Fluoride in drinking water is in the spotlight again. Let’s not forget how it transformed our oral health

What is Fluoride?

Fluoride is a natural substance found in rocks, water sources, soils, and plants. The Australian Drinking Water Guidelines recommend three compounds for fluoridating water: sodium fluoride, sodium fluorosilicate, and fluorosilicic acid. One of these compounds is usually added under carefully monitored conditions during drinking water treatment before it is sent to the tap.

Is it Good for Our Teeth?

Fluoride helps prevent cavities by making tooth enamel more resistant to acids from bacteria in your mouth. The addition of small amounts of fluoride to drinking water to prevent dental decay began in the United States in 1945. Research later confirmed that while excess fluoride can cause cosmetic discoloration, lower concentrations still prevented cavities without harmful side effects.

What are People Worried About?

There has always been opposition to fluoridation, including the argument it is “government overreach” since we can’t easily opt out from drinking tap water. A 2019 study claimed fluoride affected the IQ of children, but this work has been roundly criticized and a 2024 study detailed serious weaknesses in the study design. Multiple reviews of high-quality studies from many different countries, including the US and Australia, have found no evidence of harm.

Working Out What’s Safe

It’s reasonable to want to know what’s in our drinking water and to ensure it is safe. But discussions about toxicity are meaningless without context. Excessive fluoride intake can have harmful effects, such as weakened bones (skeletal fluorosis). But the key word is “excessive.” Anything can be toxic to humans if the dose is too high, even water itself. The amount of fluoride needed to cause harm is much higher than you get from drinking water.

Lessons from Places that Removed Fluoride

The risks of adding fluoride to water are extremely low. But several recent cases demonstrate the very real health risks of not fluoridating water. The Canadian city of Calgary removed fluoride from drinking water in 2011. Seven to eight years later, dental cavities in children were significantly higher in Calgary compared to nearby Edmonton which did not remove fluoride.

An Equity Issue

The evidence has continually demonstrated fluoride is not only safe – it has significant benefits for oral health. Some of the benefits of fluoride can be achieved via fluoridated toothpaste or fluoride treatments at the dentist. But dentistry is not included in Medicare. Fluoridating water (or table salt, as used in many European countries) remains one of the most equitable ways to ensure these benefits are not only for those who can afford it.

Conclusion

Fluoride is a natural substance that has been added to drinking water for decades to prevent dental decay. While there has always been some opposition to fluoridation, the evidence continues to show that it is safe and effective in preventing cavities. The benefits of fluoride are not limited to those who can afford to use fluoridated toothpaste or visit the dentist. Fluoridating water is an equitable way to ensure good oral health for all.

FAQs

* What is fluoride?
Fluoride is a natural substance found in rocks, water sources, soils, and plants.
* Is fluoride safe?
Yes, fluoride is safe in small amounts. Excessive fluoride intake can have harmful effects, but the key word is “excessive.”
* Why is fluoride added to drinking water?
Fluoride is added to drinking water to prevent dental decay and promote good oral health.
* Is fluoridation a government overreach?
No, fluoridation is a public health measure to ensure good oral health for all. It is not a government overreach to require fluoridation in drinking water.