The British Fluoridation Society and the American Fluoridation Society have issued an joint statement in response to the European Food Safety Authority’s (EFSA) updated review of fluoride intake earlier this year, which further enhances confidence in water fluoridation:
The EFSA set safe intake levels for different age groups and concluded that fluoride exposure from drinking water at recommended levels “does not pose a health concern.” Importantly, the EFSA also reaffirmed that fluoride levels in drinking water used in fluoridation schemes are well below the threshold associated with health risks.
Concerns about cognitive effects, which have been raised by some opponents of fluoridation, were specifically addressed by the EFSA.
The Authority noted that studies claiming such effects were based on fluoride levels far higher than those used in fluoridation schemes, and often higher than naturally occurring concentrations in many parts of the world. Research from countries including Australia, Denmark, New Zealand, Spain and Sweden consistently shows no link between optimally fluoridated water and cognitive impairment.
While mild dental fluorosis can occur, the EFSA highlighted that this is primarily linked to children swallowing large amounts of fluoride toothpaste, not drinking fluoridated water. Mild fluorosis results in faint white markings on enamel, does not damage teeth, and does not affect dental health or function.
Evidence also shows that water fluoridation provides unique benefits beyond fluoride toothpaste alone. Both pre-eruptive and post-eruptive exposure to fluoride are important for protecting teeth. Where fluoridation has been stopped, such as in Calgary, Canada, the result was a clear rise in tooth decay, leading to its reinstatement.
Tooth decay remains one of the most common chronic diseases worldwide, causing pain, infection, and avoidable treatment costs.
Community water fluoridation is one of the most effective, equitable and safe ways to prevent decay and protect oral health, particularly for children and those in more deprived communities.
Despite the increase in misleading claims circulating in print and online, the underlying science is consistent and robust. Water fluoridation works, it is safe, and it continues to be recommended by health authorities globally, including the World Health Organization, EFSA, and public health agencies in England, Ireland, the United States and beyond.
The British Fluoridation Society and the American Fluoridation Society remain committed to ensuring that the public has access to accurate information about this vital public health measure.
