Is Water Fluoridation Safe?

The Oregon Sierra Club, in order to block fluoridation, said (2004) that the “fluoride added to virtually every water supply is an industrial waste product” and that “contaminants including arsenic, lead and mercury are unintentionally being added to our water supply.” ┬áIn 2007, they again claimed, “fluoridation chemicals contain heavy metals, such as arsenic, mercury, and lead.”

The antifluoridationist group Oregon Citizens for Safe Drinking Water (2004) claimed the fluoridation chemicals were “dirty fluoride.Very dirty fluoride.”

These statements are misleading. The government regulates contaminants to protect health.

Affirmation of safety from the Centers for Disease Control and Prevention

Regulation of Fluoride Products

There are two governmental agencies that serve this function – the Food and Drug Administration (FDA) for food and drug safety and the Environmental Agency (EPA) for water safety.

The FDA oversees the safety of fluoride containing products used to reduce tooth decay that are not added to public drinking water. The standards that limit the amount of contaminants that food and drugs could contain are set by the United States Pharmacopeia (USP) which is a non-governmental, non-profit organization. Its members include representatives of medicine, pharmacy, government, and the pharmaceutical industry. For the actual testing and certification of food and drugs for quality and safety, the USP uses the National Sanitation Foundation (NSF). This non-governmental, non-profit agency has been testing food products since the 1940s.

In 1962, the U.S. Congress passed the “Drug Amendments” to the Food, Drug, and Cosmetic Act in which efficacy became a requirement in addition to safety. Because fluoride supplements had been used with obvious effectiveness and safety since the 1940s to reduce the incidence of tooth decay, they were “grandfathered” in, and were not made to go through a formal application process.

The quality and safety of fluoride products added to water is not overseen by the FDA but by the Environmental Protection Agency (EPA) established in 1972. The EPA started the Drinking Water Additives Program in 1985 to establish standards for all products added to drinking water. A committee of medical and public health professionals, governmental agencies, and product manufacturers set standards that limit the amount of contaminant that water additives could contain. This is documented in “Standards 60.” Compliance with these standards is voluntary but most states, including Oregon and Washington State, require Standard 60 certification guidelines.

The agency that tests and certifies the water additive products is the same one that tests and certifies food and drugs – the National Sanitation Foundation (NSF). These standards are very stringent and quality is closely monitored. But because NSF is a non-governmental agency, fluoridation opponents will often say, “There are no federal standards for fluoridation.


There are two types of standards that apply – one is for the purity of the product and one is for the limitation of contaminants that the product can contain.

Purity relates to the percentage of a product that actually is that product. For example, the USP standard for a fluoride compound added to toothpaste is that it is 99.9% pure. In contrast, the water quality or “industrial” grade of a fluoride product added to water is that it can be 98% pure, partly because of the high dilution factor. The 1.9% difference is usually in the form of an inorganic compound such as calcium carbonate (which is the active ingredient in Tums). Since this is not harmful in the small concentrations found in fluoridated water, it is not removed in order to keep the cost down. Purity, then, is different than contaminant levels. The greatest concern is the amount of arsenic that is present in food and minerals such as fluoride because arsenic is so abundant in nature and can be harmful to humans. It is present ubiquitously in earth so plants contain it, animals that feed on plants contain it, water naturally contains it, and any mineral mined from the earth can contain it.

The levels of arsenic and lead allowed in food and drugs by the FDA are 2 parts per million (2000 parts per billion) maximum. The standard for allowable arsenic in bottled water under the jurisdiction of the FDA is now 10 parts per billion (lowered recently from 50 ppb). The arsenic standard for drinking water set under the jurisdiction of the EPA is also now 10 parts per billion (lowered recently from 50 ppb). Of that 10 parts per billion, only 10% or 1 part per billion can be related to the addition of a fluoride compound to drinking water. Although this is the standard, the average amount of arsenic in fluoridated water at the tap, as measured by the National Sanitation Foundation, is 0.1 ppb.


The following are the regulations (allowable levels) and some actual measured levels for one contaminant “Arsenic.” Clearly the contaminants in fluoridated water are well within safe limits.


Allowable Arsenic Levels in parts per billion (ppb)

Food additives (1)


Meat (1)


Pharmaceuticals (2)


Toothpaste (1)


Fluoridated water (3)


Actual Measured Arsenic Levels in parts per billion (ppb)

Vanilla Ice Cream (4)


Rice (4)


Bread (4)


Chicken (4)


Cured Pork (4)


Pastrami (4)


Tuna (4)


Sole (4)


Pickerel (4)


Shrimp (4)


Special K (4)


Flour (4)


Apple Juice (4)


Tea (4)


Cigarettes (4)


Fluoridated water (3)


1. Federal Drug Administration, 2005

2. U.S. Pharmacopeia and National Formulary, 2002

3. National Sanitation Foundation, 2003

4. National Academy of Sciences, 1999 (