Before we dig into it's safety, let's go back in time. Why is fluoride in our water anyway?

It all goes back over 120 years to 1901, when a young dental school graduate named Frederick McKay left the East Coast to open a dental practice in Colorado Springs, Colorado. When he arrived, he found the people of Colorado Springs with brown stains on their teeth. To his surprise, the teeth afflicted by brown stains were somehow more resistant to decay than those he had seen back home.

Years later, while studying this brown stains, McKay and Dr. Grover Kempf of the United States Public Health Service (PHS) traveled to Bauxite, Arkansas. This small town was home to Aluminum Company of America (ALCOA), which mined the ore found in the ground there and built plants and mills to process this bauxite ore that is a key component in aluminum. In this town, the two men discovered that the same brown enamel disorder was prevalent among the children of Bauxite, but nonexistent in another town only five miles away.

McKay and Kempf published a report on their findings that reached the desk of ALCOA's chief chemist, H. V. Churchill. He then decided to conduct a test of the water in Bauxite, which found that the town's water had high levels of fluoride.

In January 1931, Churchill wrote a letter to McKay regarding his findings. In the letter, he advised McKay to collect water samples from other towns "where the peculiar dental trouble has been experienced. We trust that we have awakened your interest in this subject and that we may cooperate in an attempt to discover what part 'fluorine' may play in the matter."

McKay collected the samples. And, within months, he had the answer to his 30-year quest. High levels of water-borne fluoride indeed caused the discoloration of tooth enamel. It just so happened that fluoride was naturally present in the groundwater in all of these locations. It occurs due to the dissolution of fluoride-rich minerals in rocks and soil.

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Add it to the tap water.

Fourteen years later, in 1945, Grand Rapids, Michigan became the first city in the world to purposely fluoridate its drinking water, at an amount high enough to reduce decay, but low enough to prevent the brown stains. The Grand Rapids water fluoridation study was originally sponsored by the U.S. Surgeon General but was taken over by the NIDR (National Institute of Dental and Craniofacial Research) shortly after the Institute's inception in 1948. During the 15-year project, researchers monitored the rate of tooth decay among Grand Rapids' almost 30,000 schoolchildren. After just 11 years, the caries rate (tooth decay) among Grand Rapids children born after fluoride was added to the water supply dropped more than 60%. This finding, considering the thousands of participants in the study, amounted to a giant scientific breakthrough.

Today, just about every toothpaste on the market contains fluoride as its active ingredient and approximately 73% of the U.S. population on community water systems receives fluoridated water.
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But is it safe?

Robert F. Kennedy Jr. is now the Secretary of Human and Health Services in the United States. He is outspoken about the potential harms of fluoride. Earlier this year, he stated “Fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease.” These statements are getting a lot of press and so I wanted to dive into the issue.

There is a recent history of research leading to a universal change in fluoride in drinking water. In 2015, the U.S. Public Health Service (PHS) updated its recommendations for fluoride levels in community water systems.

The decision was based on several factors, including the widespread availability of fluoride in oral care products and other sources and the observation that children were experiencing dental fluorosis (white splotches on teeth) due to excessive fluoride exposure.

The new recommendation set a uniform concentration of 0.7 mg/L (or 0.7 ppm) of fluoride in drinking water. This change aimed to ensure that while cavity prevention benefits were maintained, the risk of dental fluorosis in children was also minimized.
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But even if it protects your teeth, can fluoride be doing damage to other parts of your body?

There have been several studies over the last 30 years that found fluoride could cause brain damage, but only at extreme levels – much higher than we find in water. There was also a study just last year showing that higher levels of fluoride in pregnant women’s urine showed double the odds that their children have neuro-behavioral problems by age three. There were eight other studies that looked into this same phenomena and six of them found similar results. Other studies show that those that grew up with fluorinated water showed no significant differences in IQ from those that did not. The data is all over the place.

There is also a little evidence that fluorine can cause hyperthyroidism and increase risks of bone fractures, but nothing conclusive.

Based on what I can find, there is no strong evidence or Meta Analysis that definitively says that there are dangers to drinking water with fluoride.
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But it’s still good for dental health, right?

There have been several cities that have removed fluoride from their drinking water and it is documented that kids that have grown up without fluorinated water will have around 10% more cavities. If you are already an adult, the benefits don’t appear to be as great. Permanent teeth have a thicker enamel and adults also tend to be better at brushing and flossing.

Outside of drinking water there are other sources of fluoride that we encounter. Black tea and coffee can be significant sources of fluoride. As well as seafood like crab, shrimp, and fish. Unfortunately, pesticides contain fluoride, so non-organic fruits and vegetables may also contain it. Could some of these other sources be contributing to the findings of the studies showing a link to neurological issues, hyperthyroidism and increased risks of bone fractures? Possibly.

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So what's the conclusion? There is none.

Research on this topic needs to be continued and if someone is telling you the results are conclusive in one way or the other, they likely have an agenda.

As for me and my family, we stopped buying fluoride toothpaste for our home years ago, but I still drink tap water – which here in Louisville, typically contains an average of 0.6-0.7 ppm of fluoride according to the Louisville Water Company’s website. My rational is that we are exposed to enough fluoride already and we all visit the dentist regularly. If there is a link to any dangers around fluoride consumption, taking this one source away seemed to be worth it to me.