Health effects of ingested fluoride

Fluoridation of public water supplies has aroused considerable discussion among scientists and the general public since it began in 1945. Although the majority of scientists support the measure, some take the view that fluoridation can produce not only adverse cosmetic effects from severe dental fluorosis, but also adverse health effects. Scientists have become increasingly aware of the potential for exposure to toxic concentrations of fluoride from water and other sources (e.g., foods, processed beverages, dental products, and fluoride supplements). Thus, accurate information on the potential health effects of fluoride is needed. To address that need, the U.S. Environmental Protection Agency (EPA) requested that the Committee on Toxicology (COT) review the health effects of ingested fluoride and determine whether EPA's maximum contaminant level of 4 milligrams (mg) of fluoride per liter (L) of drinking water is appropriate. In response, COT organized the Subcommittee on Health Effects of Ingested Fluoride, which included scientists with expertise in toxicology, pathology, medicine, dentistry, epidemiology, biostatistics, and risk assessment. The subcommittee reviewed various kinds of toxicity that have been attributed to ingestion of fluoride (dental fluorosis; bone fracture; reproductive, renal, gastrointestinal, and immunological toxicities; genotoxicity; and carcinogenicity) and assessed the current EPA drinking-water standard for fluoride to determine if it is protective of public health. The report of the subcommittee is intended for use by EPA in deciding whether to maintain or revise its current drinking-water standard for fluoride.