Officials Say Kids Getting Too Much Fluoride

Americans appear to be getting too much fluoride, so the federal government is proposing to tweak its recommendations for fluoride in drinking water. The concern is over a condition called fluorosis, which can produce white lines or spots on teeth. A recent federal study found that 40 percent of adolescents have this condition, though in the vast majority of cases, the spots and lines are barely visible. Fluorosis is on the upswing because children are getting fluoride from drinking water and toothpaste.

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MELISSA BLOCK, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Melissa Block.

MICHELE NORRIS, host:

And I'm Michele Norris.

Chlorine and fluorine are closely related chemical elements. They're also both added to public water supplies but for different reasons. Chlorine kills germs, fluoride prevents cavities. And now there's a move on to reduce the amount of both of them in our water. We'll get to chlorine in just a moment.

But first, NPR's Richard Harris tells us about new government proposals to change the standard for fluoride.

RICHARD HARRIS: Fluoride helps prevent cavities throughout a person's lifetime. But you can have too much of a good thing. In children, too much fluoride can create a condition called fluorosis. Dental professor Howard Pollick at U.C. San Francisco says it's usually very subtle.

Mr. HOWARD POLLICK (Dental Professor, University of California San Francisco): We see a little white streaking, perhaps, when we dry the teeth and look closely with a good light.

HARRIS: And fluorosis is on the rise. A recent federal study found that 40 percent of adolescents have subtle signs of it. Occasionally, it's worse. But Pollick says those serious cases are not on account of fluoride deliberately added to the water to make teeth stronger.

Mr. POLLICK: We only see those where there is a natural level of fluoride that's very high in the water. This is well beyond the areas of water fluoridation.

HARRIS: Nearly five years ago, the National Academy of Sciences suggested that the federal government review its fluoride guidelines. And today, finally, the U.S. Environmental Protection Agency said okay. It will review its standard for the maximum amount of fluoride that's safe for drinking water. That process will take at least another two years, according to an EPA spokesman.

But another part of the federal bureaucracy is planning to move faster. Today, the Department of Health and Human Services announced that it's proposing to lower its recommendation for how much fluoride utilities should deliberately add to the water to prevent cavities. Dr. Howard Koh is the Assistant Secretary for Health.

Dr. HOWARD KOH (Assistant Secretary for Health): In the past, people received almost all their fluoride from drinking water only, but currently it's now been recognized that people receive fluoride from at least several other sources, from toothpaste and mouth rinses, for example.

HARRIS: The old standard was also a sliding scale. It recommended less fluoride in hot climates, figuring that kids from the South who were playing outside would drink a lot more water than kids in cool climates, so they would need less in any given gulp to protect against cavities.

Dr. KOH: But with the advent of air-conditioning and other advances, it was found in a study published only a year ago, actually, that people drink about the same amount of water regardless of where they live around the country. So that's where the science showed us that a range is no longer needed. And instead, a single target was a better public health recommendation.

HARRIS: That new target is the number that used to be at the bottom end of the current range. That is 0.7 milligrams per liter.

Still, there are always people who object to having any fluoride added to the water supply. In response to them, Dr. Koh says simply that the public health benefits of fluoridation are proven, and the new recommendations should help reduce the incidence of the cosmetic side-effect of tooth discoloration.

And after all, the federal government doesn't require that fluoride be added to drinking water.

Dr. KOH: We are putting up these proposed recommendations on the federal register for public notice over the next 30 days. And then, ultimately, these are decisions that are made at the local level.

HARRIS: And at home, parents can make sure their kids swallow less fluoridated toothpaste. Richard Harris, NPR News, Washington.

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