Fluoride in Drinking Water

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Fluoride in Drinking Water

South Bend Water Works adds fluoride to the drinking water at a concentration of 0.7 milligrams per liter (mg/L) as recommended by renowned health organizations such as the Indiana Department of Health, the Centers for Disease Control and Prevention (CDC), the US Environmental Protection Agency (EPA) and the Federal RegisterThe addition of fluoride to drinking water is called community water fluoridation. 

Why does South Bend Water Works add fluoride to the drinking water?

South Bend Water Works, like many other public water utilities, adds fluoride to the drinking water to help prevent tooth decay and strengthen tooth enamel.

Community water fluoridation is the most cost-effective way for everyone to get the benefits of fluoride, regardless of their age or socioeconomic status. Per the Indiana Department of Health, data from the CDC show that for every dollar spent on water fluoridation, $38 are saved in reduced costs for dental care. Although other sources of fluoride are now available, customers of water utilities without fluoridation continue to have higher rates of dental decay than those served by fluoridated water utilities. 

Is community water fluoridation safe?

Yes! According to the CDC, the safety and effectiveness of fluoride at levels used in community water fluoridation have been thoroughly reviewed by multinational scientific and public health organizations using evidence-based reviews and expert panels. 

Many reputable national health associations endorse water fluoridation, including the American Medical Association, the American Dental Association, and the American Academy of Pediatrics, the American Academy of Family Physicians, the American Public Health Association, the American Dental Hygienists Association, the American Nurses Association, the National Environmental Health Association, and the American Water Works Association.

Would excess fluoride in water be a concern?

Excessive intake of high fluoride levels can have negative effects; however, not at the level that South Bend Water Works provides in the drinking water.

EPA's current maximum allowable concentration of fluoride in drinking water is 4.0 mg/L to prevent a condition called skeletal fluorosis, which causes joint pain and tenderness. EPA also established a secondary limit of 2.0 mg/L to protect small children from getting tooth discoloration or pitting as their teeth are just coming in.

The US Public Health Services recommends a concentration of 0.7 mg/L fluoride as the optimal amount to provide dental benefits without risk of any negative effects.

The World Health Organization states that excessive fluoride usually occurs from groundwater that is naturally high in fluoride from the type of rock it travels through in the ground.  Some areas have naturally occurring fluoride over 4.0 mg/L and communities using that water must remove some of the fluoride to provide water at the recommended concentration.  

In South Bend, the groundwater has a natural fluoride concentration of only 0.1-0.2 mg/L, which is not enough to provide dental benefits. The addition of fluoride brings our groundwater up to the recommended concentration and South Bend Water Works consistently provides water with fluoride at an average concentration of 0.7 mg/L.

Should you drink fluoridated water and use toothpaste that contains fluoride? 

Yes, they both contribute to better oral health.  The CDC states, "Both drinking water and toothpaste with fluoride provide important and complementary benefits. Fluoridated water keeps a low level of fluoride in saliva and dental plaque all day. The much higher concentration of fluoride in toothpaste offers additional benefit.  In studies conducted after other fluoride products, such as toothpaste, were widely available, scientists found additional reductions in tooth decay – up to 25 percent – among people with community water fluoridation as compared to those without fluoridation." 

Will using a home water filtration device remove the fluoride from my water?

Most point of use filters that attach to faucets and pitcher filters do not remove fluoride, but there are devices that do.  It is best to check with the manufacturer of a particular device if you are unsure.

Will water fluoridation cause pipe corrosion or increased lead in drinking water?

Adding fluoride to water does not increase pipe corrosion or lead to leach from pipes and household plumbing fixtures.

311 Process Notes

Those with objections to water fluoridation can be directed to share their thoughts at public council meetings.  Please send any water fluoridation questions to 5994.