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The public health practice of adding fluoride to water supplies is facing new scrutiny because a few recent reports raise concerns about health risks and the benefits may not be as significant as they once were.
brand new Report The Cochrane Collaboration, an independent group that systematically reviews scientific research, found a small benefit of adding fluoride to tap water, which resulted in slightly fewer cavities in children's teeth.
Studies prior to 1975 showed significant benefits; Children who live in areas where water is fluoridated have on average one more primary tooth decay than those who live in areas where water is not fluoridated.
But those findings don't apply to today's population, which has wider access to other sources of fluoride and lower dental caries, the authors say. Especially since the 1970s, toothpaste containing fluoride has become widely available and widely used.
Recent studies have linked fluoride in water to an average of about a quarter of the difference in tooth decay, according to a new report published this week.
“Adding fluoride to water may slightly increase the number of children who do not have tooth decay in both their baby teeth and their permanent teeth,” the study authors wrote. “However, these results may make little or no difference in tooth decay.”
And considering fluoride's potential risk to young children's brain development, a federal judge last month ordered the U.S. Environmental Protection Agency to do so. Additional fluoride control in drinking water.
Fluoride is a naturally occurring mineral in some foods and groundwater. It helps prevent tooth decay by strengthening the protective outer layer of enamel, which can be worn away by bacteria, plaque and acids created by sugar in the mouth. In 1945, fluoride was added to public water systems in the United States.
Now, about three-quarters of the U.S. population — about 209 million people — is served by fluoridated drinking water systems. Data From the US Centers for Disease Control and Prevention.
CDC promotes the safety and benefits of community water fluoridation.
“Water fluoridation has been identified as the most cost-effective method of delivering fluoride to all segments of the population, regardless of age, education level, or income level,” the agency wrote. press release In May.
But emerging evidence may be tipping the balance of risks and benefits toward long-term public health interventions.
The new analysis from Cochrane raises concerns about the dangers of adding fluoride to public water, raising concerns over other reports.
Weighing the benefits and risks
A Research In May, he got exposure to that published on the JAMA network Fluoridated water during pregnancy has been associated with an increase in neurobehavioral problems in children. long federal Evaluation A study published in August by the National Institutes of Health Toxicology Program concluded that high levels of fluoride are associated with lower IQ in children.
In a lawsuit against the EPA, U.S. District Judge Edward Chen ruled that there was no conclusive evidence that high levels of fluoride added to water could lower IQ in children, but that there was enough evidence to warrant an investigation.
EPA sets limits on what is allowed and recommended under the Safe Drinking Water Act. The agency said it is “in the process of reviewing the district court's decision” and is “coordinating with the Department of Justice to consider all options to determine next steps.”
Experts say the findings of the new Cochrane report are not particularly conclusive for adding fluoride to drinking water.
“Currently, it is difficult to say whether and how much benefit there is to continuing water fluoridation programs, especially as alternative, more accessible sources of fluoride prevent tooth decay and should be considered now. Professor of Preventive Medicine at Keck School of Medicine in Southern California and the NIH/ Dr. Howard Hu, founding director of the NIEHS Center for Children's Environmental Health, said in an email to that Hu was an expert witness for the plaintiffs in the federal fluoride trial.
The risks include tooth decay that fluoride can cause, as well as “accumulating evidence” that prenatal fluoride exposure is dangerously toxic to neurodevelopment, Hu wrote in the study.
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Some key health organizations – including the American Academy of Pediatrics and the American Dental Association, along with the CDC – continue to use fluoride as a safe and effective way to maintain dental health.
The American Academy of Pediatrics highlighted key limitations in a National Institutes of Health review and the potential lifelong effects of tooth decay and cavities—a common and preventable chronic disease.
“While more research and potential biological mechanisms are needed to better understand the association, I am not concerned about the research[regarding]… toothpaste use and low levels of fluoride from drinking fluoridated water,” said Dr. Charlotte W. Lewis, professor of pediatrics at the University of Washington School of Medicine and Seattle Children's Hospital. The attending physician in press release.