridate drinking water in the US are hazardous waste byproducts of the phosphate fertiliser industry”.

The proposed cut bucks a trend of promoting fluoride that began in the 1940s. The Health and Human Services Dept has now proposed cutting the level to 0.7 milligrams per litre of water, from the current standard of 0.7 – 1.2 mg/litre, according to an AP report. The American Dental Association has welcomed the move, reports the AOL Health website.

Last year, a research paper published in the the Research Journal of Medical Sciences, found on the Medwell Journals website, stated that the national standard for fluoride level in Malaysian water is 0.5 – 0.9 mg/litre.

The Malaysian paper found that dental fluorosis, a hypoplasia or hypomineralisation of tooth enamel or dentin produced by excessive fluoride intake, was not a problem in the three areas studied – Pasir Mas, Kuala Terengganu and Kota Kinabalu – in November 2003 and 2004.

Critics point out that most European countries do not fluoridate their water – with little impact on dental health.

In the light of the latest US recommendations, it might be time for us in Malaysia to undertake a more comprehensive study.

Even 0.7mg is too high, says the Fluoride Action Network’s website, which issued the following statement in an immediate response:

January 8, 2011

The wheels of bureaucracy grind slowly. Fourteen years after public health dentists recommended that fluoride levels be reduced to 0.7 ppm (Heller et al.), the Department of Health & Human Services has officially recommended doing so.

Fluoride Action Network is concerned that this new level of fluoride in drinking water has been set too high. It neither protects teeth from dental fluorosis, the stated reason for the lowering, nor does it protect the baby’s developing brain, an issue not even mentioned by either the CDC or the EPA.

• A recent government report estimated that 41% of adolescents aged 12-15 have dental fluorosis (Beltrán-Aguilar et al.). However, the government has not investigated if these adolescents have suffered any other effects from overexposure to fluoride.

• There have now been over 100 studies reporting that fluoride damages animal brain. There have also been 24 studies that have shown an association between exposure to moderate-to-high levels of fluoride and lowered IQ in children (Connett et al.). While some proponents have criticized the methodology of some of these studies, no fluoridated country (except for one small study in NZ) has attempted to repeat them. Ironically, the 24th IQ study (Xiang et al.) has just been pre-published online by Environmental Health Perspectives. This journal is published by the National Institute for Environmental Health Sciences (NIEHS) which is part of the DHHS. So the DHHS can hardly dismiss this study based upon a weak study design since it was peer-reviewed and deemed suitable for publication by one of its own agencies — an agency, in fact, that specializes in environmental health research.

• An infant who receives formula reconstituted with fluoridated tap water at this new level (0.7 ppm), will receive approximately 175 times more fluoride than a breast-fed infant. These infants are not being protected with this new level and CDC, EPA and ADA must clearly inform parents, caregivers, and health providers that infant formula should only be reconstituted with non-fluoridated water. In fact, a failure to be aggressive with such warnings is tantamount to admitting that this apparent concern about dental fluorosis is a sham intended to deflect attention from other more serious health concerns.

• In its announcement, the DHHS made no mention of other adverse effects of fluoride in drinking water aside from dental fluorosis. The landmark report published by the National Research Council of the National Academies (NRC 2006) noted three adverse health effects that warranted lowering of the current Maximum Contaminant Level allowed for fluoride in drinking water (currently set at 4 ppm). The following two adverse health effects were not mentioned by DHHS: bone fractures and pre-clincical stages of skeletal fluorosis, which manifests with symptoms identical to arthritis (stiffness of the joints and pain in the joints and bones).

• When EPA Assistant Administrator for the Office of Water Peter Silva stated, “EPA’s new analysis will help us make sure that people benefit from tooth decay prevention while at the same time avoiding the unwanted health effects from too much fluoride” (DHHS 2011) he was violating the mandate of the EPA in determining water standards. The EPA regulates contaminants not additives to water. It has no role to play in assessing the purported benefits of additives. Moreover, when determining the maximum contaminant level for contaminants that determination should be based entirely on what is deemed safe. This determination should not be tainted by concerns about purported benefits. Thus this collaboration between the DHHS (actually the oral health division of the CDC) is undermining the EPA’s procedures and represents a clear conflict of interest. The CDC is actively involved in the promotion of water fluoridation and the EPA’s Office of Drinking Water is supposed to be setting water standards which are protective of the whole population, including vulnerable subsets, from known and reasonably anticipated adverse health effects.

The EPA must tell us what is safe and use the best science to do it. Accommodating the CDC’s desire to protect the water fluoridation program at all costs, is a betrayal of the American public’s trust in the EPA. That betrayal is best observed in the willingness of the EPA to do away with a margin of safety in determining a safe reference dose (RfD). The reasoning they used for eliminating a safety factor (or in their jargon, choosing an “uncertainty factor” of 1) was as follows:

“In establishing an estimated oral RfD for fluoride, data on nutritional benefit were assessed in combination with the data on severe dental fluorosis to define a level that provides anticaries protection without causing severe dental fluorosis when consumed daily for a lifetime. Conventional application of uncertainty factors is not always appropriate when carrying out a risk assessment for nutrients and other beneficial substances, especially when there is a relatively small difference between the levels that satisfy need and those that cause adverse effects. For this reason the total uncertainty factor applied was 1.” (US EPA, 2010).

What independent observers would conclude based on this tortuous logic is that there is an unacceptable safety margin between a so-called beneficial level and the level that causes harm and that this makes the fluoridation program untenable. Moreover, such analysis only considers the damage to teeth (dental fluorosis)– and doesn’t even begin to address the issue of how small the margin of safety is between the level that purportedly reduces tooth decay and the levels that may cause a lowering of IQ.

• According to Kathleen Thiessen, PhD, one of the authors of the NRC 2006 report:

“[W]hile the proposed recommendation for a lower national fluoride level in drinking water is a step in the right direction, and a quiet admission that some people are ingesting too much fluoride, a number of concerns are not yet addressed. Infants fed reconstituted formula, people with high water consumption (e.g., athletes, laborers, persons with medical conditions such as diabetes insipidus), persons with impaired kidney function (and consequent reduced excretion of fluoride), and persons with a hypersensitivity to fluoride will continue to have fluoride intakes in excess of a safe level, even when the new recommendation is implemented. These people also deserve to be protected.” (Thiessen, 2011)

• No mention has been made by the HHS or EPA that the chemicals used to fluoridate drinking water in the US are hazardous waste byproducts of the phosphate fertilizer industry. This is the first time in the history of mankind that highly hazardous waste has been shown to have health benefits, yet no toxicological studies have been performed on them.

Note: The EPA released many pages of analysis that will contribute to a risk assessment to establish a new safe drinking water standard. We have not had time to examine these in detail but we will be responding to those later. The alarming thing to note now is that the EPA water division has clearly signaled its intention to produce (or engineer) an MCLG that avoids challenging the safety of the water fluoridation program. Once again politics has triumphed over science.

Please help to support this blog if you can.

Read the commenting guidlelines for this blog.
Notify of

Most Voted
Newest Oldest
Inline Feedbacks
View all comments

QuackWatch mentions this topic: I feel as though we’re watching the more-or-less predictable outcome of allowing democracy to fail into the terrible inadequacy of the 2-party system. There is only diametrical opposition and it’s never going to be sufficient to capture any community’s diversity of views. It is remarkable that nationwide fluoridation is essentially state drug administration and I imagine plausible cases both anti- and pro- can be made in much the same way that I’m sure one could argue that obligatory education of minors constitutes unlawful detention. It doesn’t surprise me that USian activists would be more vocal… Read more »

Wayang Street

This serious, anil!

It’s an expensive affair, what with the diminishing food sources and their nutritonal values for general health.

After 5 decades it’s made Malaysians lost their bite!

Do you think Rais has two sets of false’s? 😉

semuanya OK kot

This was originally a byproduct of the nuclear industry. Similarly, chlorine was a byproduct of some chemical factories.

I suppose boiling water may drive off both these additives.

That brushing and commercial toothpaste are the basis of good teeth are modern commercial myths. An American dentist who sailed around the world about the time of Darwin noted that aborigine children everywhere had sound teeth even though the teeth were stained or dirty.

If you must use toothpaste, it is important to wash out every last drop after brushing. Children are more likely to be careless in doing this.


I am a strong proponent of fluoridation in water. You mentioned most European countries do not fluoridate their water and have little impact on their dental health. But one must remember that European patients have a very different attitude and perception when it comes to dental health and nutrition. Most of them are very diligent in their oral care, and also they do not have a high sugar diet. In countries where there is a poor control of diet and where there is little or no access to good oral health, then fluoridation is the key to help prevent and… Read more »

Ong Eu Soon

Let me tell you a story about fluoride poisoning. There is an American company that went to China to set up a tooth paste factory. Little did they know that there is a third shift of factory operation underway each and every night. One day one of the staff went back to the factory well after mid night, to his surprise there are people working in the factory floor. Afraid to be silenced my friend keep the secret to himself. Later after he return to Malaysia, only he realized that the Chinese has attempted to steal the skill and knowledge… Read more »

Ong Eu Soon

If you ever think that milk poisoning in China is bad, it is just because you didn’t realise that there is a prevalent fluoride poisoning in China that took placed for more than a decade.

Ong Eu Soon

What can affect you on your teeth, will affect your kidney. Image when you only use a toothpaste with excessive fluoride, it can change the white teeth to yellowish permanently. What will happen to your kidney and your bone when you swallow the drinking water with excessive fluoride? Your kidney will degrade faster than usual and your bone will lost it’s density faster than normal. In the end you will age faster than normal.

Ong Eu Soon

Take a good look at the teeth of China dolls…

Ong Eu Soon

The fluoride poisoning problem is more acute on tooth paste especially those make from China. The symptoms of fluoride poisoning is the strange yellowish color of the teeth. This problem is so acute that it led the FDA to place an import ban all toothpaste from China.
The seriousness of fluoride poisoning due to excessive fluoride in the toothpaste eventually led to concern about the fluoride level in drinking water.
As usual the Chinese paid the price and the Western learn the lesson while the rest of the world waiting to pay the price and learn the bitter lesson.


Ong Eu Soon: As usual the Chinese paid the price and the Western learn the lesson while the rest of the world waiting to pay the price and learn the bitter lesson. A classic case of scientists playing god to the ‘heaven’-sent solutions for the helpless modern mankind who as usual willingly play guinea pigs to pay the price. It is only after the facts that we decide to make amends to whatever foolishness (or is it the scientists’) but that has become too late for the victims, not the scientists and big pharmas/corporations who might/most probably racked in obscene… Read more »


Comprehensive study about fluoride use in Malaysia ? Is it necessary?
IMHO, for poor remote area people, provide them with fluoride toothpaste is more than adequate. Since fluoride are pretty effective strengthen one tooth through ion replacement process. In addition, those people less prone to take fine processing food and sugar in their daily diet.